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BMC Musculoskelet Disord 2021 Jun 18;22(1):555. Epub 2021 Jun 18.

Bergen Accident and Emergency Department, Bergen, Norway.

Background: Fractures in children under 2 years of age are rare, and little has been published on their mechanisms. We aimed at examining the incidence, mechanisms, pattern and fracture characteristics in a large, population-based cohort of otherwise healthy children.

Methods: This retrospective, cross-sectional study includes all children aged 0-2 years, attending the Accident and Emergency department in Bergen between 2010 and 2015, due to an injury warranting radiography. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021 Jun;35(6):661-666

Department of Orthopedics, First Medical Center of the Chinese PLA General Hospital, Beijing, 100853, P.R.China.

Objective: To review the research progress of different surgical approaches in the treatment of acetabular both-column fractures.

Methods: The domestic and foreign related research literature on surgical approaches for acetabular both-column fractures was extensively consulted. The anatomical characteristics, exposure ranges, advantages, disadvantages, and indications of various common surgical approaches for both-column fractures were mainly summarized. Read More

Ann Biomed Eng 2021 Jun 17. Epub 2021 Jun 17.

Johns Hopkins Applied Physics Lab, Laurel, MD, USA.

Previous studies involving whole-body post-mortem human surrogates (PHMS) have generated biomechanical response specifications for physically simulated accelerative loading intended to reproduce seat and floor velocity histories occurring in under-body blast (UBB) events (e.g.,. Read More

J Orthop Case Rep 2021 Feb;11(2):119-127

Department of Orthopaedic surgery, Sri Ramachandra Institute of Higher Education and Research Centre, Chennai, Tamil Nadu, India.

Introduction: Severe open injuries of limbs, especially of the femur and tibia when associated with vascular injuries, present major challenges in management. The decision to amputate or salvage can often be a difficult one even for experienced surgeons. Mangled lower extremity results due to high-energy trauma, especially due to motor vehicle accidents, and is defined as injury to three of the four systems in the extremity that is soft tissues, bone, vascular, and nerve. Read More

J Orthop Case Rep 2021 Feb;11(2):1-5

Department of Orthopaedics, Max Super Speciality Hospital, 108 A, I.P. Extension, Patparganj, New Delhi, India.

Introduction: Periprosthetic fractures (PPFs) in total knee replacement are an uncommon condition. The floating knee injury around total knee arthroplasty (TKA) is even rare and poses challenges in management. Incidence is increasing due to growing primary joint arthroplasties and revision procedures. Read More

J Orthop Case Rep 2021 ;11(1):5-11

Department of Orthopaedics, Sarojini Naidu Medical College, Agra, India.

Introduction: Severe open fractures continue to be a nightmare for orthopedicians even with use of more accepted line of treatment. Open fractures and infected non-union of femur bone are not infrequently seen in orthopedic wards as femur is the most common long bone injured. We present a case series of 14 such patients treated successfully with limb reconstruction system enabling recovery to pre-injury status and activities. Read More

Acta Orthop Belg 2021 Mar;87(1):1-7

Elderly patients who present with an inability to weight bear following a fall, with normal radiographs, should be appropriately investigated to rule out an occult hip fracture (OHF). We aim to identify both the range and incidence of the differential diagnosis of acute traumatic hip pain in a large series of patients investigated for OHF. A retrospective analysis of consecutive patients investigated for an OHF with magnetic resonance imaging (MRI) was performed. Read More

BMC Health Serv Res 2021 Jun 13;21(1):576. Epub 2021 Jun 13.

ICES, Toronto, Canada.

Background: Health care funding reforms are being used worldwide to improve system performance but may invoke unintended consequences. We assessed the effects of introducing a targeted hospital funding model, based on fixed price and volume, for hip fractures. We hypothesized the policy change was associated with reduction in wait times for hip fracture surgery, increase in wait times for non-hip fracture surgery, and increase in the incidence of after-hours hip fracture surgery. Read More

Int J Surg Case Rep 2021 Jun 9;84:106066. Epub 2021 Jun 9.

Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA; University of South Florida, Tampa, FL, USA.

Introduction And Importance: Low voltage electrical injuries (less than 1000 V) can produce enough tetany to cause fractures, usually of the upper extremities. Simultaneous bilateral fractures of the femoral neck are an extremely rare occurrence. It is even more uncommon for a young healthy male to suffer significant fractures from a low voltage injury. Read More

Arch Orthop Trauma Surg 2021 Jun 7. Epub 2021 Jun 7.

Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT, 84108, USA.

Introduction: Distal femur fractures are challenging injuries historically associated with high rates of nonunion and varus collapse with operative management. As a result, clinical and research interest in dual plating (DP) of distal femur fractures has seen a dramatic increase in recent years. The purpose of this study was to systematically review the literature regarding vascular anatomy and biomechanics of distal femur fractures treated with DP constructs. Read More

Clin Orthop Surg 2021 Jun 18;13(2):135-143. Epub 2021 May 18.

Lancashire Teaching Hospitals, Royal Preston Hospital, Preston, UK.

Background: Increased 30-day mortality rates have been reported for patients with hip fractures and a concurrent diagnosis of coronavirus disease 19 (COVID-19) infection. Due to nosocomial spread of infection and the variable incubation period with the virus, follow-up past 30 days after injury is required to evaluate the true mortality amongst these patients. We aim to assess 120-day mortality rates in hip fracture patients with COVID-19 infection and compare this to hip fracture patients without COVID-19 infection presenting during the same time period. Read More

BMC Musculoskelet Disord 2021 Jun 4;22(1):512. Epub 2021 Jun 4.

Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Isreal Deconess Medical Center, 330 Brookline Ave, MA, 02215, Boston, USA.

Background: Nonunion following treatment of supracondylar femur fractures with lateral locked plates (LLP) has been reported to be as high as 21 %. Implant related and surgeon-controlled variables have been postulated to contribute to nonunion by modulating fracture-fixation construct stiffness. The purpose of this study is to evaluate the effect of surgeon-controlled factors on stiffness when treating supracondylar femur fractures with LLPs: 1. Read More

Int J Environ Res Public Health 2021 May 31;18(11). Epub 2021 May 31.

Clinical Research, Trauma and Vascular Surgery, Hamad General Hospital, Doha, Qatar.

Background: Femur is the most fractured long bone in the body that often necessitates surgical fixation; however, data on the impact of the mechanism of injury (MOI), age, and timing of intervention are lacking in our region of the Arab Middle East. We aimed to describe the patterns, management, and outcome of traumatic femoral shaft fractures.

Methods: A retrospective descriptive observational study was conducted for all trauma patients admitted with femoral shaft fractures between January 2012 and December 2015 at the only level 1 trauma center and tertiary hospital in the country. Read More

Medicina (Kaunas) 2021 May 21;57(6). Epub 2021 May 21.

Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, 35043 Marburg, Germany.

Appropriate timing of surgery for periprosthetic femoral fractures (PFFs) in geriatric patients remains unclear. Data from a large international geriatric trauma register were analyzed to examine the outcome of patients with PFF with respect to the timing of surgical stabilization. The Registry for Geriatric Trauma of the German Trauma Society (Deutsche Gesellschaft für Unfallchirurgie (DGU)) (ATR-DGU) was analyzed. Read More

J Am Geriatr Soc 2021 Jun 1. Epub 2021 Jun 1.

Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

Background: Fractures in late life are highly consequential for health, services use, and spending. Little is known about trends in extremity fracture hospitalizations among older adults in the United States.

Design: Retrospective longitudinal cohort study. Read More

Nat Commun 2021 05 31;12(1):3247. Epub 2021 May 31.

Surrozen, Inc., South San Francisco, CA, USA.

The Wnt signaling pathway is intricately connected with bone mass regulation in humans and rodent models. We designed an antibody-based platform that generates potent and selective Wnt mimetics. Using this platform, we engineer bi-specific Wnt mimetics that target Frizzled and low-density lipoprotein receptor-related proteins and evaluate their effects on bone accrual in murine models. Read More

BMJ Case Rep 2021 May 31;14(5). Epub 2021 May 31.

The Department of Orthopaedic and Trauma Surgery, Zuyderland Medical Centre Heerlen, Heerlen, Limburg, The Netherlands.

We present the case of an 82-year-old female, who experienced a ground-level fall on the trochanter of the right femur. X-rays showed a proximal femoral fracture (PFF) with an unclear and unusual fracture pattern. Three-dimensional CT images were obtained and showed a displaced femoral neck fracture and ipsilateral fracture of the greater trochanter. Read More

Orthop Clin North Am 2021 Jul 7;52(3):215-229. Epub 2021 May 7.

Department of Orthoapedics, Division of Orthopaedic Trauma, University of Pennsylvania, 3737 Market Street, 6th Floor, Philadelphia, PA 19104, USA. Electronic address:

Rotational malreduction is a common yet underreported postoperative complication following intramedullary nailing of long bone fractures. In most situations, this can be prevented at the time of initial surgery with meticulous preoperative planning, careful use of intraoperative fluoroscopy, and awareness of risk factors for malrotation. However, rotational alignment remains difficult to assess by clinical examination so a high index of suspicion is always necessary. Read More

Oper Orthop Traumatol 2021 Jun 27;33(3):245-261. Epub 2021 May 27.

Fachbereich Orthopädie, Klinik für Unfallchirurgie und Orthopädie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, Gebäude Ost 10, 20246, Hamburg, Deutschland.

Objective: Restoration of pain-free joint function by implantation of a bipolar hemiarthroplasty via anterolateral approach.

Indications: Elderly multimorbid patients >70 years, age >80 years, low functional demand.

Contraindications: Infection. Read More

Cureus 2021 Apr 21;13(4):e14609. Epub 2021 Apr 21.

Emergency Medicine, Belgavi Institute of Medical Sciences, Belgaum, IND.

Background On March 24, 2020, the Government of India declared a nationwide lockdown and a series of measures aimed at limiting the spread of the coronavirus disease 2019 (COVID-19) infection. This led to dynamic changes in patient inflow and management in the emergency department.This study aims to evaluate the impact of the pre-lockdown and lockdown periods on the demography of trauma in a tertiary care teaching hospitaland to compare it with the homologous period of 2019. Read More

Injury 2021 Jul 13;52(7):1801-1806. Epub 2021 May 13.

Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. Correspondence should be addressed to: Taipei Veterans General Hospital 201, Sec.2, Shih-Pai Rd. Taipei 112 Taiwan. Electronic address:

Background: Bipolar hemiarthroplasty is a well-established treatment for displaced femoral neck fracture in elderly patients. Implant subsidence is a potential complication with cementless femoral stems, and smaller canal fill ratio has been reported as a radiographic risk factor. We aimed to determine the risk factors for subsidence, particularly the initial implant position relative to the resected medial calcar of proximal femur. Read More

Injury 2021 Jul 13;52(7):1793-1800. Epub 2021 May 13.

Working Committee on Geriatric Trauma Registry of the German Trauma Society (DGU), Berlin, Germany.

Background: There is no well-established gold standard for treating trochanteric femur fractures in the elderly. The two common treatment options are cephalomedullary nails (CMN) and sliding hip screws (SHS). In this study, treatment using CMN and SHS were compared for a cohort of patients older than 70 years of age: The main outcomes were quality of life and main residence after surgery. Read More

BMC Musculoskelet Disord 2021 May 25;22(1):482. Epub 2021 May 25.

Department of Orthopaedic Surgery, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.

Background: Hip arthroplasty using acrylic prosthesis was once conducted; however, it has now been abandoned because of early breakages and wear of material. Therefore, complications or revision surgeries due to the use of acrylic prostheses are becoming rare.

Case Presentation: A 76-year-old woman presented with a sudden onset of severe pain in her left femur while walking. Read More

Injury 2021 Jul 12;52(7):1875-1879. Epub 2021 May 12.

Department of Orthopaedic Surgery, University of Texas Health Science Center at Houston, Houston, TX, 77005, USA. Electronic address:

Background: Periprosthetic distal femur fractures (PPDFFs) present a challenge in terms of optimizing fixation in patients with poor bone quality and limited bone stock. The main treatment options include laterally based plating and intramedullary nailing. We hypothesized that treatment of PPDFFs with intramedullary nails would result in improved union rate, fewer complications, and an equivalent rate of malalignment compared to plating. Read More

BMC Musculoskelet Disord 2021 May 24;22(1):478. Epub 2021 May 24.

Department of Orthopedics and Sports Medicine, Houston Methodist Willowbrook Hospital, 18220 TX-249, Houston, TX, 77070, USA.

Background: Dislocation after primary total hip arthroplasty (THA) has an incidence of 2-3%. Approximately 77% of dislocations occur within the first year after surgery. The SuperPATH technique is a minimally invasive approach for THA that preserves soft tissue attachments. Read More

Bone Jt Open 2021 May;2(5):330-336

University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

Aims: It is imperative to understand the risks of operating on urgent cases during the COVID-19 (SARS-Cov-2 virus) pandemic for clinical decision-making and medical resource planning. The primary aim was to determine the mortality risk and associated variables when operating on urgent cases during the COVID-19 pandemic. The secondary objective was to assess differences in the outcome of patients treated between sites treating COVID-19 and a separate surgical site. Read More

J Int Med Res 2021 May;49(5):3000605211015031

North China University of Science and Technology, Tangshan, Hebei province, China.

Background: We compared the outcomes of three fixation techniques for Müller type C2 and C3 distal femoral fractures.

Methods: We retrospectively analyzed patients undergoing internal fixation for Müller type C2 and C3 distal femoral fractures via locking plate (Group A), lateral locking condylar plate and medial contoured reconstruction plate (Group B), and lateral locking condylar plate and anterior reconstruction plate (Group C). Knee joint functional recovery and functional outcomes were evaluated 12 months postoperatively. Read More

Acta Ortop Mex 2020 Nov-Dec;34(6):376-381

División de Investigación, Facultad de Medicina UNAM, Ciudad de México. México.

Introduction: Motorcycle accidents are one of the leading causes of death and disability in Mexico's young population. There are no local studies describing the pattern of AO-based injuries.

Objective: Define the pattern and type of most common bone fractures in a Regional Hospital of High Specialty, from January to August 2017. Read More

Injury 2021 Jul 1;52(7):1861-1867. Epub 2021 May 1.

Department of Orthopaedics and Trauma Surgery, Lucerne Cantonal Hospital, Switzerland.

Objectives: Despite continual improvement in the methods and devices used for treatment of proximal femoral fractures, unacceptably high failure rates remain. Novel screw-blade implant systems, combining a lag screw with a blade - the latter adding rotational stability to the femoral head - offer improvement of osseous purchase, especially in osteoporotic bone. The aim of this study was to compare biomechanically the head element (HE) anchorage of two screw-blade implant systems differing in blade orientation in the femoral head - vertical versus horizontal. Read More

J Clin Orthop Trauma 2021 Jul 27;18:157-170. Epub 2021 Apr 27.

Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, Maharashtra, India.

Purpose: Proximal femoral extracapsular fractures with associated ipsilateral hip dislocation is an extremely rare pattern of injury. These fractures may be associated with a spectrum of severity from isolated trochanteric fractures to comminuted intertrochanteric and subtrochanteric fractures with hip dislocation. To date, this pattern of injury is not described in any injury classification system and no clear cut guidelines for the same are available. Read More