Commentary on: “Acute Hindfoot Nailing for Ankle Fractures: A Systematic Review of Indications and Outcomes”
No abstract available (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - October 21, 2021 Category: Orthopaedics Tags: Invited Commentary Source Type: research
Acute Hindfoot Nailing for Ankle Fractures: A Systematic Review of Indications and Outcomes
Conclusions:
Hindfoot nailing of acute ankle and pilon fractures in elderly patients and patients with diabetes is associated with complication rates comparable with other methods of fixation. Issues with elimination of subtalar joint motion and implant complications secondary to poor implant fixation persist. The literature to date has composed of primarily Level IV studies with considerable bias. Further research is necessary to clarify the role of hindfoot nailing of acute ankle and pilon fractures.
Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of e...
Source: Journal of Orthopaedic Trauma - October 21, 2021 Category: Orthopaedics Tags: Review Article Source Type: research
Very Distal Femoral Periprosthetic Fractures: Replacement Versus Fixation: A Systematic Review
Conclusions:
vDFPFs in the elderly treated with DFR underwent fewer reoperations relative to DFLP (0%–45% vs. 0%–77%, respectively). Time to weight-bearing was observably shorter in DFR studies relative to DFLP studies. Functional outcomes and postoperative range of motion indicated a trend for DFLP knees to outperform DFR knees. Future research should include prospective studies and cost-effectiveness evaluations to better understand the utility of DFR for these fractures.
Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. (Source: Journa...
Source: Journal of Orthopaedic Trauma - October 21, 2021 Category: Orthopaedics Tags: Review Article Source Type: research
In Reply to Commentary on: “Definitive Fixation Outcomes of Open Tibial Shaft Fractures: Systematic Review and Network Meta-analysis”
No abstract available (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - October 21, 2021 Category: Orthopaedics Tags: In Reply Source Type: research
Commentary on: “Definitive Fixation Outcomes of Open Tibial Shaft Fractures: Systematic Review and Network Meta-analysis”
No abstract available (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - October 21, 2021 Category: Orthopaedics Tags: Invited Commentary Source Type: research
Definitive Fixation Outcomes of Open Tibial Shaft Fractures: Systematic Review and Network Meta-analysis
Conclusions:
Intramedullary nailing reduces the risk of unplanned reoperation by a third compared with EF, with a slightly larger reduction in type III open fractures. Future trials should focus on major complication rates and health-related quality of life in high-grade tibial shaft fractures.
Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - October 21, 2021 Category: Orthopaedics Tags: Review Article Source Type: research
Cling Wrap Technique: An Inexpensive and Simple Way to Seal Negative Pressure Wound Therapy on External Fixation Devices
Summary:
Negative pressure therapy is often applied to treat limb traumas with or without bone exposure. However, sealing a negative pressure dressing in the presence of an external fixation device may be complicated and time consuming. In this technique, we attempted to maintain vacuum conditions by preventing air leakage around the screws using plastic drape and cling wrap as the final layer over the external fixation device. To prevent rupturing of the wrap, the prominences of the pins and rods were covered using cotton wool roll. This novel solution is also effective for complex and extended wounds, with no need fo...
Source: Journal of Orthopaedic Trauma - September 23, 2021 Category: Orthopaedics Tags: Technical Trick Source Type: research
A Machine Learning Algorithm to Identify Patients at Risk of Unplanned Subsequent Surgery After Intramedullary Nailing for Tibial Shaft Fractures
Conclusions:
An ML algorithm was developed to predict the probability of subsequent surgery after IMN for TSFs. This ML algorithm may assist surgeons to inform patients about the probability of subsequent surgery and might help to identify patients who need a different perioperative plan or a more intensive approach.
Level of Evidence:
Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - September 23, 2021 Category: Orthopaedics Tags: Original Article Source Type: research
Incidence of Surgical Site Infections and Acute Kidney Injuries After Topical Antibiotic Powder Application in Orthopaedic Trauma Surgery
Conclusion:
There was no detectable difference, with wide confidence intervals, in SSI and AKI between the topical antibiotic and control groups. Further studies need to be conducted to evaluate the relationship between topical antibiotics and clinical outcomes in orthopaedic trauma surgery.
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 - September 23, 2021 Category: Orthopaedics Tags: Original Article Source Type: research
Complications and Soft-Tissue Coverage After Complete Articular, Open Tibial Plafond Fractures
Objectives:
To evaluate the incidence of nonunion and wound complications after open, complete articular pilon fractures. Second, to study the effect that both timing of fixation and timing of flap coverage have on deep infection rates.
Design:
Retrospective case series.
Setting:
Three Academic Level 1 Trauma Centers.
Patients:
One hundred sixty-one patients with open OTA/AO type 43C distal tibia fractures treated with open reduction internal fixation (ORIF) between 2002 and 2018. The mean (SD) age was 46 (14) years, 70% male, with median (interquartile range) follow-up of 2.1 (1.3–5.0) years (mi...
Source: Journal of Orthopaedic Trauma - September 23, 2021 Category: Orthopaedics Tags: Original Article Source Type: research
Gunshot Fractures of the Forearm: A Multicenter Evaluation
Conclusions:
Open fractures of the forearm from GSWs are serious injuries that carry high rates of nonunion and infection. Fractures with significant bone defects are at an increased risk of nonunion and should be treated with stable fixation and proper soft-tissue handling. Ulna fractures are at a particularly high risk for deep infection and septic nonunion and should be treated aggressively. Forearm fractures from GSWs should be followed until union to identify long-term complications.
Level of Evidence:
Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence. (Sourc...
Source: Journal of Orthopaedic Trauma - September 23, 2021 Category: Orthopaedics Tags: Original Article Source Type: research
Outpatient Surgical Fixation of Proximal Humerus Fractures Can Be Performed Without Increased Rates of Short-Term Complications or Readmissions
Objective:
To delineate differences in short-term complications between outpatient versus inpatient open reduction and internal fixation (ORIF) of proximal humerus fractures.
Design:
Retrospective database review.
Setting:
Hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program database.
Patients:
Patients in the National Surgical Quality Improvement Program database with proximal humerus fractures from 2005 to 2017.
Intervention:
Proximal humerus fracture ORIF.
Main Outcome Measurements:
Thirty-day readmission, reoperation, thromboemb...
Source: Journal of Orthopaedic Trauma - September 23, 2021 Category: Orthopaedics Tags: Original Article Source Type: research
Predicting the Behavior of Humeral Shaft Fractures: An Independent Validation Study of the Radiographic Union Score for HUmeral Fractures and Value of Assessing Fracture Mobility
Conclusion:
The RUSHU score and clinical assessment of fracture mobility are effective and valid tools in identifying patients at risk of developing nonunion of humeral shaft fractures and can enhance early decision making in fracture management.
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 - September 23, 2021 Category: Orthopaedics Tags: Original Article Source Type: research
Does Provisional Minifragment Fixation Prevent Compression With Dynamic Compression Plating? A Biomechanical Analysis
Conclusion:
Provisional minifragment fixation does not have any adverse effect on the forces generated during compression plating. These findings suggest that provisional minifragment plates do not need to be removed before definitive fixation. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - September 23, 2021 Category: Orthopaedics Tags: Original Article Source Type: research
Monitored Anesthesia Care and Soft-Tissue Infiltration With Local Anesthesia: An Anesthetic Option for High-Risk Patients With Hip Fractures
Conclusions:
This feasibility study demonstrates safety for the MAC-STILA protocol with comparison to spinal and general anesthesia. The MAC-STILA protocol is a viable option for treatment of OTA/AO 13.A1-3 intertrochanteric fractures with a short cephalomedullary nail and may be the preferred method for patients with severe medical comorbidities or relative contraindications to general and/or spinal anesthesia.
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 - September 23, 2021 Category: Orthopaedics Tags: Original Article Source Type: research
