4,835 results match your criteria Journal of orthopaedic trauma[Journal]


Risk Assessment Following Orthopedic Trauma: Coming of Age.

Authors:
J A Caprini

J Orthop Trauma 2019 Apr 9. Epub 2019 Apr 9.

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http://dx.doi.org/10.1097/BOT.0000000000001483DOI Listing

The importance of syndesmotic reduction on clinical outcome after syndesmosis injuries.

J Orthop Trauma 2019 Apr 9. Epub 2019 Apr 9.

Department of Orthopaedic Surgery, Baerum Hospital, Vestre Viken Hospital Trust, Norway. E-mail:

Objectives: To evaluate the relationship between syndesmosis reduction and outcome.

Design: Level III diagnostic study.

Setting: One level 1 and one level 3 Trauma Centre. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001485DOI Listing
April 2019
2 Reads

Radiographic Evaluation of Bone Remodeling Around Osseointegration Implants Among Transfemoral Amputees.

J Orthop Trauma 2019 Apr 9. Epub 2019 Apr 9.

The Australian School of Advanced Medicine, Macquarie University, North Ryde, NSW 2109, Australia.

Objectives: To examine periprosthetic bone remodeling among the recipients of two types of lower-limb osseointegrated systems, the Integral Leg Prosthesis (ILP) and the Osseointegration Prosthetic Limb Type-A (OPL), over a > 24-month period.

Design: Retrospective cohort study.

Setting: Private hospital, with a specialized osseointegration unit. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001488DOI Listing

Tranexamic Acid Use in Open Reduction and Internal Fixation of Fractures of the Pelvis, Acetabulum, and Proximal Femur: A Randomized Controlled Trial.

J Orthop Trauma 2019 Mar 29. Epub 2019 Mar 29.

University of Tennessee College of Medicine Chattanooga.

Objectives: Assess the safety and efficacy of tranexamic acid(TXA) use in fractures of the pelvic ring, acetabulum, and proximal femur DESIGN:: Prospective, randomized controlled trial SETTING:: Single Level 1 trauma center PATIENTS:: Fourty-seven patients were randomized to the study group and 46 patients comprised the control group INTERVENTION:: The study group received 15mg/kg IV TXA prior to incision and a second identical dose 3 hours after the initial dose.

Main Outcome Measurements: transfusion rates, total blood loss (via hemoglobin dilutional method, rates of venous thromboembolic events) RESULTS:: Total blood loss was significantly higher in the control group (TXA=952mL, No TXA=1325mL, p=0.028). Read More

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http://dx.doi.org/10.1097/BOT.0000000000001480DOI Listing
March 2019
1 Read

Treatment Discrepancy for Pelvic Fracture Patients with Urethral Injuries: A Survey of Orthopaedic and Urologic Surgeons.

J Orthop Trauma 2019 Mar 29. Epub 2019 Mar 29.

Department of Urology, University of Washington, Seattle, WA.

Objectives: In patients with traumatic pelvic fracture urethral injuries (PFUI), the interaction between urethral management and orthopaedic decision-making remains unknown. We aimed to survey orthopaedic and urologic surgeons to assess inter-disciplinary interactions in the management of PFUI.

Methods: An anonymous cross-sectional survey of members of the Orthopaedic Trauma Association (OTA) and the Society of Genitourinary Reconstructive Surgeons (GURS) was conducted between September 2017 and August 2018. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001482DOI Listing

Non-United Lower Extremity Fractures Initially Repaired Outside the Developed Western World Develop a High Rate of Post-Operative Complications Following Nonunion Repair.

J Orthop Trauma 2019 Mar 13. Epub 2019 Mar 13.

Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA.

Objectives: To evaluate clinical and functional outcomes following operative repair of non-united lower extremity fractures initially repaired outside the developed Western world.

Design: Retrospective analysis of prospectively collected data.

Setting: Academic medical center. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001476DOI Listing

Radiographic Healing of Far Cortical Locking Constructs in Distal Femur Fractures: A Comparative Study with Standard Locking Plates.

J Orthop Trauma 2019 Mar 13. Epub 2019 Mar 13.

Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242.

Objectives: To investigate the radiographic healing of Far Cortical Locking (FCL) construct fixation in distal femur fractures compared with traditional locking plate constructs (LP).

Design: A retrospective cohort of 143 consecutive patients with 146 distal femur fractures.

Setting: Level I trauma centerPatients/Participants: After excluding patients with OTA/AO Type B fractures, referred non-union cases, patients less than 16 years old, and patients with less than 24 weeks follow-up, 69 patients with 70 total fractures were included for analysis. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001464DOI Listing
March 2019
1.540 Impact Factor

Percutaneous Strain Reduction Screws-A Safe and Simple Surgical Option for Problems With Bony Union. A Technical Trick.

J Orthop Trauma 2019 Apr;33(4):e151-e157

Oxford Trauma Unit, John Radcliffe Hospital, Headington, Oxford, United Kingdom.

This article describes percutaneous strain reduction screws, a technical trick, to provide effective stability in a simple manner and at low cost. Percutaneous strain reduction screws are an option when a surgeon has decided that further intervention is indicated for a fracture that has not united. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001396DOI Listing
April 2019
6 Reads

Miniplate Augmented Tension-Band Wiring for Comminuted Patella Fractures.

J Orthop Trauma 2019 Apr;33(4):e143-e150

Department of Orthopedic Surgery, Guro Hospital, Korea University Medical Center, Seoul, South Korea.

The aim of this study was to introduce various applications of miniplate augmented tension-band wiring (TBW) for comminuted patella fractures and to evaluate the clinical outcomes. Comminuted articular patella fractures were managed with anterior cortical miniplate fixation with a TBW technique from January 2014 to January 2016. The primary end point was radiographic union. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001390DOI Listing
April 2019
1 Read

A New Fastener With Improved Bone-To-Implant Interface Shows Superior Torque Stripping Resistance Compared With the Standard Buttress Screw.

J Orthop Trauma 2019 Apr;33(4):e137-e142

Department of Orthopaedics, University of Colorado, School of Medicine, Aurora, CO.

Objective: The conventional AO buttress screw used for fracture fixation relies on a historic buttress thread design, which is prone to stripping at the bone-implant interface. We hypothesized that a new Bone-Screw-Fastener with an innovative interlocking thread design demonstrates increased resistance to torque stripping forces compared with the buttress screw, without compromising pullout strength.

Methods: A biomechanical model was established in 6 matched pairs of adult human cadaveric tibiae to test torque resistance between the 3. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001415DOI Listing
April 2019
6 Reads

Ultrasound-Guided Nerve Blocks as Analgesia for Nonoperative Management of Distal Radius Fractures-Two Consecutive Randomized Controlled Trials.

J Orthop Trauma 2019 Apr;33(4):e124-e130

Departments of Orthopedic Surgery.

Objectives: To investigate whether a conventional fracture hematoma block (FHB) or an ultrasound-guided peripheral nerve block has more superior analgesic effect during nonoperative management of distal radius fractures in an emergency department setting. Two peripheral nerve block types were investigated, one at the level of the elbow, or cubital nerve block (CNB), and another an axillary nerve block (ANB).

Design: Two prospective randomized controlled studies were performed to compare the difference in pain intensity during closed reduction of a distal radius fracture between FHB-, CNB-, and, ANB-treated patients. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001388DOI Listing

Apparent Proximal Ulna Dorsal Angulation Variation Due to Ulnar Rotation.

J Orthop Trauma 2019 Apr;33(4):e120-e123

The University of British Columbia, St. Paul's Hospital, Vancouver, BC, Canada.

Objective: To investigate the effect of ulna rotation on the apparent proximal ulna dorsal angulation (PUDA).

Methods: Computed tomography images of 59 ulnas were included in this study, 48 being bilateral specimens and the remaining 11 were unilateral. Three-dimensional models of the entire ulna were obtained, and the ulnas were rotated in 5-degree increments in internal rotation or external rotation from neutral. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001408DOI Listing

Morphology of the Posterior Malleolar Fracture Associated With a Spiral Distal Tibia Fracture.

J Orthop Trauma 2019 Apr;33(4):185-188

Department of Orthopaedic Surgery and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN.

Objective: To define the pathoanatomy of the posterior malleolus fracture associated with a spiral distal tibia fracture to guide clamp and implant placement when treating these common injuries.

Design: Retrospective cohort.

Setting: Level I trauma center. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001398DOI Listing
April 2019
4 Reads

Restoring Condylar Width: Radiographic Relationship Between the Lateral Tibial Plateau and Lateral Femoral Condyle in Normal Adult Knees.

J Orthop Trauma 2019 Apr;33(4):180-184

Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA.

Objectives: We hypothesized that a constant radiographic relationship exists between the lateral tibial and femoral condyles and that no side-to-side variation exists.

Methods: We reviewed anteroposterior x-rays of 217 uninjured adults ages 18-65, Included 109 unilateral and 108 bilateral radiographs with no or minimal osteoarthrosis (Kellgren-Lawrence grades 0-1). The perpendicular distance between the lateral-most margins of the tibial plateau articular surface (A) and the lateral femoral epicondyle (B) and the lateral femoral condyle articular surface (C) was measured in millimeters (mm). Read More

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http://dx.doi.org/10.1097/BOT.0000000000001412DOI Listing
April 2019
1 Read

Short Versus Long InterTAN Fixation for Geriatric Intertrochanteric Hip Fractures: A Multicentre Head-to-Head Comparison.

J Orthop Trauma 2019 Apr;33(4):169-174

Department of Surgery, Western University, London, ON, Canada.

Objective: To determine if geriatric intertrochanteric hip fracture patients achieve equivalent postoperative functional status after management with either a short (180-200 mm) or a long (260-460 mm) InterTAN intramedullary device.

Design: Retrospective review of a prospective randomized control trial.

Setting: Four Level I Trauma Centers. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001409DOI Listing
April 2019
1 Read

Delay in Flap Coverage Past 7 Days Increases Complications for Open Tibia Fractures: A Cohort Study of 140 North American Trauma Centers.

J Orthop Trauma 2019 Apr;33(4):161-168

Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.

Objectives: To measure time to flap coverage after open tibia fractures and assess whether delays are associated with inpatient complications.

Design: Retrospective cohort study.

Setting: One forty level I and II trauma centers in Canada and the United States. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001434DOI Listing
April 2019
2 Reads

Systemic Change for Value-Based Care in Orthopedic Trauma.

J Orthop Trauma 2019 Feb 6. Epub 2019 Feb 6.

Medical Center Boulevard Wake Forest School of Medicine Department of Orthopedic Surgery Winston-Salem, NC 27157.

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http://dx.doi.org/10.1097/BOT.0000000000001452DOI Listing
February 2019

External fixation as a definitive treatment for humeral shaft fractures. Radiographic and functional results with analysis of outcome predictors.

J Orthop Trauma 2019 Feb 26. Epub 2019 Feb 26.

Section of Orthopaedics and Trauma, Department of Public Health, "Federico II" University, Naples, Italy.

Objectives: to evaluate the results obtained using unilateral external fixation as a definitive treatment for humeral shaft fractures and to identify possible predictors of radiographic and functional outcomes.

Design: Retrospective study.

Setting: Study involving one large metropolitan hospital. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001457DOI Listing
February 2019

Uncemented Reverse Total Shoulder Arthroplasty as Initial Treatment for Comminuted Proximal Humerus Fractures.

J Orthop Trauma 2019 Feb 26. Epub 2019 Feb 26.

Department of Orthopedic Surgery, Beaumont Health, Royal Oak, MI, USA.

Objectives: To determine if uncemented implants would provide similar outcomes while avoiding the complications associated with cement in the treatment of elderly patients with proximal humerus fractures (PHFs) with primary reverse total shoulder arthroplasty (RTSA).

Design: Case series SETTING:: A single Level I trauma centerPatients/Participants: A prospectively-obtained cohort of 30 patients who underwent uncemented RTSA as initial treatment for a comminuted PHF: 4 male, 26 female; average age 71 ± 11 years.

Intervention: Uncemented reverse total shoulder arthroplasty. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001465DOI Listing
February 2019

Letter to the Editor.

Authors:
Rafael Neiman

J Orthop Trauma 2019 Feb 26. Epub 2019 Feb 26.

Sutter Roseville Medical Center Roseville.

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http://dx.doi.org/10.1097/BOT.0000000000001473DOI Listing
February 2019

In response.

Authors:
Roy Sanders

J Orthop Trauma 2019 Feb 26. Epub 2019 Feb 26.

Editor-in-Chief.

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http://dx.doi.org/10.1097/BOT.0000000000001475DOI Listing
February 2019

In response.

Authors:
Sancar Serbest

J Orthop Trauma 2019 Feb 26. Epub 2019 Feb 26.

Kırıkkale University, Faculty of Medicine KIRIKKALE, TURKEY.

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http://dx.doi.org/10.1097/BOT.0000000000001474DOI Listing
February 2019

Sternoclavicular Joint Dislocation: A systematic review and meta-analysis.

J Orthop Trauma 2019 Feb 26. Epub 2019 Feb 26.

Pikeville Medical Center Orthopedic Trauma, Pikeville, KY.

Objectives: This meta-analysis was performed to answer the following questions: (1) What is the expected outcome of SC dislocations left untreated? (2) What are the indications for closed reduction of SC dislocations? (3) What are the indications for open reduction of SC dislocations? (4) Does the evidence support the need for a cardiothoracic surgeon to be available for the open reduction of a SC dislocation?

Data Sources: Articles were obtained from the database EBSCOhost and supplemented by hand searching of bibliographies of included references. A search using the following terms: sternoclavicular joint AND (dislocation OR injuries OR vascular injury OR cardiovascular surgeon) of the English-language literature from 1970-2018 on the topic of SC joint dislocations was performed.

Study Selection: Studies were included if they contained clinical data on one or more of our study objectives. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001463DOI Listing
February 2019
7 Reads

Is the Cranial and Posterior Screw of the "Inverted Triangle" Configuration for Femoral Neck Fractures Safe?

J Orthop Trauma 2019 Feb 26. Epub 2019 Feb 26.

McGovern Medical School at UTHealth Houston, Department of Orthopedic Surgery.

Objectives: To determine the frequency where a posterior and cranial screw in a femoral neck that appeared contained on fluoroscopy violates the cortex.

Methods: Ten specimens including the hemipelves with the proximal femur were obtained from unidentified embalmed specimens that were to be cremated after an institutional review board waiver was granted. Under fluoroscopy, the posterior and cranial screw of the inverted triangle configuration for the femoral neck was placed using standard technique with a cannulated 6. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001461DOI Listing
February 2019
2 Reads

Nonoperative Geriatric Hip Fracture Treatment is Associated with Increased Mortality: A Matched Cohort Study.

J Orthop Trauma 2019 Feb 26. Epub 2019 Feb 26.

University of Vermont Medical Center, Burlington, VT, USA.

Objective: To report the mortality data and life expectancy of geriatric hip fracture patients who underwent nonoperative management and compare that to a matched operative cohort.

Design: Retrospective cohort study SETTING:: Level 1 trauma center PATIENTS:: Geriatric (65 years of age and older) femoral neck or intertrochanteric fracture (AO/OTA 31A and 31B) patients.

Intervention: Operative treatment with either arthroplasty, cannulated screws, sliding hip screw device or cephalomedullary nail compared to nonoperative cohort. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001460DOI Listing
February 2019
2 Reads

Loss of Independence After Operative Management of Femoral Neck Fractures.

J Orthop Trauma 2019 Feb 18. Epub 2019 Feb 18.

Department of Health Research Methods, Evidence, and Impact, McMaster University.

Objectives: The FAITH trial evaluated effects of sliding hip screw versus cancellous screws in femoral neck fracture patients. Using FAITH trial data, we quantified changes in living status, use of aids, and investigated factors associated with living and walking independently 12-months post-fracture.

Methods: We conducted a descriptive analysis to quantify patients' changes in living status, use of aids, and used multivariable Cox regression analyses to determine factors associated with living and walking independently post-fracture. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001444DOI Listing
February 2019
5 Reads

Opiate Prescribing Practices After Common Isolated Lower Extremity Injuries.

J Orthop Trauma 2019 Mar;33(3):e93-e99

Vanderbilt Medical Center, Nashville, TN.

Objective: This retrospective study aimed at identifying opiate prescribing practices, the number of morphine milligram equivalents (MMEs) prescribed by orthopaedic and nonorthopaedic providers in patients with operatively treated isolated lower extremity fractures, and provide opiate prescribing recommendations.

Methods: Patients older than 18 years with isolated lower extremity (unicondylar, bicondylar, tibial shaft, pilon, and ankle) fractures between 2005 and 2016 were identified. Prescribing information was obtained from the State Controlled Substance Monitoring Database. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001375DOI Listing

Psychiatric Illness Is Common in Elderly Fracture Patients.

J Orthop Trauma 2019 Mar;33(3):149-154

Department of Orthopaedics, Dartmouth-Hitchcock Medical Center, Lebanon, NH.

Objectives: To (1) describe the prevalence of psychiatric illness in fracture patients ≥70 years of age and (2) investigate the association between psychiatric illness and complications requiring unplanned readmission in elderly patients.

Design: Retrospective cohort study.

Patients/participants: One thousand one hundred eighty-six patients ≥70 years of age with surgically treated fractures and ≥1-month follow-up treated from 2012 to 2017. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001371DOI Listing
March 2019
9 Reads

Distal Nail Target and Alignment of Distal Tibia Fractures.

J Orthop Trauma 2019 Mar;33(3):137-142

Department of Orthopaedic Surgery, Loyola University Medical Center, Chicago, IL.

Objectives: To assess the relationship between the distal nail target and postoperative alignment for distal tibia fractures treated with intramedullary nailing.

Design: Retrospective cohort study.

Setting: A single level 1 trauma center. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001358DOI Listing
March 2019
8 Reads

A Retrospective Comparative Cohort Study Comparing Temporary Internal Fixation to External Fixation at the First Stage Debridement in the Treatment of Type IIIB Open Diaphyseal Tibial Fractures.

J Orthop Trauma 2019 Mar;33(3):125-130

Department of Trauma and Orthopaedic Surgery, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom.

Objectives: To compare the rates of deep infection, flap failure, and nonunion after temporary internal fixation (TIF) with temporary external fixation (ex-fix) in the management of Gustilo-Anderson type IIIB open tibia fractures.

Design: Retrospective comparative cohort study.

Setting: Level 1 trauma center. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001362DOI Listing
March 2019
1 Read

Garden 1 and 2 Femoral Neck Fractures Collapse More Than Expected After Closed Reduction and Percutaneous Pinning.

J Orthop Trauma 2019 Mar;33(3):116-119

Department of Orthopaedic Surgery, Boston Medical Center, Boston University School of Medicine, Boston, MA.

Objectives: To report on the final displacement after in situ percutaneous pinning for Garden type 1 and 2 fractures in height, femoral neck fracture collapse, and loss of offset.

Design: Retrospectively reviewed case series.

Setting: Three Academic Medical Centers. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001360DOI Listing
March 2019
5 Reads

Tensioned Wire-Assisted Intramedullary Nail Treatment of Proximal Tibia Shaft Fractures: A Technical Trick.

J Orthop Trauma 2019 Mar;33(3):e104-e109

Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, University of Miami, Miami, FL.

Proximal tibia shaft fractures are often challenging to manage because of their intrinsic tendency toward valgus and apex anterior deformity. In recent years, intramedullary nailing (IMN) has become more frequently used to treat these injuries, allowing for biologic advantages such as load-sharing, immediate weight-bearing, and avoidance of disruption of periosteal blood supply. Several adjunctive techniques, such as semiextended positioning, blocking screws, and external fixation, have been developed to assist with fracture reduction during IMN. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001410DOI Listing

Syndesmosis and Syndesmotic Equivalent Injuries in Tibial Plafond Fractures.

J Orthop Trauma 2019 Mar;33(3):e74-e78

Department of Orthopedic Surgery, Harborview Medical Center, University of Washington, Seattle, WA.

Objectives: To identify the incidence and fracture characteristics associated with syndesmotic injury in tibial plafond fractures and report the incidence of posttraumatic osteoarthrosis (PTOA).

Design: Retrospective comparative study.

Setting: Two level-1 academic trauma centers. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001363DOI Listing
March 2019
1 Read

Locking Hole Inserts: Effect of Insertion Torque on Fatigue Performance and Insert Loosening in Locking Plates.

J Orthop Trauma 2019 Mar;33(3):120-124

Washington University St. Louis School of Medicine, St. Louis, MO.

Objectives: To evaluate the effect of locking hole inserts (LHIs) and their insertion torque on locking plate fatigue life.

Methods: Eighteen standard 3.5-mm locking plates were instrumented with LHIs (Smith & Nephew, Memphis, TN) of 1. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001387DOI Listing
March 2019
3 Reads

Inter-Rater Reliability of The Modified Radiographic Union Score for Diaphyseal Tibial (mRUST) Fractures with Bone Defects.

J Orthop Trauma 2019 Jan 24. Epub 2019 Jan 24.

Department of Orthopaedic Surgery, Boston University, Boston, MA.

Objectives: To evaluate inter-rater reliability of the modified Radiographic Union Score for Tibial (mRUST) fractures among patients with open, diaphyseal tibia fractures with a bone defect treated with intramedullary nails (IMNs), plates, or definitive external fixation (ex-fix).

Design: Retrospective cohort study.

Setting: 15 level one civilian trauma centers; 2 military treatment facilities. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001445DOI Listing
January 2019
5 Reads

Treatment of Peritrochanteric Femur Fractures with Proximal Femur Locked Plating.

J Orthop Trauma 2019 Jan 30. Epub 2019 Jan 30.

Wake Forest Baptist Medical Center.

Objectives: To report on our results using a proximal femoral locking plate for the treatment of peritrochanteric femur fractures DESIGN:: Retrospective SETTING:: Level I Academic Medical Center PATIENTS:: Sixty-eight patients with sixty- eight fractures INTERVENTION:: Demographics, fracture morphology, preoperative imaging, rationale against nailing, and outcomes were collected.

Main Outcome Measurements: Outcomes were grouped into no complication, minor complication, or major complication. Minor complications included healed fractures with implant failure or change in alignment from immediate post-operative radiographs which did not require intervention, or elective implant removal. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001442DOI Listing
January 2019
3 Reads

Differences in the Majeed Pelvic Score between injured and uninjured patients.

J Orthop Trauma 2019 Jan 30. Epub 2019 Jan 30.

Brabant Trauma Registry, Network Emergency Care Brabant, The Netherlands.

Objectives: To investigate the differences in the Majeed Pelvic Score (MPS) between injured and uninjured patients. Discriminative power and applicability of the MPS in elderly are also investigated, and a norm score for the MPS in the Netherlands is provided.

Design: Cross-sectional cohort study. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001428DOI Listing
January 2019

New 5-Factor Modified Frailty Index Predicts Morbidity and Mortality in Geriatric Hip Fractures.

J Orthop Trauma 2019 Jan 30. Epub 2019 Jan 30.

Medical University of South Carolina Department of Orthopaedics 96 Jonathan Lucas Dr CSB 708 Charleston, SC 29425.

Introduction: While the 11-factor modified frailty index (mFI-11) has been shown to predict adverse outcomes in elderly patients undergoing surgery for hip fractures, the newer 5-factor index has not been evaluated in this population. The goal of this study is to evaluate the mFI-5 as a predictor of morbidity and mortality in elderly patients undergoing surgical management for hip fractures.

Methods: The NSQIP database was queried for patients aged 60 years and older who underwent surgical management for hip fractures between 2005-2016. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001455DOI Listing
January 2019
3 Reads

Bundled Care for Hip Fractures: A Machine Learning Approach to an Untenable Patient-Specific Payment Model.

J Orthop Trauma 2019 Jan 30. Epub 2019 Jan 30.

Cleveland Clinic, Department of Orthopedic Surgery, Cleveland, Ohio, USA.

Objectives: With the transition to a value-based model of care delivery, bundled payment models have been implemented with demonstrated success in elective lower extremity joint arthroplasty. Yet, hip fracture outcomes are dependent on patient-level factors that may not be optimized pre-operatively due to acuity of care. The objectives of this study are to (1) develop a supervised Naïve Bayes machine-learning algorithm using pre-operative patient data to predict length of stay and cost after hip fracture and (2) propose a patient-specific payment model to project reimbursements based on patient comorbidities. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001454DOI Listing
January 2019
2 Reads
1.540 Impact Factor

Hypoalbuminemia is an Independent Risk Factor for 30-Day Mortality, Postoperative Complications, Readmission, and Reoperation in the Operative Lower Extremity Orthopedic Trauma Patient.

J Orthop Trauma 2019 Jan 29. Epub 2019 Jan 29.

Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.

Introduction: Malnutrition, as indicated by hypoalbuminemia, is known to have detrimental effects on outcomes following arthroplasty, geriatric hip fractures, and multiple general surgeries. Hypoalbuminemia has been examined in the critically ill but has largely been ignored in the orthopedic trauma literature. We hypothesized that admission albumin levels would correlate with postoperative course in the non-geriatric lower extremity trauma patient. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001448DOI Listing
January 2019
1 Read

Biomechanical Comparison of Tension Band Fixation of Transverse Patella Fractures with Headless Compression Screws vs Headed Screws.

J Orthop Trauma 2019 Jan 29. Epub 2019 Jan 29.

Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.

Objective: This study aimed to investigate the stability and strength of tension band wire fixation using headless compression screws versus headed screws for transverse patella fractures.

Methods: Six matched pairs of fresh-frozen cadaveric knees with transverse osteotomies created at the midpoint of the patella were surgically fixed, with one knee randomly receiving fixation with headless screws (Acumed Acutrak 4/5), and the other with headed screws (Synthes 4.0 partially threaded cannulated screws). Read More

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http://dx.doi.org/10.1097/BOT.0000000000001447DOI Listing
January 2019
1 Read

Standardized hospital-based care programs improve geriatric hip fracture outcomes: an analysis of the ACS-NSQIP targeted hip fracture series.

J Orthop Trauma 2019 Jan 22. Epub 2019 Jan 22.

Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

Objective: To determine relative complication rates and outcome measures in patients treated under a standardized hip fracture program (SHFP).

Methods: The American College of Surgeons National Surgical Quality Improvement Program was queried to identify patients who underwent operative fixation of femoral neck, intertrochanteric, and subtrochanteric hip fractures in 2016. Cohorts of patients who were and were not treated under a documented SHFP were identified. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001443DOI Listing
January 2019
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Knee Disarticulation versus Transfemoral Amputations: Functional Outcomes.

J Orthop Trauma 2019 Jan 22. Epub 2019 Jan 22.

Department of Surgery, Uniformed Services University, Bethesda, MD.

Objectives: To determine if there is a patient-reported functional difference between combat-related knee disarticulations (KD) and transfemoral amputations (TFA).

Setting: Role 3 Military Trauma Centers PATIENTS:: We identified and contacted all KDs and TFAs performed at Walter Reed National Military Medical Center, Walter Reed Army Medical Center, and National Naval Medical Center from January 2003 until July 2012 to participate in a retrospective functional cohort analysis. Ten KD patients were available for study completion and were matched against 18 patients in the TFA group. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001440DOI Listing
January 2019

Risk Factors for Infection After Intramedullary Nailing of Open Tibial Shaft Fractures in Low- and Middle-Income Countries.

J Orthop Trauma 2019 Jan 24. Epub 2019 Jan 24.

Arizona State University, Tempe, AZ.

Objectives: 1) To determine the infection rate following fixation of open tibial shaft fractures using the Surgical Implant Generation Network (SIGN) intramedullary nail in low- and middle-income countries; and 2) to identify risk factors for infection.

Design: Prospective cohort study using an international online database.

Setting: Multiple hospitals in low- and middle-income countries worldwide. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001441DOI Listing
January 2019

Combined Pelvic Ring Disruption and Acetabular Fracture: Outcomes Using a Sequential Reduction Protocol and an Anterior Subcutaneous Pelvic Fixator (INFIX).

J Orthop Trauma 2019 Feb;33 Suppl 2:S66-S71

Detroit Medical Center, Michigan State University, Detroit, MI.

Objective: The purposes of this article were to (1) compare our combined pelvic ring and acetabular fracture patients' rate of mortality and Injury Severity Score (ISS) to those of patients with isolated injuries at our center and to those with combined injuries as reported in the literature, (2) describe our treatment algorithm using the INFIX for these combination injuries, and (3) report our patients' radiographic and functional outcomes.

Design: Retrospective IRB-approved case series and literature review.

Setting: US Level 1 Trauma Center. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001416DOI Listing
February 2019
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Current Trends in the Surgical Treatment of Open-Book Pelvic Ring Injuries: An International Survey Among Experienced Trauma Surgeons.

J Orthop Trauma 2019 Feb;33 Suppl 2:S61-S65

AO Clinical Investigation and Documentation, AO Foundation, Duebendorf, Switzerland.

Introduction: In the open-book, rotationally unstable (OTA/AO type 61-B1.1) pelvic ring injury, the posterior sacroiliac complex is believed to remain intact. Therefore, anterior ring stabilization alone has been the standard treatment recommendation. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001411DOI Listing
February 2019

Do We Need a Separate Classification for Fragility Fractures of the Pelvis?

J Orthop Trauma 2019 Feb;33 Suppl 2:S55-S60

Department for Traumatology and Orthopaedics, Westpfalz-Clinic Kaiserslautern, Kaiserslautern, Germany.

Fragility fractures of the pelvis are occurring with increasing frequency. These fractures, occurring in the geriatric patient population, are low-energy injuries and are dissimilar in many ways from those caused by high-energy trauma. For example, the mechanism of injury is different and emergency treatment is usually not necessary. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001402DOI Listing
February 2019

Outcomes of Surgical Treatment of Periprosthetic Acetabular Fractures.

J Orthop Trauma 2019 Feb;33 Suppl 2:S49-S54

Orthopaedic Trauma Service, Hospital for Special Surgery and New York Presbyterian Hospital, Weill Cornell Medicine, New York, NY.

Periprosthetic acetabular fractures sustained following acute trauma after total hip arthroplasty are rare and historically have poor outcomes. This article reviews 5 cases and the treatment algorithm used by a single orthopaedic surgeon specializing in acetabular fracture care with a co-surgeon specializing in arthroplasty. Team-based surgical management with arthroplasty- and fracture-trained surgeon(s) is paramount for optimal outcome. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001400DOI Listing
February 2019
8 Reads