Marijuana Use Results in Increased Time to Union in Surgically Treated Pediatric Fracture Patients
Objective:
To identify the impact of marijuana use on fracture healing in surgically treated pediatric patients.
Design:
Retrospective review.
Setting:
Level 1 trauma center, single-center study.
Patients/Participants:
Surgically treated pediatric patients 10–18 years with extremity fractures from 2010 to 2020. Conservatively treated patients and patients with nonunions were excluded from the study. Three hundred thirty-nine patients were included in the study, 21 of which were confirmed marijuana users by toxicology screening.
Intervention:
Surgical treatment of extremity fractures by any...
Source: Journal of Orthopaedic Trauma - February 18, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Current Role of Reverse Total Shoulder Arthroplasty for Fractures of the Proximal Humerus
Summary:
Level of Evidence:
Therapeutic Level V. See Instructions for Authors for a complete description of levels of evidence.
Treatment of proximal humeral fractures can be challenging. The surgeon's options include nonoperative treatment, open reduction internal fixation, humeral hemiarthroplasty, or reverse shoulder arthroplasty. Reverse shoulder arthroplasty adds an option that can lead to predictable pain relief and good functional outcomes in treating challenging fractures in elderly patients and managing fracture complications and sequelae. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - February 18, 2022 Category: Orthopaedics Tags: Review Article Source Type: research
Periprosthetic Supracondylar Femoral Fractures Above a Total Knee Replacement: An Updated Compatibility and Technique Guide for Fixation With a Retrograde Intramedullary Nail
Conclusions:
This update further empowers surgeons to use all the tools available when treating periprosthetic femur fractures and allows efficient identification of the compatibility of different TKR designs with various intramedullary nails.
Level of Evidence:
Therapeutic Level V. See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - February 18, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Important Factors for Retrograde Nailing Through Total Knee Arthroplasty: A Cadaveric Study
Objectives:
Evaluate how total knee arthroplasty (TKA) implant design, femoral component size, and preoperative knee range of motion affect retrograde femoral nailing.
Methods:
Cadaveric specimens were prepared for TKA with a single radius (SR) or medial pivot (MP) design and tested with cruciate retaining (CR), cruciate substituting (CS), and posterior stabilizing (PS) 9-mm liners. Knee extension identified the minimum flexion required to pass an opening reamer without impinging on TKA components. The angle between the reamer path and the femoral shaft was calculated from lateral fluoroscopic images.
Results...
Source: Journal of Orthopaedic Trauma - February 18, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Tibial Shaft and Pilon Fractures With Associated Syndesmotic Injury: A Matched Cohort Assessment
Conclusions:
Although syndesmotic injuries with tibial shaft or pilon fractures are rare, they are a marker of a potentially limb-threatening injury. Limbs with this combined injury are at increased risk of deep infection, unplanned reoperation, and amputation. The presence of a segmental fibula fracture should raise clinical suspicion to evaluate for syndesmotic injury.
Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - February 18, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
High-Energy Transsyndesmotic Ankle Fracture Dislocation—Injury Characteristics, Radiographic Outcomes, and Factors Affecting the Rate of Posttraumatic Arthritis in Logsplitter Injuries
Conclusions:
The logsplitter injury is one with devastating outcomes and high rates of arthritis; it should be considered separately from conventional ankle fractures. The role of deltoid repair remains unclear. Further study of this injury pattern is required.
Level of Evidence:
Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - February 18, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Efficacy and Safety of Locally Injected Tranexamic Acid in Hip Fracture Patients: A Retrospective Review
Conclusion:
Locally injected TXA significantly reduced the need for postoperative transfusion in the surgical treatment of fragility hip fractures. In addition, there was no increased risk of complications in those receiving TXA versus those who did not. Locally injected TXA seems to be both a safe and effective way to reduce postoperative blood transfusions in patients with fragility hip fractures.
Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - February 18, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Fascia Iliaca Blocks Performed in the Emergency Department Decrease Opioid Consumption and Length of Stay in Patients with Hip Fracture
Conclusions:
Undergoing FI block in the emergency department was associated with decreased opioid consumption, decreased length of stay, and decreased hospital readmission within 30 days of hip fracture.
Level of Evidence:
Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - February 18, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Pediatric and Adolescent Fractures of the Acetabulum Treated With ORIF: What Are Their Functional Outcomes?
Conclusion:
In this small cohort, 86% (18/21) of these patients had a favorable functional outcome with the exception of the SMFA Functional Index that was significantly less than population norms. Although long-term follow-up is needed, we advocate for operative management of pediatric and adolescent acetabulum fractures when adult displacement and instability criteria are present.
Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - February 18, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Outcome After Open Reduction Internal Fixation of Acetabular Fractures in the Elderly
Objectives:
(1) Assess outcomes of acetabular open reduction and internal fixation (ORIF) in the elderly, (2) investigate factors influencing outcome, and (3) compare outcomes after low-energy and high-energy mechanisms of injury.
Design:
Retrospective case series.
Setting:
Level 1 trauma center.
Patients:
Seventy-eight patients older than 60 years (age: 70.1 ± 7.4; 73.1% males).
Intervention:
ORIF for acetabular fractures.
Main Outcome Measurements:
Complications, reoperation rates, Oxford Hip Score (OHS), and joint preservation and development of symptomatic osteoarthritis. Cases w...
Source: Journal of Orthopaedic Trauma - February 18, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
The Impact of Surgical Approaches for Isolated Acetabulum Fracture on Sexual Functions: A Prospective Study
Conclusions:
As a result of our study, it was observed that the posterior approach is more advantageous than anterior approaches in preserving the sexual functions of male patients in acetabular fracture surgery. However, the surgical approach did not affect the sexual functions of female patients.
Level of Evidence:
Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - February 18, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Quantifying Urinary and Sexual Dysfunction After Pelvic Fracture
Objectives:
To quantify the severity of urinary and sexual dysfunction and to evaluate the relationship between urinary and sexual dysfunction, injury, and treatment factors in patients with pelvic fracture.
Design:
Prospective cohort study.
Setting:
Level 1 trauma center.
Patients/Participants:
One hundred thirteen patients with surgically treated pelvic fracture (65.5% OTA/AO 61B fractures; 7 open fractures; 74 men).
Interventions:
Surgical pelvic stabilization.
Main Outcome Measures:
The 36-Item Short Form Health Survey and International Consultation Incontinence Questionnaire resp...
Source: Journal of Orthopaedic Trauma - February 18, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Risk of Surgical Site Infections in OTA/AO Type C Tibial Plateau and Tibial Plafond Fractures: A Systematic Review and Meta-Analysis
Conclusions:
Patients with these specific fractures develop infections at a notable frequency. The rates of deep infections were approximately 6% in tibial plateau fractures and 9% in tibial plafond fractures. These results may be useful as a reference for patient counseling and other future studies aimed at minimizing postoperative infection for these injuries.
Level of Evidence:
Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - February 18, 2022 Category: Orthopaedics Tags: Review Article Source Type: research
Erratum
No abstract available (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - January 29, 2022 Category: Orthopaedics Tags: Erratum Source Type: research
Treatment of Recalcitrant Femoral Shaft Nonunion With Medial Femoral Condyle Pedicled Autograft: Technical Trick
Summary:
Nonunited fractures of the femoral shaft and distal femur are usually successfully addressed with stabilization with or without autogenous bone grafting. For the small subset of these problems that prove recalcitrant to front-line treatment, a pedicled medial femoral condyle (MFC) bone flap can provide a source of vascularized autograft with minimal donor site morbidity. The MFC has gained recent widespread adoption as a free vascularized bone transfer, and here, we present a surgical technique and retrospective analysis of patients treated with a pedicled MFC technique. This serves as a useful treatment optio...
Source: Journal of Orthopaedic Trauma - January 29, 2022 Category: Orthopaedics Tags: Technical Trick Source Type: research
