Outcomes After Operative Reconstruction of Symptomatic Rib Nonunions
Conclusions:
Successful treatment of symptomatic rib nonunion is possible using rib plates in conjunction with bone grafting and has high union rates, satisfactory results, and limited complications.
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 - April 24, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Surgeons Consider Initial Nonoperative Treatment With Potential for Future Conversion to Reverse Arthroplasty a Reasonable Option for Older, Relatively Infirm, and Less-Active Patients
Conclusions:
These findings suggest that surgeons may consider initial nonoperative treatment with potential for future conversion to reverse arthroplasty an acceptable treatment option, particularly for older, less-active, more infirm individuals, and relatively less displaced fractures with little comminution. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - April 24, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
In Vivo Syndesmotic Motion After Rigid and Flexible Fixation Using 4-Dimensional Computerized Tomography
Introduction:
Maintaining reduction after syndesmotic injury is crucial to patient function; however, malreduction remains common. Flexible suture button fixation may allow more physiologic motion of the syndesmosis compared with rigid screw fixation. Conventional syndesmotic imaging fails to account for physiologic syndesmotic motion with ankle range of motion (ROM), providing misleading results. Four-dimensional computerized tomography (4DCT) can image joints through a dynamic ROM. Our purpose was to compare syndesmotic motion after rigid and flexible fixation using 4DCT.
Methods:
We analyzed 13 patients with ...
Source: Journal of Orthopaedic Trauma - April 24, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
What Are the Risk Factors for Infection After Operative Treatment of Peritalar Fracture Dislocations?
Objective:
To assess the risk factors associated with deep infection after operative treatment of peritalar fracture dislocations.
Design:
A retrospective study was performed to identify patients who had operative treatment of a peritalar fracture dislocation over an 11-year period (2008–2019).
Setting:
Level 1 trauma center.
Participants:
Patients were identified by review of all surgical billing that included open reduction of peritalar dislocation. Minimum follow-up for inclusion was 3 months or the outcome of interest. A total of 178 patients were identified, and 154 patients met inclusion cr...
Source: Journal of Orthopaedic Trauma - April 24, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Cost Reduction for Knee-Spanning External Fixation in the Staged Treatment of Tibial Plateau Fractures: A Practical Intervention
Conclusion:
An educational intervention created a reduction in the average total implant construction costs for temporary knee-spanning external fixation in the treatment of tibial plateau fractures. Surgical implant selection and cost variance remain an ideal area to improve value for patients and hospitals. Empowering surgeons with knowledge regarding implant prices is a critical part of working toward the cost reductions of external fixation constructs. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - April 24, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
In-Hospital Morbidity and Mortality With Delays in Femoral Shaft Fracture Fixation
Objectives:
To investigate trends in the timing of femur fracture fixation in trauma centers in the United States, identify predictors for delayed treatment, and analyze the association of timing of fixation with in-hospital morbidity and mortality using data from the National Trauma Data Bank.
Methods:
Patients with femoral shaft fractures treated from 2007 to 2015 were identified from the National Trauma Data Bank and grouped by timing of femur fixation: 48 hours after hospital presentation. The primary outcome measure was in-hospital postoperative mortality rate. Secondary outcomes included complication rates...
Source: Journal of Orthopaedic Trauma - April 24, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Effects of Spinal Anesthesia in Geriatric Hip Fracture: A Propensity-Matched Study
Conclusions:
No mortality difference exists between patients undergoing SA and those undergoing GA for hip fracture surgery. For patients undergoing hip fracture surgery with SA, there is lower 30-day complication profile and higher discharge to home rate compared with those undergoing GA. Both anesthesia modalities may be acceptable.
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 - April 24, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Outcomes After Operative Fixation of Vancouver B2 and B3 Type Periprosthetic Fractures
Conclusions:
In geriatric patients with Vancouver B2 and B3 type periprosthetic fractures with known loose stems, ORIF may offer a similarly safe method of treatment than revision arthroplasty.
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 - April 24, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Avoid the In-Out-In Posterosuperior Femoral Neck Screw: The Use of the Piriformis Fossa Radiographic Landmark
Conclusions:
Placing the posterosuperior screw of the inverted triangle caudal to the PF inferior margin on the AP view seems to avoid cortical breach during percutaneous screw fixation of femoral neck fractures. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - April 24, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Adaptation of the Centers for Disease Control Surgical Wound Classification System for Orthopaedic Trauma Surgery
Conclusions:
Both the CDC SWCS and orthopaedic-specific SWCS have excellent interobserver reliability. Incorporation of orthopaedic-specific language affects wound classification. There is low satisfaction with the current CDC SWCS and a desire exists for further development and validation of an orthopaedic-specific SWCS. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - April 24, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
Deltoid-Splitting Approach
No abstract available (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - March 27, 2022 Category: Orthopaedics Tags: Care Controversies Source Type: research
Considerations for selecting a surgical approach in Proximal Humerus Fractures
Clinical vignette:
A 47 year old male is injured in a single car motor vehicle collision when he falls asleep at the wheel. He is unable to lift his arm after the event and is brought by EMS to the hospital. A trauma workup reveals an isolated 3 part proximal humerus fracture. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - March 27, 2022 Category: Orthopaedics Tags: Care Controversies Source Type: research
Urinary Bladder Matrix Grafting: A Simple and Effective Alternative to Flap Coverage for Wounds in High-Risk Orthopaedic Trauma Patients
Summary:
Complex traumatic and/or infected wounds and their sequelae are a significant burden for high-volume trauma centers. Local or free flap coverage options are well described; however, they may be high risk in poor hosts with multiple comorbidities and active infections. In addition, flap coverage can result in delays in wound coverage depending on specialist availability. Porcine urinary bladder matrix grafting has been shown to be a simple definitive wound coverage option that can be performed without delay in multiple patient populations for wounds that would otherwise require flap coverage. The purpose of thi...
Source: Journal of Orthopaedic Trauma - March 27, 2022 Category: Orthopaedics Tags: Technical Trick Source Type: research
Subtrochanteric Femur Fractures Treated With Femoral Nail: The Effect of Cerclage Wire Augmentation on Complications, Fracture Union, and Reduction: A Systematic Review and Meta-Analysis of Comparative Studies
Conclusions:
There is no statistically significant advantage in using cerclage wire with femoral intramedullary nail when treating subtrochanteric femur fractures regarding risk of reoperation, nonunion, loss of fixation, and implant failure or time to union. An advantage favoring cerclage wire was seen for accuracy of fracture reduction. Cerclage wiring was used more often in cases associated with high-energy trauma. Given the relatively small number of events available to be modelled, a clinical benefit for cerclage wiring may still exist for certain fracture types.
Level of Evidence:
Therapeutic Level III. Se...
Source: Journal of Orthopaedic Trauma - March 27, 2022 Category: Orthopaedics Tags: Review Article Source Type: research
Outcomes of Anterior Decompression and Anterior Instrumentation in Thoracolumbar Burst Fractures—A Prospective Observational Study With Mid-Term Follow-up
Objective:
To analyze the functional, neurological, and radiological outcomes after anterior surgery in thoracolumbar burst fractures.
Design:
Prospective observational study.
Setting:
Tertiary care hospital.
Patients:
Thirty-six patients with thoracolumbar burst fractures (T11-L2).
Intervention:
Anterior decompression, anterior column reconstruction with mesh cage, and instrumented stabilization.
Outcome:
Functional (Visual Analog Score, Oswestry Disability Index, and Spinal Cord Independence Measure), neurological (ASIA Impairment Scale), and radiological (kyphosis, anterior vertebr...
Source: Journal of Orthopaedic Trauma - March 27, 2022 Category: Orthopaedics Tags: Original Article Source Type: research
