Debate Update: Surgery After 48 Hours of Admission for Geriatric Hip Fracture Patients Is Associated With Increase in Mortality and Complication Rate: A Study of 27,058 Patients Using the National Trauma Data Bank
Objective:
To determine the association between surgical timing and short-term morbidity and mortality in elderly patients who sustain hip fractures using a national trauma database (OTA/AO 31A1-3, 31B1-3).
Design:
Retrospective cohort study.
Setting:
Level I–IV trauma centers in the United States.
Patients/Participants:
All patients ≥65 years of age who underwent surgery for hip fracture from 2011 to 2013.
Intervention:
Time to surgery of 48 hours from admission.
Main outcome measurements:
Primary outcome was mortality by hospital discharge. Secondary outcomes were complications ...
Source: Journal of Orthopaedic Trauma - September 23, 2021 Category: Orthopaedics Tags: Original Article Source Type: research
Femoral Neck Shaft Angle and Management of Proximal Femur Fractures: Is the Contralateral Femur a Reliable Template?
Conclusions:
There is no significant variability between bilateral femora in males and females. Use of this measurement method and contralateral NSA for proximal femur fracture planning is supported. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - September 23, 2021 Category: Orthopaedics Tags: Original Article Source Type: research
Gluteus Minimus Debridement During Acetabular Fracture Surgery Does Not Prevent Heterotopic Ossification—A Comparative Study
Conclusion:
GMM debridement was not associated with a decreased incidence of HO after acetabular fracture surgery. American Society of Anesthesiologists class is a novel risk factor associated with severe HO formation.
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
Smith–Petersen Versus Watson–Jones Approach Does Not Affect Quality of Open Reduction of Femoral Neck Fracture
Objective:
To compare immediate quality of open reduction of femoral neck fractures by alternative surgical approaches.
Design:
Retrospective cohort study.
Setting:
Twelve Level 1 North American trauma centers.
Patients:
Eighty adults 18–65 years of age with isolated, displaced, OTA/AO type 31-B2 or -B3 femoral neck fractures treated with internal fixation.
Intervention:
Thirty-two modified Smith–Petersen anterior approaches versus 48 Watson–Jones anterolateral approaches for open reduction performed by fellowship-trained orthopaedic trauma surgeons.
Main outcome:
Reduction qual...
Source: Journal of Orthopaedic Trauma - September 23, 2021 Category: Orthopaedics Tags: Original Article Source Type: research
Combined Orthopaedic and Vascular Injuries With Ischemia: A Multicenter Analysis
Conclusions:
In this series of combined orthopaedic and vascular injuries, we found a high rate of acute and late amputations. It is possible that other protocols, such as shunting and stabilizing the osseous injury, before vascular repair may benefit limb salvage, although this needs more study.
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
A Systematic Review and Analysis of the Quality of Randomized Controlled Trials Comparing Infrapatellar and Suprapatellar Approach for Nailing of Tibial Fractures
Conclusions:
RCTs are historically regarded as the gold standard for establishing principles of evidence-based medicine. However, our evaluation of the evidence shows that though they followed the Oxford LOE, RCTs were considered poor by the other 2 methods. The majority of studies that were included in our review were considered poor using the Modified Coleman and CONSORT systems. Half the articles supported suprapatellar tibial nailing over the infrapatellar approach, whereas other half demonstrated equivocal results between the 2 techniques. This study highlights the importance of evaluating studies judiciously rega...
Source: Journal of Orthopaedic Trauma - September 23, 2021 Category: Orthopaedics Tags: Review Article Source Type: research
Introduction—JOT Care Controversies
No abstract available (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - September 23, 2021 Category: Orthopaedics Tags: Introduction Source Type: research
In response
No abstract available (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - August 26, 2021 Category: Orthopaedics Tags: Letters to the Editor Source Type: research
Letter to the Editor on “Does the Helical Blade Lead to Higher Rates of Fixation Failure as Compared to Lag Screw in the Cephalomedullary Nailing Treatment of Hip Fractures? A Systematic Review and Meta-analysis”
No abstract available (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - August 26, 2021 Category: Orthopaedics Tags: Letters to the Editor Source Type: research
Technique for Removal of Broken InterTAN Integrated Cephalomedullary Screw
We present a case of a broken nail as well as a broken integrated screw, and describe a technique for successful implant removal. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - August 26, 2021 Category: Orthopaedics Tags: Technical Trick Source Type: research
An Economic Analysis of Direct Costs of Distal Radius Fixation and the Implications of a Disposable Distal Radius Kit
Conclusions:
Eighty-three percent of the surgically treated distal radius fractures were treated with VP fixation alone. A disposable kit could help limit cost variance per case by roughly 22%, as only ancillary fixation varies these costs. Closed fractures and extra-articular fractures in older patients or female patients are more amenable to VP fixation alone.
Level of Evidence:
Economic Level III. See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - August 26, 2021 Category: Orthopaedics Tags: Original Article Source Type: research
Splint Padding Thickness: Temperature Effects and X-ray Visualization
Conclusions:
Padding thickness can be consistently determined on X-ray. We determined that at least 2 layers of Webril significantly decrease temperature change at the level of the skin caused by plaster curing. Two layers of Webril can be identified on X-ray by measuring at least 1 mm of padding. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - August 26, 2021 Category: Orthopaedics Tags: Original Article Source Type: research
The Anatomic Relevance of the Iliopectineal Fascia for Acetabular Surgery
Conclusions:
The anatomic variants of the attachment of the IPF to the pelvic brim and its variants in relation to the external iliac vessels must be accounted for when performing acetabular surgery to prevent vascular injury and attain adequate exposure. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - August 26, 2021 Category: Orthopaedics Tags: Original Article Source Type: research
Reconstruction of Septic Tibial Bone Defects With the Masquelet Technique and External Ring Fixation—A Low Healing Rate and High Complication and Revision Rates
Conclusions:
The combination of the Masquelet technique and external fixation yielded a low healing rate and was associated with a significant number of cases of treatment failure.
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 - August 26, 2021 Category: Orthopaedics Tags: Original Article Source Type: research
Defining the Mean Angle of Diaphyseal Long Bone Nonunions—Does Shear Prevail?
Conclusions:
This study demonstrates the mean angle of diaphyseal nonunions from long bones of the lower limb approaches 45 degrees. This is noted in all types of fractures and is irrespective of anatomic location or sex. This confirms the hypothesis that shear is likely to play a role in the development of a nonunion. This study provides further evidence that nonunions occur primarily because of mechanical instability.
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 - August 26, 2021 Category: Orthopaedics Tags: Original Article Source Type: research
