4,802 results match your criteria Journal of orthopaedic trauma[Journal]


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

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
1 Read

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
2 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
1 Read

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
1 Read

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
4 Reads

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
4 Reads

Does Routine Postoperative Computerized Tomography After Acetabular Fracture Fixation Affect Management?

J Orthop Trauma 2019 Feb;33 Suppl 2:S43-S48

North Bristol NHS Trust, Bristol, United Kingdom.

Introduction And Aims: The use of routine postoperative computerized tomography (CT) scan after acetabular fracture reconstruction remains controversial. CT scan may provide more accurate detail regarding metalwork position, retained intra-articular fragments, and quality of reduction but does expose the patient to additional radiation dosage and incurs increased cost. The aim of this study was to evaluate a protocol of routine postoperative CT scan for all acetabular fractures after surgical fixation and assess the effect this has on patient management. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001405DOI Listing
February 2019

Improved Intraoperative Fluoroscopy for Pelvic and Acetabular Surgery.

J Orthop Trauma 2019 Feb;33 Suppl 2:S37-S42

Department of Orthopaedic Surgery, UT Health McGovern Medical School, Houston, TX.

Over the past 3 decades, the evolution of pelvic and acetabular surgery has been supported by the advances in intraoperative pelvic fluoroscopic imaging technology. The new Ziehm RFD 3D C-arm unit provides routine fluoroscopic pelvic imaging but also offers rapid and high-quality real-time axial, sagittal, and coronal intraoperative imaging. This technology allows the surgeon to accurately assess fracture reduction, loose body removal, and implant locations while the patient is still under anesthesia. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001403DOI Listing
February 2019

The Role of the Computed Tomographic Scan in the Diagnosis of Acetabular Fracture in the Immature Pelvis.

J Orthop Trauma 2019 Feb;33 Suppl 2:S32-S36

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

Objectives: We present a series of skeletally immature patients sustaining acetabular fractures. We hypothesized that if the secondary ossification centers of the acetabulum are not completely ossified, fractures often will not be identified on plain radiography. Our objective was to determine the efficacy of diagnostic plain radiography in these patients. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001414DOI Listing
February 2019
2 Reads

Supplemental Superior Buttress Plating for the Treatment of Posterosuperior Wall Acetabulum Fractures.

J Orthop Trauma 2019 Feb;33 Suppl 2:S27-S31

Department Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, NC.

Posterosuperior wall acetabulum fractures are a unique and uncommon fracture pattern. Traditional plate fixation may not provide adequate fixation of these fracture fragments. This article presents a surgical technique and the results of a case series using a supplemental 1/3 tubular superior buttress plate to improve fracture reduction and better neutralize shear forces in the treatment of superior posterior wall fractures. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001394DOI Listing
February 2019

Anterior Intrapelvic Approaches: Fracture Patterns You May Want to Reconsider.

J Orthop Trauma 2019 Feb;33 Suppl 2:S21-S26

R Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, MD.

The anterior intrapelvic approach with a lateral window is gaining popularity for the surgical treatment of anterior fracture patterns of the acetabulum. Certain fracture patterns and characteristics present challenges when using anterior approaches. This article aims to describe some of the fracture patterns that may be particularly difficult to address using the anterior intrapelvic approach with or without the lateral window. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001413DOI Listing
February 2019

The Ilioinguinal Surgical Approach Using a Modified Medial Window: Origin, Evolution, and Applications. A 34-Year Perspective.

J Orthop Trauma 2019 Feb;33 Suppl 2:S14-S20

Hansjörg Wyss Hip and Pelvic Center, Swedish Hospital, Seattle, WA.

Emile Letournel's ilioinguinal approach provided unprecedented surgical access to the anterior aspect of the innominate bone. A refinement of this approach is described which incorporates a modified medial window that limits dissection around the external iliac vessels, expands surgical exposure of the anterior pelvic ring, and provides additional reduction possibilities while preserving the capabilities of the lateral and middle windows. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001404DOI Listing
February 2019

Geriatric Acetabular Surgery: Letournel's Contraindications Then and Now-Data From the German Pelvic Registry.

J Orthop Trauma 2019 Feb;33 Suppl 2:S8-S13

Department of Trauma, Hand and Reconstructive Surgery, Saarland University, Homburg, Germany.

Objective: In his original series of 129 surgically treated acetabular fractures, Letournel did not operate on patients older than 60 years. Almost 30 years later, he still emphasized that no patients with reduced bone quality should be operated on. The aim of the study was to analyze epidemiologic characteristics and treatment modes for today's cohort of elderly patients with acetabular fractures. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001406DOI Listing
February 2019
2 Reads

The Relevance of the Judet and Letournel Acetabular Fracture Classification System in the Modern Era: A Review.

J Orthop Trauma 2019 Feb;33 Suppl 2:S3-S7

Department of Orthopaedic Surgery, Northwestern Memorial Hospital, Chicago, IL.

The Judet and Letournel acetabular fracture classification system, based on the idea of bicolumnar support of the acetabulum, was first described in a landmark article published in the 1960s. It has stood the test of time and continues to be the preferred method for describing acetabular fractures for the majority of orthopaedic trauma surgeons. Still, there have been attempts to modify or replace Letournel system since its introduction for a variety of reasons, chief among them a perceived inability of the classification system to account for a number of transitional fracture patterns and injury modifiers that may affect surgical decision making and patient outcomes. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001401DOI Listing
February 2019

Acetabulum Fractures: Classification and Management.

Authors:
Emile Letournel

J Orthop Trauma 2019 Feb;33 Suppl 2:S1-S2

Professeur Agregé d'Orthopédie et Traumatologie, C.H.U. de Paris-Broussais.

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http://dx.doi.org/10.1097/BOT.0000000000001424DOI Listing
February 2019

The Life and Contributions of Emile Letournel, MD, 1927-1994.

J Orthop Trauma 2019 Feb;33 Suppl 2:Sii-Siii

CHS David Geffen School of Medicine University of California Los Angeles, Los Angeles, CA.

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http://dx.doi.org/10.1097/BOT.0000000000001393DOI Listing
February 2019

Foreword.

J Orthop Trauma 2019 Feb;33 Suppl 2:Si

Department of Orthopaedic Surgery, Cedars Sinai Hospital, Los Angeles, CA Los Angeles, CA.

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http://dx.doi.org/10.1097/BOT.0000000000001399DOI Listing
February 2019

In response.

Authors:
J Brock Walker

J Orthop Trauma 2019 Feb;33(2):e73

University of Arizona College of Medicine-Phoenix, Phoenix, AZ.

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http://dx.doi.org/10.1097/BOT.0000000000001419DOI Listing
February 2019

Effect of Tuberosity Healing on Clinical Outcomes in Elderly Patients Treated With a Reverse Shoulder Arthroplasty for 3- and 4-Part Proximal Humerus Fractures.

J Orthop Trauma 2019 Feb;33(2):e39-e45

Department of Orthopaedic Surgery, Hospital for Joint Disease, NYU Langone Medical Center, New York, NY.

Objectives: To evaluate tuberosity union rate and clinical outcome after 3- and 4-part proximal humerus fractures in the elderly.

Design: Retrospective, multicenter database cohort study.

Setting: Level I and Level II trauma centers. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001348DOI Listing
February 2019

Unstable Pelvic Ring Injuries: How Soon Can Patients Safely Bear Weight?

J Orthop Trauma 2019 Feb;33(2):71-77

Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT.

Objective: To determine if time to weight bearing (WB) is associated with complications in operatively treated pelvic ring injuries.

Design: Retrospective cohort study.

Setting: Academic Level I trauma hospital. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001356DOI Listing
February 2019

Long-Term Patient-Reported Functional Outcome of Polytraumatized Patients With Operatively Treated Pelvic Fractures.

J Orthop Trauma 2019 Feb;33(2):64-70

Department of Pelvic and Acetabular Surgery, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom.

Objectives: To report the long-term functional outcome of a cohort of patients with operatively treated unstable pelvic fractures using validated patient-reported outcome measures.

Design: Long-term observational study using prospective and retrospective data.

Setting: Tertiary referral pelvic trauma center, Bristol, United Kingdom. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001355DOI Listing
February 2019

Clinical Practice Guidelines for Pain Management in Acute Musculoskeletal Injury.

J Orthop Trauma 2019 Jan 23. Epub 2019 Jan 23.

Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, NC.

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http://dx.doi.org/10.1097/BOT.0000000000001430DOI Listing
January 2019

Ability of a Risk Prediction Tool to Stratify Quality and Cost of Older Patients with Operative Ankle Fractures.

J Orthop Trauma 2019 Jan 17. Epub 2019 Jan 17.

NYU Langone Orthopedic Hospital, NYU Langone Medical Center, New York, New York.

Objectives: To investigate the ability of a validated geriatric trauma risk prediction tool to stratify hospital quality metrics and inpatient cost for middle-aged and geriatric patients admitted from the ED for operative treatment of an ankle fracture.

Design: Prospective cohort study SETTING:: Single Academic Medical Center PATIENTS:: Patients aged 55 and older who sustained a rotational ankle fracture and were treated operatively during their index hospitalization INTERVENTION:: Calculation of validated trauma triage score, Score for Trauma Triage in Geriatric and Middle Aged (STTGMA), using patient's demographic, injury severity, and functional status. Patients were stratified into groups based on scores to create a minimal-, low-, moderate-, and high-risk cohort. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001446DOI Listing
January 2019
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Correlation of Fracture Energy with Sanders Classification and Post-Traumatic Osteoarthritis following Displaced Intra-Articular Calcaneus Fractures.

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

Department of Orthopaedics and Rehabilitation, the University of Iowa, Iowa City, Iowa.

Objectives: To quantify fracture severity for a series of displaced intra-articular calcaneal fractures (DIACFs) and correlate it with Sanders classification, post traumatic osteoarthritis (PTOA), and patient outcomes.

Design: Retrospective review and fracture severity analysis SETTING:: The University of Iowa Hospitals and Clinics is a level 1 trauma center affiliated with the University of Iowa in Iowa City, Iowa.

Patients/participants: Thirty-six patients with 48 DIACFs were selected from 153 patients previously treated. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001432DOI Listing
January 2019

Fewer Hospitals Provide Operative Fracture Care to Medicaid Patients Than Otherwise-Insured Patients in Four Large States.

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

Department of Orthopaedic Surgery, University of California, San Francisco.

Objective: To determine whether Medicaid patients receive operative fracture care at an equal number of hospitals as otherwise-insured patients and to compare travel distances between Medicaid and otherwise-insured patients.

Design: Retrospective, population-based cohort study of administrative health data.

Setting: One thousand seventy-five hospitals in California, Florida, New York, and Texas. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001439DOI Listing
January 2019

Are geriatric patients who sustain high-energy traumatic injury likely to return to functional independence?

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

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

Objectives: To evaluate physical function and return to independence of geriatric trauma patients, to compare physical function outcomes of geriatric patients who sustained high-energy trauma with that of those who sustained low-energy trauma, and to identify predictors of physical function outcomes.

Design: Retrospective SETTING:: Urban Level I trauma center PATIENTS:: Study group of 216 patients with high-energy trauma and comparison group of 117 patients with low-energy trauma.

Intervention: Injury mechanism (high- versus low-energy mechanism) MAIN OUTCOME MEASUREMENT:: Patient Reported Outcome Measurement Information System (PROMIS) Physical Function patient reported outcome measure, and change in living situation and mobility. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001436DOI Listing
January 2019

Biomechanical Evaluation of Interfragmentary Compression of Lag Screw versus Positional Screw at Different Angles of Fixation.

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

University of Kentucky Orthopaedic Surgery and Sports Medicine, Lexington, KY.

Objectives: The purpose of this study was to compare the compressive force achieved and retained with lag versus positional screw technique at various angles of screw application.

Methods: Sixty humeral sawbones were stratified into six groups based on technique (lag or positional) and fixation angle (30°, 60°, or 90° relative to the fracture plane). A sensor was placed between fragments to record compressive force. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001429DOI Listing
January 2019

Salter-Harris II Ankle Fractures in Children: Does Fracture Pattern Matter?

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

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http://dx.doi.org/10.1097/BOT.0000000000001422DOI Listing
January 2019
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The fracture pattern and periosteal entrapment in adolescent displaced distal tibial physeal fractures: an MRI study.

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

Department of Orthopedic Surgery, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, 88, Olympic-ro, 43-gil, Songpa-gu, Seoul 05505, Republic of Korea.

Objectives: to investigate the fracture pattern and periosteal entrapment in adolescent distal tibial physeal fractures.

Design: Retrospective case series SETTING:: Level I academic trauma centerPatients/Participants: Fifty patients (age 10-16 years) with displaced Salter-Harris type II, III, or IV distal tibial physeal fractures were retrospectively reviewed.

Intervention: periosteal involvement, fracture pattern MAIN OUTCOME MEASUREMENTS:: We investigated the incidence and location of periosteal entrapment in those fractures and the angle of the fracture plane of metaphyseal fragments on axial plane by using MRI. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001421DOI Listing
January 2019
1 Read

The Effect of Elbow Position on Load to Failure in Olecranon Fracture Fixation: A Biomechanical Cadaveric Study.

J Orthop Trauma 2019 Jan 14. Epub 2019 Jan 14.

The University of Texas Medical Branch Department of Orthopaedic Surgery and Rehabilitation 301 University Blvd., Rt. 0165 Galveston, TX 77555-0165.

Objectives: This study evaluates if relative flexion or extension of the ulnohumeral joint affects the strength of repair in olecranon fractures treated with a pre-contoured locking plate.

Methods: A cadaveric study was performed in matched pair cadaveric elbows. All soft tissue was dissected from the radius, ulna and elbow of each specimen, leaving interosseous ligaments and joint capsules intact. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001423DOI Listing
January 2019
1 Read

Autograft, allograft, and bone graft substitutes: clinical evidence and indications for use in the setting of orthopaedic trauma surgery.

J Orthop Trauma 2019 Jan 14. Epub 2019 Jan 14.

Department of Orthopedics, Orlando Regional Medical Center, Orlando FL, United States.

Bone grafts are the second most common tissue transplanted in the United States, and they are an essential treatment tool in the field of acute and reconstructive traumatic orthopaedic surgery. Available in cancellous, cortical, or bone marrow aspirate form, autogenous bone graft is regarded as the gold standard in the treatment of post-traumatic conditions such as fracture, delayed union, and nonunion. However, drawbacks including donor-site morbidity and limited quantity of graft available for harvest makes autograft a less-than-ideal option for certain patient populations. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001420DOI Listing
January 2019
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Orthogonal Plating with a 95 Degree Blade Plate for Salvage of Unsuccessful Cephalomedullary Nailing of Atypic Femur Fractures: A Technical Trick.

J Orthop Trauma 2019 Jan 9. Epub 2019 Jan 9.

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

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http://dx.doi.org/10.1097/BOT.0000000000001426DOI Listing
January 2019

Risk factors that influence subsequent recurrent instability in terrible triad injury of the elbow.

J Orthop Trauma 2019 Jan 9. Epub 2019 Jan 9.

Department of Orthopedic Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine.

Objective: To identify risk factors associated with subsequent recurrent instability and to identify predictors of poor outcomes in terrible triad injury of the elbow.

Design: Retrospective cohort study.

Setting: University trauma center. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001425DOI Listing
January 2019
4 Reads
1.540 Impact Factor

Orthopaedic Trauma Quality Measures for Value-Based Health Care Delivery: A Systematic Review.

J Orthop Trauma 2019 Feb;33(2):104-110

VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University Medical Center, Redwood City, CA.

Objectives: To assess the current portfolio of quality measures and candidate quality measures that address orthopaedic trauma surgery.

Data Sources: We systematically reviewed the National Quality Forum, the Agency for Healthcare Research and Quality, and the Quality Payment Program for quality measures relevant to fracture surgery. We also searched MEDLINE/PubMed, Embase/Scopus, and Cochrane libraries. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001372DOI Listing
February 2019

Cortical Impaction in Posterior Wall Acetabular Fractures.

J Orthop Trauma 2019 Jan 2. Epub 2019 Jan 2.

Department of Orthopaedic Surgery, University of Texas, Health Sciences Center at Houston, TX.

Objectives: To report the incidence of patients with extraarticular posterosuperior acetabular cortical impaction associated with a posterior wall acetabular fracture-dislocation.

Design: Retrospective case series SETTING:: Regional Level 1 Trauma CenterPatients/Participants: 97 patients who sustained an isolated posterior wall acetabular fracture dislocation from July 2007 until July 2017.

Intervention: The medical record and the computed tomography (CT) scan of the abdomen and pelvis were reviewed including axial, coronal and sagittal reconstruction images, and 3D surface renderings. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001427DOI Listing
January 2019
2 Reads

Distal Femur Locking Plates Fit Poorly Before and After Total Knee Arthroplasty.

J Orthop Trauma 2019 Jan 3. Epub 2019 Jan 3.

Department of Orthopaedic Surgery, Stanford University Hospital.

Objective: To evaluate the fit of distal femur locking plates. Secondarily, we sought to compare plate fit among patients with and without a total knee arthroplasty (TKA).

Design: We retrospectively reviewed full-length femur radiographs of patients who underwent primary TKA. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001431DOI Listing
January 2019
5 Reads

Surgical Gowning Technique: Are We Contaminated Before We Cut?

J Orthop Trauma 2019 Feb;33(2):59-63

Departments of Orthopedic Surgery and Rehabilitation, and.

Objectives: To assess possible breaches of sterility during the initial gowning step.

Design: Observational study. Twenty-seven gowning events were monitored for contamination during a simulated two-person gowning process in which a surgical technician assists a surgeon in the gowning process at the beginning of a surgical procedure. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001357DOI Listing
February 2019

Using historical variation in opioid prescribing immediately after fracture surgery to guide maximum initial prescriptions.

J Orthop Trauma 2018 Dec 12. Epub 2018 Dec 12.

Department of Orthopaedics, Massachusetts General Hospital, Harvard Orthopaedic Trauma Initiative, Harvard Medical School, 55 Fruit St., Boston, MA, USA.

Objectives: Recent studies have advocated for prescription opioid maximums (based on percentage reductions from historical amounts) to reduce excess prescribing. Implementing this in orthopaedic trauma has been difficult given injury variety and limited historical data on post-operative prescribing. We report on the initial opioid prescriptions for a large cohort of post-operative, opiate-naïve fracture patients and hypothesize that prescribing was associated with fracture location and morphology. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001392DOI Listing
December 2018