Anterior Pelvic Ring Fracture Pattern Predicts Subsequent Displacement in Lateral Compression Sacral Fractures
Objective:
To determine if anterior pelvic fracture pattern in lateral compression (LC) sacral fractures correlates with subsequent displacement on examination under anesthesia (EUA) or follow-up in both nonoperative and operative cases.
Design:
Retrospective cohort study.
Setting:
Level 1 trauma center.
Patients:
Two hundred twenty-seven skeletally mature patients with traumatic LC (OTA/AO 61B1.1, 61B2.1-2, and 61B3.1-2) pelvic ring injuries treated nonoperatively, with EUA, or with pelvic fixation were included.
Intervention:
The study intervention included retrospective review of patients...
Source: Journal of Orthopaedic Trauma - October 20, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Clean Shot: Bacterial Contamination After Positive Pressure Irrigation of Low-Velocity Gunshot Wounds
Conclusions:
Positive pressure irrigation with up to 500 cc normal saline did not significantly alter the quantity of bacterial growth within a simulated GSW cavity. The data suggest that bedside positive pressure irrigation may not be beneficial in the initial emergency department treatment of LV-GSWs. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - October 20, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Surgical Management of Delayed Brachial Plexopathy After Clavicle Nonunion
Summary
Brachial plexopathy after conservative therapy or surgical treatment of clavicular fractures is an uncommon, yet serious complication that is associated with compression of the brachial plexus or the subclavian artery and vein because they traverse through the thoracic outlet. Surgical decompression of the brachial plexus is the recommended treatment if this condition is to occur. Although there are multiple reports of these cases in the literature, at present, there are no clear guidelines for their management. We are highlighting an institutional management algorithm, illustrated by a small retrospective case...
Source: Journal of Orthopaedic Trauma - September 19, 2022 Category: Orthopaedics Tags: Technical Trick Source Type: research
Standardizing Screw Head Orthopaedic Trauma Implants. Is There an Interest? An OTA Member Survey
Conclusions:
Members of the orthopaedic community, as represented in the membership of the OTA, are interested in the adoption of universal standards in implant design. Establishing standard screw heads and drivers will optimize the delivery of operative care. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - September 19, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Can Laser-Assisted Indocyanine Green Angiography Be Used to Quantify Perfusion Changes During Staged Fixation of Pilon Fractures? A Pilot Study
Conclusions:
Quantitative improvement in soft tissue perfusion was identified through the course of staged surgical management in pilon fractures. LA-ICGA potentially may be used to determine appropriate timing for definitive surgical intervention based on the readiness of the soft tissue envelope. Ultimately, these findings may influence clinical outcomes with respect to choice of surgical approach, soft tissue management, surgical timing, and wound healing.
Level of Evidence:
Diagnostic 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 19, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Utility of Plasma Protein Biomarkers and Mid-infrared Spectroscopy for Diagnosing Fracture-related Infections: A Pilot Study
Objectives:
To compare a large panel of plasma protein inflammatory biomarkers and mid-infrared (MIR) spectral patterns in patients with confirmed fracture-related infections (FRIs) with those in controls without infection.
Design:
Prospective case–control study.
Setting:
Academic, Level 1 trauma center.
Patients:
Thirteen patients meeting confirmatory FRI criteria were matched to 13 controls based on age, time after surgery, and fracture region.
Intervention:
Plasma levels of 49 proteins were measured using enzyme-linked immunosorbent assay techniques. Fourier transform infrared spectrosc...
Source: Journal of Orthopaedic Trauma - September 19, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Urinary Bladder Matrix Grafting Versus Flap Coverage for Acute or Infected Wound Defects in Patients With Orthopaedic Trauma
Objectives:
Urinary bladder matrix (UBM) grafting of acute or infected wound defects has been reported to be successful in small case series. The purpose of this study was to compare the outcomes of UBM grafting with flap coverage.
Design:
This is a retrospective comparative study.
Setting:
Level-1 trauma center.
Patients:
Orthopaedic trauma patients with wound defects not amenable to primary closure or skin grafting.
Intervention:
Wound coverage with UBM grafting (n = 26) by orthopaedic trauma surgeons versus flap coverage (n = 26) by microvascular-trained plastic surgeons.
Main Outcome ...
Source: Journal of Orthopaedic Trauma - September 19, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Arterial Injury Portends Worse Soft Tissue Outcomes and Delayed Coverage in Open Tibial Fractures
Conclusions:
Arterial injuries in open tibia fractures with or without repair, have significantly higher rates of wound healing complications, FRI, delayed time to final closure, and need for amputation. Arterial injuries appear to effect wound healing in the affected angiosome.
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 - September 19, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Are Infection Rates Increased After Sterilization of the External Fixator During Staged Internal Fixation of High-Energy Tibial Plateau Fractures?
Objectives:
To compare infection rates after second-stage definitive surgery for high-energy tibial plateau fractures between groups of patients who had the external fixator prepped into the surgical field and those who did not.
Design:
Retrospective cohort study.
Setting:
Two academic Level 1 trauma centers.
Patients/Participants:
Two hundred forty-four patients met inclusion and exclusion criteria between the 2 institutions.
Intervention:
Prepping of the external fixator into the surgical field during second-stage definitive open reduction and internal fixation. 162 patients were in the pr...
Source: Journal of Orthopaedic Trauma - September 19, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Using the Greater Tuberosity as a Reference for Placement of Proximal Humerus Plates Leads to a High Rate of Calcar Screw Malposition
Conclusions:
Placement of PHLPs based on distance from the GT results in unacceptable position of the calcar screw 28% of the time and up to 36% in fixed-angle plates. This could be further compounded if the GT is malreduced. Current technique guide recommendations result in an unacceptably high rate of calcar screw malposition. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - September 19, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Effect of Body Mass Index on Femur Fracture Location: A Retrospective Database Study
Objectives:
Use a large database design and multivariable analyses to assess the associations between body mass index (BMI) and femur fracture patterns after controlling for other risk factors.
Design:
Retrospective cohort study.
Setting:
National insurance claims database of patient records from 2010 to 2018.
Patients/Participants:
Patients with femur fracture diagnoses were identified. Patients with multiple fractures within 1 week (polytrauma patients), patients without a BMI diagnosis code within 6 months of fracture, and patients with multiple BMI diagnosis codes (implying a substantial change...
Source: Journal of Orthopaedic Trauma - September 19, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Axial and Rotational Malreduction (Golf Club Deformity) in Distal Femur Fractures
Objectives:
To describe malreduction of supracondylar distal femur fractures stabilized with lateral femoral locking plates and determine whether a mismatch in axial lateral distal femur anatomy and lateral distal femoral plate design contributes to supracondylar distal femoral fracture malreduction.
Materials and Methods:
OTA/AO 33A were simulated in 7 cadaver femurs and fixed with a lateral distal locking femoral plate placed flush to the lateral femoral condyle (group 1). In group 2, the anterior flange of the plate was externally rotated 10 degrees in relation to the lateral condyle. A motion capture system ...
Source: Journal of Orthopaedic Trauma - September 19, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
The Effect of Surgeon Experience on Short- to Medium-Term Complication Rate Following Operative Fixation of Acetabular Fractures
Conclusion:
Surgeon experience had a significant association with reoperation rate, quality of reduction, and readmission rate after open reduction internal fixation of acetabular fractures. Other patient outcomes were not found to be associated with surgeon experience.
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 19, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Biomechanical Comparison of 4 Transsacral Fixation Constructs in a Type 61C, Zone II Pelvic Fracture Model
Conclusions:
The novel interdigitating washer design may be superior to using a screw construct alone to achieve rigid, locked posterior ring fixation in a synthetic pelvis model with a Type C pelvic ring disruption. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - September 19, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Defining Sacral Dysmorphism: What Size Corridor Precludes Transsacral Screw Placement
Objective:
To determine what size S1-transsacral (TS) corridor is amenable to TS screw placement, as this is commonly used to identify sacral dysmorphism, and to determine if gender, ethnicity, or screw breach is associated with narrow corridors.
Design:
Retrospective review.
Setting:
Urban level-1 trauma center.
Patients:
Two hundred ninety patients with pelvic ring injuries and preoperative computed tomography (CT) scans.
Intervention:
Percutaneous posterior pelvic ring fixation.
Main Outcome Measurements:
The width of the S1-TS corridor was measured on the axial (inlet) and coronal...
Source: Journal of Orthopaedic Trauma - September 19, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
