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Injury 2019 Feb 8. Epub 2019 Feb 8.

Department of Orthopedic Oncology, Azienda Ospedaliera Universitaria Careggi, Largo P. Palagi 1, 50134 Firenze, Italy. Electronic address:

Introduction: Displaced intra-articular calcaneal fractures (DIACF) represent a challenging and controversial issue in traumatology. Conservative treatment has been recommended to avoid surgical problems and complications. The final result, however, is often a painful malunioun of the calcaneus with peroneal impingement. Read More

J Neurosci Rural Pract 2019 Jan-Mar;10(1):151-153

Department of Neurological Surgery, University College Hospital, Ibadan, Nigeria.

Chance fracture occurs from flexion-distraction injury in motor vehicle road crash usually when the patient is on a seat belt. It is often associated with intra-abdominal injuries. We managed a 22-year old female unbelted rear seat passenger of a bus which was involved in a lone accident. Read More

J Orthop Case Rep 2018 Sep-Oct;8(5):54-56

Department of Spine, Aster MIMS Hospital, Govindapurasam, Calicut, Kerala, India.

Introduction: Pathological fractures resulting from trivial trauma may be overlooked, especially, when it is after a road traffic accident.

Case Report: A 56-year-old male was operated elsewhere for burst fracture L3 vertebra following a trivial road traffic accident. Due to the persistence of symptoms, he was reevaluated. Read More

Ned Tijdschr Geneeskd 2019 Jan 29;163. Epub 2019 Jan 29.

LUMC, afd. Traumachirurgie, Leiden.

There is an ongoing discussion about optimal timing of hip fracture surgery and much has been published about this subject. There is no literature-based consensus regarding the timeframe in which a hip fracture patient should be operated on; nonetheless, the National Health Care Institute in the Netherlands has been using 'time to operation' as a quality indicator since 2017. Analysis of the data from the Health and Youth Care Inspectorate on the quality indicator 'Percentage of patients operated on within one calendar day' showed that in Dutch hospitals 93% of the ASA grade 1-2 patients and 86% of the ASA grade > 2 patients were operated on within one calendar day. Read More

J Biol Regul Homeost Agents 2018 Nov-Dec;32(6 Suppl. 1):71-76

Department of Oncologic and Degenerative Spine Surgery, IRCCS Istituto Ortopedico Rizzoli - Bologna, Italy.

The use of pedicle screws in low bone quality patients implicates risks of secondary implant loosening for grip lack. In fact, the result is a reduced mechanical stability at bone-screw interface and consequently an increased chance of pullout and hardware failure. Augmentation techniques have been described for many years and fenestrated screws that allow cement injection is one of them. Read More

J Orthop Trauma 2019 Jan 8. Epub 2019 Jan 8.

Cincinnati Children's Hospital Medical Center.

Objectives: The purpose of this study was to determine the correlation of Salter-Harris II fracture patterns with premature physeal closure (PPC) and resultant angular deformity of the ankle.

Design: Retrospective review SETTING:: Cincinnati Children's Hospital Medical Center (Outpatient level of care)Patients/Participants: We searched the digital ankle radiographs taken at our institution from 2001 thru 2010, identifying all skeletally immature patients with confirmed ankle fractures.

Intervention: Fracture patterns were sub-classified according to the Dias-Tachdjian classification system. Read More

Chin J Traumatol 2018 Dec 19;21(6):329-332. Epub 2018 Oct 19.

University of Alabama at Birmingham, 1313 13th Street South, Suite 226, Birmingham, AL, 35205, United States.

Purpose: Periprosthetic fracture (PPF) is a serious complication that occurs in 0.3%-2.5% of all total knee arthroplasties used to treat end-stage arthritis. Read More

Injury 2018 Dec 3;49 Suppl 4:S48-S57. Epub 2018 Dec 3.

Hip Department - Orthopedic and Trauma v, I.R.C.C.S. Policlinico San Donato, 20097, San Donato Mil.se, Milan, Italy; Division of Orthopaedic Surgery, McMaster University, Canada.

An infected non-union is a major and potentially devastating complication following bone fractures. It is often debilitating for the patients, physically and psychologically, because of its long healing period and emotional toll on patient and caregivers. Different surgical procedures (in one or two stages) are described in literature for its treatment. Read More

Musculoskelet Surg 2018 Dec 4. Epub 2018 Dec 4.

Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, Pathumwan, Bangkok, 10330, Thailand.

Purpose: Displaced pediatric supracondylar humerus fracture (SCHF) requires a reduction and instrumentation. The trend is to send the cases to a fellowship-trained pediatric orthopedist. This study reviewed the outcomes and complications of SCHF surgically managed by orthopedic surgeons with different backgrounds of subspecialty training. Read More

J Mech Behav Biomed Mater 2019 Feb 12;90:587-590. Epub 2018 Nov 12.

Post-graduate Program in Dentistry, Dental School, University of Passo Fundo, Campus I, BR285, Passo Fundo, RS 99052-900, Brazil. Electronic address:

Objective: To evaluate the edge chip resistance (R) of two CAD/CAM monolithic ceramics (GC- IPS e.max CAD and YZ- Zenostar Zr Translucent) bonded to a dentine analogue substrate (G10- NEMA G10).

Methods: Plate-shaped specimens were prepared from GC and YZ ceramics and were either bonded (B) to G10 or attached (NB) to a universal testing machine for edge chipping test. Read More

Korean J Neurotrauma 2018 Oct 31;14(2):169-172. Epub 2018 Oct 31.

Department of Neurosurgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.

Pediatric seat-belt fracture is a rare condition, and its management has not been well defined. The authors report a case of pediatric Chance fracture that was managed conservatively and that demonstrated rapid bone healing. A 7-year-old boy presented with back pain after a motor vehicle accident. Read More

Chin Med J (Engl) 2018 Nov;131(21):2589-2598

Department of Orthopaedic, Graduate School of Peking Union Medical College, China-Japan Friendship Hospital Institute of Clinical Medicine, Beijing 100029, China.

Objective: To propose a new definition of the pericollapse stage of osteonecrosis of the femoral head (ONFH) and review its significance in disease diagnosis and treatment selection.

Data Sources: A search for eligible studies was conducted in three electronic databases including PubMed, Cochrane Library, and Embase up to August 10, 2018, using the following keywords: "osteonecrosis", "prognosis", and "treatment".

Study Selection: Investigations appraising the clinical signs, symptoms, and imaging manifestations in different stages of ONFH were included. Read More

J Back Musculoskelet Rehabil 2018 Oct 10. Epub 2018 Oct 10.

University of Novi Sad, Faculty of Medicine Novi Sad, Serbia.

Objective: Vertebral fractures are the most common osteoporotic fractures occurring due to low bone mineral density, as well as other risk factors. The aim of the paper is to investigate risk factors for vertebral osteoporotic fracture occurrence in postmenopausal women.

Methods: Retrospective analysis of data pertaining to 651 postmenopausal women obtained from the National Osteoporosis Registry of Serbia was conducted. Read More

Asian J Neurosurg 2018 Jul-Sep;13(3):906-909

Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

Cervical spine chance fracture (flexion-distraction) is a rare type of fracture, and the surgical management remains a dilemma to the neurosurgeons as there is a paucity of evidence accordingly. We herein report a traumatic chance fracture of C7 fractures and its surgical management. A 33-year-old male was transferred to our center after being hit as pedestrian and was diagnosed to have a chance fracture of C7 and bilateral C7 root injury. Read More

Arch Osteoporos 2018 Sep 28;13(1):103. Epub 2018 Sep 28.

Faculty of Medicine, University of Toronto, Toronto, Canada.

Overtreatment of osteoporosis increases costs and puts patients at unnecessary risk of experiencing adverse drug events. In the Patient Activation After DXA Receipt Notification (PAADRN) trial, we found that 8% of individuals with no indication for therapy were recommended a new osteoporosis medication or continuation of an existing medication.

Purpose: There is a robust body of literature addressing undertreatment in osteoporosis, but limited data addressing overtreatment. Read More

JBJS Essent Surg Tech 2018 Jun 23;8(2):e16. Epub 2018 May 23.

Department of Orthopaedic Surgery, Akershus University Hospital, Lørenskog, Akershus, Norway.

Background: The treatment of completely displaced midshaft clavicle fractures is still controversial, but surgical treatment provides a shorter recovery period and higher union rates than nonoperative treatment with a sling. Even though the literature does not clearly support surgery for these fractures, surgery is becoming more frequent. Elastic stable intramedullary nailing (ESIN) with a titanium nail is a well-documented mini-invasive procedure with functional outcomes comparable with those of plate fixation after 1 year but a high rate of implant removal of up to 80%. Read More

Eur J Trauma Emerg Surg 2018 Aug 24. Epub 2018 Aug 24.

Department of Neurosurgery, Western General Hospital, University of Edinburgh, Crewe Road South, Edinburgh, EH4 2XU, UK.

Purpose: Paediatric cervical spine injuries are fortunately a rare entity. However, they do have the potential for devastating neurological sequelae with lifelong impact on the patient and their family. Thus, management ought to be exceptional from the initial evaluation at the scene of the injury, through to definitive management and rehabilitation. Read More

Eur J Trauma Emerg Surg 2018 Aug 23. Epub 2018 Aug 23.

Orthopedic Department, Rabin Medical Center, Beilinson Hospital, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, 39 Jabotinsky St., Petah Tikva, 49100, Tel Aviv, Israel.

Purpose: To define risk factors for rehospitalization following fragility hip fractures and to create a predictive model.

Methods: A retrospective cohort study of patients 65 years and older, who were treated operatively following fragility hip fractures between 01.2011 and 06. Read More

J Child Orthop 2018 Aug;12(4):398-405

Department of Orthopaedic Surgery, Peterborough City Hospital, Bretton Gate, Peterborough, UK.

Purpose: To determine if the detection of musculoskeletal pathology in children with a limp or acute limb disuse can be optimized by screening with blood tests for raised inflammatory markers, followed by MRI.

Methods: This was a prospective observational study. Entry criteria were children (0 to 16 years of age) presenting to our emergency department with a non-traumatic limp or pseudoparalysis of a limb, and no abnormality on plain radiographs. Read More

JBJS Case Connect 2018 Jul-Sep;8(3):e64

Department of Orthopaedic Surgery, Division of Orthopaedic Trauma, Rutgers New Jersey Medical School, Newark, New Jersey.

Case: We present the case of a 10-year-old girl who sustained a transepiphyseal femoral neck fracture with posterior dislocation of the femoral epiphysis and an associated transverse posterior wall acetabular fracture, leading to complete separation of the capital femoral epiphysis. She underwent urgent operative intervention; she was followed for 13 years and achieved an excellent outcome.

Conclusion: Pediatric hip fracture-dislocations are complex injuries that should be managed by a competent pelvic reconstructive surgeon in a well-resuscitated patient. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2018 09;32(9):1157-1161

Department of Orthopedics, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Guangdong, 510120, P.R.China.

Objective: To evaluate the effectiveness of cemented polyethylene liner technique in hip revision.

Methods: Based on inclusion criteria, the clinical data of 26 patients who were undergone hip revision between January 2011 and December 2013, were retrospectively reviewed. Among them, 14 cases were treated with isolated liner exchange (group A) and 12 cases were treated with cemented polyethylene liner technique (group B). Read More

Ann Vasc Surg 2019 Feb 4;55:260-271. Epub 2018 Aug 4.

Department of Vascular Surgery, AXEPA University Hospital, Aristotle University of Thessaloniki, Greece.

Background: Pulseless hand after a supracondylar humeral fracture (SHF) in children is well known in the bibliography. Although things are clearer in the management of a "pale pulseless hand," controversy still exists about the "pink pulseless hand" (PPH).

Methods: We reviewed the literature from the electronic database PubMed for studies with main object the vascular injuries after SHF in children and especially the pulseless hand. Read More

J Investig Clin Dent 2018 Nov 13;9(4):e12348. Epub 2018 Jul 13.

Postgraduate Program in Dentistry, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil.

Aim: The aim of the present study was to assess the association of sex, age, group of teeth, and type of accident (exposure) with dental fractures (outcome: enamel-dentine fracture without [EDF] or with pulp exposure [EDPF] and root fracture RF]).

Methods: In total, 1046 patients were selected. Logistic binary regression was used. Read More

Acta Ortop Bras 2018 Mar-Apr;26(2):117-122

. Osteometabolic Diseases Group, Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil.

Objective: To evaluate the profile of patients with osteoporotic fractures treated at a tertiary orthopedic hospital.

Methods: Using questionnaires, 70 patients with osteoporotic fractures (OF) were compared with 50 outpatients with multiple osteoarthritis (OA) followed through an outpatient clinic.

Results: The OF group was older (p <0. Read More

Ir J Med Sci 2018 Jul 4. Epub 2018 Jul 4.

Department of Orthopaedic Surgery, St. Vincent's University Hospital, Dublin, Ireland.

Background And Aims: Current best practice states that hip fracture patients should undergo surgery within 48 hours to minimise perioperative complications. There are 10 emergency departments (EDs) in Ireland that receive hip fracture patients without a trauma and orthopaedic surgery unit on site. Idle periods and duplicated preoperative investigations can lead to a prolonged time to surgery. Read More

J Am Med Dir Assoc 2018 Oct 27;19(10):840-845. Epub 2018 Jun 27.

Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm, Sweden.

Objective: Systematic rehabilitation by geriatric interdisciplinary teams has been associated with favorable outcomes in frail older patients. The aim of the present meta-analysis was to evaluate the effects of interdisciplinary geriatric team rehabilitation in older patients with hip fracture.

Design, Setting, And Participants: Randomized controlled trials involving participants sustaining hip fractures at the age of 65 years or older were included. Read More

Cureus 2018 Apr 17;10(4):e2496. Epub 2018 Apr 17.

Department of Trauma and Orthopaedic Surgery, Galway University Hospital, Galway, IRL.

Lateral femoral prosthesis perforation is an uncommon periprosthetic fracture. Periprosthetic fractures may be fixed with open reduction and internal fixation, or with revision arthroplasty, depending on the type of fracture, the condition of the host bone in the proximal femur, the stability of the implant, and occasionally the medical co-morbidities of the patient. Proximal femoral replacement is a complex and challenging procedure but provides a better chance of early mobilisation. Read More

BMC Public Health 2018 Jun 15;18(1):744. Epub 2018 Jun 15.

Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Beijing, 100191, China.

Background: Understanding the correlates of self-rated health (SRH) can help public health professionals prioritize health-promotion and disease-prevention interventions. This study aimed to investigate the association between multiple comorbidities and global SRH and age-comparative SRH.

Methods: A total of 512,891 participants aged 30-79 years old were recruited into the China Kadoorie Biobank study from ten regions between 2004 and 2008. Read More

Arthrosc Tech 2018 May 16;7(5):e491-e497. Epub 2018 Apr 16.

Department of Orthopaedic Surgery, Mansoura University Hospital, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt.

Avulsion fractures of the tibial eminence, although generally a rare injury pattern, are more common in children and adolescents than in adults. Many open and arthroscopic techniques are available with variable degrees of satisfying results and incidence of complications and adverse effects. Arthroscopic fixation appeared to improve the functional outcomes with fewer complications than the open fixation. Read More

Ostomy Wound Manage 2018 05;64(5):47-52

The challenges of managing Gustilo IIIB tibial fractures (ie, high energy trauma with a contaminated wound >10 cm in length, severe comminution ["crumbling"] or segmental fractures, and periosteal stripping) in children are unique in part because no clear guidelines exist and the injuries may cause short-term and long-term complications. Repeated wound debridement and secondary reconstruction are required in approximately 20% of these cases in both adults and children. A 13-year-old girl presented with severe polytrauma including an open Gustilo type IIIB fracture of the left lower leg. Read More

Eur J Orthop Surg Traumatol 2018 May 11. Epub 2018 May 11.

Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.

Background: Our primary goal was to audit the incidence of erythrocyte blood transfusion (EBT) after hip fracture surgery and study the effects on perioperative complications and early and late mortality.

Methods: In a retrospective cohort study all patients 65 years old and above treated operatively for an acute hip fracture were included over a 48-month period with a 2-year follow-up period. Postoperative hemoglobin levels were used to investigate at what threshold EBT was used. Read More

Pediatr Emerg Care 2018 May 5. Epub 2018 May 5.

Lower extremity fractures (LEFs) caused by road traffic accidents (RTAs) can result in significant morbidity and account for a substantial part of nonfatal injuries requiring hospitalization. This study investigated the epidemiology of RTA-associated LEFs in the pediatric population. Based on the National Trauma Registry, data of 28,924 RTA hospitalized pediatric patients were reviewed. Read More

Eur Spine J 2018 May 7. Epub 2018 May 7.

Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Ave. Room M779, San Francisco, CA, 94143, USA.

Purpose: Minimally invasive lateral approaches to the lumbar spine allow for interbody fusion with good visualization of the disk space, minimal blood loss, and decreased length of stay. Major neurologic, vascular, and visceral complications are rare with this approach; however, the steps in management for severe vascular injuries are not well defined. We present a case report of aortic injury during lateral interbody fusion and discuss the use of endovascular repair. Read More

Asian J Urol 2018 Apr 2;5(2):107-117. Epub 2018 Mar 2.

Department of Reconstructive Urology, Kulkarni Reconstructive Urology Centre, Pune, India.

Objectives: Pelvic fracture urethral injuries (PFUI) result from traumatic disruption of the urethra. A significant proportion of cases are complex rendering their management challenging. We described management strategies for eight different complex PFUI scenarios. Read More

Sex Med 2018 Sep 3;6(3):263-266. Epub 2018 May 3.

Sexual Medicine Group, Division of Urology, University of Sao Paulo Medical School, Sao Paulo, SP, Brazil.

Introduction: Penile refracture is an exceedingly rare event, with very few published studies. To the best of our knowledge, this is the first documented case in the literature of penile fracture with 3 same-site recurrences.

Aims: To describe the case of a 25-year-old Caucasian man with recurrent penile fracture ultimately treated with resuture and patch reinforcement. Read More

J Neurosci Rural Pract 2018 Apr-Jun;9(2):226-231

Department of Medicine, AIIMS, Jodhpur, Rajasthan, India.

Objective: The aim of this study was to evaluate clinico-radiological profile and outcome of pediatric traumatic brain injury (TBI).

Design: Prospective observational study.

Setting: Intensive Care Unit, ward and OPD of Pediatrics, Dr. Read More

Clin Neurol Neurosurg 2018 Jun 22;169:166-173. Epub 2018 Apr 22.

Department of Neurosurgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122, Essen, Germany.

Objective: The demographic change in the population leads to a rising number of patients presenting with fractures of the cervical spine, especially C-2, due to falls. With an increase of co-morbidities in these elder patients, the risk for intra- and postoperative complications is increased likewise. Thus, an alternative strategy instead of operative management of these fractures should be taken into account whenever possible. Read More

Health Policy 2018 06 13;122(6):660-666. Epub 2018 Apr 13.

Alliance Manchester Business School, University of Manchester, United Kingdom. Electronic address:

Interventions to reduce variation in care quality are increasingly targeted at both individual doctors and the organisations in which they work. Concerns remain about the scope and consequences for such performance management, the relative contribution of individuals and organisations to observed variation, and whether performance can be measured reliably. This study explores these issues in the context of the English National Health Service by analysing comprehensive administrative data for all patients treated for four clinical conditions (acute myocardial infarction, hip fracture, pneumonia, ischemic stroke) and two surgical procedures (coronary artery bypass, hip replacement) during April 2010-February 2013. Read More

Ann Ig 2018 May-Jun;30(3):191-199

Operative Orthopaedics Unit, Cosenza General Hospital, Cosenza, Italy.

Background: Diagnostic Therapeutic Pathways (DTPs) are multidisciplinary plans designed by each healthcare organization for a specific category of patients to reduce the variability of professional behaviors and to ensure greater safety and better overall healthcare outcomes. Hip fractures are a frequent traumatic injury, particularly in the elderly, and DTPs recommend early surgical intervention, often not done due to organizational challenges and bureaucracy. Medical conditions suggesting a delay are not frequent, however long waiting times not only increase the risk of complications and mortality, but also increase the number of diagnostic test and physician consultations. Read More

Hand Clin 2018 05;34(2):149-165

Hand and Upper Extremity Surgery, Department of Orthopaedic Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, 330 Brookline Avenue-Stoneman 10, Boston, MA 02215, USA. Electronic address:

Fracture dislocations of the proximal interphalangeal (PIP) joint of the finger are often caused by axial load applied to a flexed joint. The most common injury pattern is a dorsal fracture dislocation with a volar lip fracture of the middle phalanx. Damage to the soft-tissue stabilizers of the PIP joint contributes to the deformity seen with these fracture patterns. Read More

Indian J Orthop 2018 Mar-Apr;52(2):161-169

Fourth Department of Orthopaedics and Traumatology, KAT Hospital, Kifissia, 2 Nikis Street, 145 61, Athens, Greece.

Background: Tibial plateau fractures are common due to high energy injuries. The principles of treatment include respect for the soft tissues, restoring the congruity of the articular surface and reduction of the anatomic alignment of the lower limb to enable early movement of the knee joint. There are various surgical fixation methods that can achieve these principles of treatment. Read More

Int J Surg 2018 May 16;53:72-79. Epub 2018 Mar 16.

The Department of Orthopaedic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. Electronic address:

Background: Though several systematic reviews concerned have been published, controversy still exists. The current systematic review was designed to clarify the detailed advantages and disadvantages of the negative pressure wound therapy (NPWT) in treatment of open fractures in comparison with the conventional wound dressings.

Methods: A systematic search was performed in Pubmed, Cochrane Library, Embase, and Google Scholar for the published relevant clinical studies. Read More

J Oral Maxillofac Surg 2018 Jun 20;76(6):1280.e1-1280.e8. Epub 2018 Feb 20.

Professor, Department of Dental Medicine, State University of Londrina, Londrina, Brazil.

Purpose: We aimed to evaluate whether the Facial Injury Severity Scale (FISS), proposed by Bagheri et al in 2006, can predict intervention needs in the operating room (OR), length of hospital stay, and need for support by other specialties.

Patients And Methods: Data were collected from the medical records of trauma patients from a public tertiary hospital between January 2009 and December 2015, related to age, gender, comorbidities, habits, history of maxillofacial trauma, etiology, and presence and location of fractures and lacerations, in addition to type of treatment performed and period of hospitalization. A score was applied to each patient according to the FISS. Read More

Int J Surg Case Rep 2017 7;41:438-442. Epub 2017 Nov 7.

Mehmet Ali Aydınlar Acıbadem University School of Medicine, Kerem Aydinlar Kampusu Kayisdagi Cad. 32 Atasehir, Istanbul, Turkey. Electronic address:

Introduction: Skeletal deformity correction is a procedure of high aesthetic and functional demand. Therefore, meticulous surgical planning has always been mandatory. However, it is known that during the surgery things may often get slippery, leaving the surgeon no chance but improvisation. Read More

Hand (N Y) 2018 Feb 1:1558944718760861. Epub 2018 Feb 1.

2 Kaiser Permanente, Anaheim, CA, USA.

Background: Distal radius fractures treated with open reduction and internal fixation are commonly stabilized with a volar locking plate; however, more complex fracture patterns may require supplemental fixation with fragment-specific implants. The objective of this study was to evaluate the outcomes of distal radius fractures treated with radial column plates.

Methods: A consecutive series of 61 patients who sustained distal radius fractures underwent radial column plating alone or in conjunction with other implants between August 2006 and January 2014. Read More

Clin Podiatr Med Surg 2018 Apr 4;35(2):233-257. Epub 2018 Jan 4.

University Orthopaedic Associates, 2 World's Fair Drive, Somerset, NJ 08873, USA.

At present there is controversy regarding the appropriate treatment of severely comminuted fractures of the lower extremity. Even with near-perfect anatomic reduction of severely comminuted fractures, development of posttraumatic arthritis is still present at an increased rate. Primary fusion of comminuted fractures of the foot and ankle creates successful and predictable outcomes, which dismisses the chance of developing posttraumatic arthritis and decreases complications and the need for revisional procedures. Read More

J Orthop Trauma 2018 Mar;32 Suppl 1:S21-S24

University of Missouri, Columbia, MO.

Fracture surgeons do a great job of managing bone issues, but they may overlook the associated soft tissue injuries that play a significant role in the final outcome after musculoskeletal injury. The soft tissue reconstruction ladder can help guide reconstructive procedures based on the least complex procedure that allows the best chance of fracture healing. Muscle injury, volume loss, and deconditioning occur with traumatic injury and during the recovery phase. Read More