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Medicine (Baltimore) 2022 Jun 24;101(25):e29436. Epub 2022 Jun 24.

Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.

Abstract: Breakage of the intramedullary nail is a rare complication after proximal femoral nail antirotation (PFNA) in intertrochanteric fracture treatment. The purpose of this study was (1) to investigate the frequency of nail breakage among the patients who were treated for mechanical failure after PFNA for intertrochanteric/pertrochanteric fracture, and (2) to determine the risk factors for nail breakage in PFNA treatment of intertrochanteric fracture.To identify mechanical failure after internal fixation using PFNA, we retrospectively reviewed the data of 35 patients (35 hips) who required reoperation after PFNA with a helical blade for intertrochanteric/pertrochanteric fracture between June 2005 and June 2018. Read More

J Neurol Surg Rep 2022 Apr 24;83(2):e54-e62. Epub 2022 Jun 24.

Department of Surgery, St. Luke's University Health Network, Bethlehem, Pennsylvania, United States.

Nail gun use and its associated incidence of injury have continued to increase since it was first introduced in 1959. While most of these injuries involve the extremities, a subset of patients suffer intracranial trauma. The most recent comprehensive review on this particular subject referenced 41 cases and advocated for further discussion regarding proper treatment plans for these individuals. Read More

JB JS Open Access 2022 Apr-Jun;7(2). Epub 2022 Jun 22.

Hospital Sirio Libanes, Buenos Aires, Argentina.

The purposes of the present study were (1) to characterize open tibial fractures and their treatment in trauma centers located across different regions of Argentina and (2) to evaluate the rates of and indications for reoperation after the surgical treatment of such fractures.

Methods: This retrospective multicenter study evaluated open tibial fractures in Argentina that were operatively treated by experienced orthopaedic trauma surgeon-members of the Argentine Association of Orthopedic Trauma (AATO) between January 2015 and June 2020. Data were collected from 13 hospital databases; 8 hospitals were designated as "interior," and 5 hospitals were designated as "exterior. Read More

Cureus 2022 May 22;14(5):e25210. Epub 2022 May 22.

Orthopaedic Surgery, Wright State University, Dayton, USA.

Purpose Basicervical femoral neck fractures are uncommon injuries that occur at the extracapsular base of the femoral neck at its transition with the intertrochanteric line. Controversy remains in the orthopedic literature as to the optimal method of treatment for this fracture type given the inherent instability and greater rate of implant failure with traditional fixation constructs. The purpose of this study is to quantify the incidence and preferred treatment methods of basicervical hip fractures at a single, regional, Level 1 trauma center and to identify differences in postoperative complications between treatment options. Read More

Medicina (Kaunas) 2022 Jun 7;58(6). Epub 2022 Jun 7.

AO Research Institute Davos, 7270 Davos, Switzerland.

Freehand distal interlocking of intramedullary nails is technically demanding and prone to handling issues. It requires precise placement of a screw through the nail under fluoroscopy guidance and can result in a time consuming and radiation expensive procedure. Dedicated training could help overcome these problems. Read More

Life (Basel) 2022 May 27;12(6). Epub 2022 May 27.

Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy.

Background: Onychomycosis produces nail chromatic alterations that lead patients to mask them with cosmetic enamels. Objectives Evaluate drug transungual permeation and antimycotic activity against selected strains after application of CPX-HPCH nail lacquer (NL) on the nail pre-covered with breathable cosmetic polish.

Methods: CPX transungual permeation after applying CPX-HPCH NL once or twice a day on bovine hoof membranes pre-covered with a breathable cosmetic nail polish was compared to that obtained applying CPX-HPCH NL directly on the membrane. Read More

Children (Basel) 2022 Jun 7;9(6). Epub 2022 Jun 7.

Department of Pediatric Surgery, University Hospital of Split, 21000 Split, Croatia.

Objective: The aim of this study was to analyze the outcomes and complications in children treated with elastic stable intramedullary nailing (ESIN) for tibial fractures.

Methods: The study included 132 patients (92 males) with a median age of 11 years (IQR 10, 15) treated with ESIN for displaced tibial shaft fractures or dia-metaphyseal distal tibial fractures from March 2002 to March 2022. The median follow-up was 118. Read More

Antibiotics (Basel) 2022 May 25;11(6). Epub 2022 May 25.

International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD 21215, USA.

Antibiotic cement-coated intramedullary nails (ACCINs) are increasing in popularity as a viable solution for the treatment of fracture-related infections (FRIs), infected long bone nonunions, and arthrodeses without an external fixator. ACCINs effectively manage to fulfill three of the basic principles for eradicating osteomyelitis: dead space management, antibiotic delivery, and bone stability. We performed a retrospective review of 111 patients who were treated with ACCINs between January 2014 and December 2020. Read More

Arch Orthop Trauma Surg 2022 Jun 23. Epub 2022 Jun 23.

Department of Trauma Surgery, University Medical Centre Regensburg, Franz‑Josef‑Strauss Allee 11, 93053, Regensburg, Germany.

Introduction: Intracapsular femoral neck fractures are one of the most common fractures in Germany. Nevertheless, the epidemiology and treatment modalities are not described comprehensively. For this reason, this study highlights the epidemiology of femoral neck fractures in different age groups and summarizes treatment strategies within the period from 2009 to 2019 based on nationwide data. Read More

Strategies Trauma Limb Reconstr 2022 Jan-Apr;17(1):14-18

Paediatric and Limb Reconstruction Unit, Royal National Orthopaedic Hospital, London, United Kingdom.

Aims: The pixel value ratio (PVR) can be used to assess regenerate consolidation after lengthening and guide advice for full weight-bearing (FWB). This study aimed to analyse the PVR in adults having femoral lengthening, the time to FWB and compare findings with the reported values in the literature.

Materials And Methods: A retrospective database review identified 100 eligible patients who underwent lengthening using the PRECICE nail (68 antegrade and 32 retrograde). Read More

Strategies Trauma Limb Reconstr 2022 Jan-Apr;17(1):55-58

Department of Trauma and Orthopaedics, Kings College Hospital, London, England, United Kingdom.

Aim: To present a novel technique developed in our institution to remove incarcerated and broken intramedullary (IM) tibial and femoral nails.

Background: IM nails are commonly used to treat diaphyseal fractures in both the tibia and femur. These nails can become problematic for the orthopaedic surgeon when they need to be removed, especially in the rare event that the nail has failed and broken. Read More

J Orthop 2022 Jul-Aug;32:151-155. Epub 2022 Jun 8.

Department of Orthopaedics, Phramongkutklao Hospital, Bangkok, Thailand.

Background: Intertrochanteric fracture is one of the most burdensome osteoporotic fractures in the elderly. Chronic kidney disease is associated with sarcopenia, especially in its advanced stages and, thus may impact functional status. Combining an intertrochanteric fracture with advanced CKD may diminish results after surgical fixation. Read More

Mol Cancer 2022 Jun 22;21(1):133. Epub 2022 Jun 22.

Research Institute of General Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002, Jiangsu, China.

Background: Undifferentiated carcinoma with osteoclast-like giant cells (OGCs) of pancreas (UCOGCP) is a rare subtype of pancreatic ductal adenocarcinoma (PDAC), which had poorly described histopathological and clinical features.

Methods: In this study, single-cell RNA sequencing (scRNA-seq) was used to profile the distinct tumor microenvironment of UCOGCP using samples obtained from one UCOGCP patient and three PDAC patients. Bioinformatic analysis was carried out and immunohistochemical (IHC) staining was used to support the findings of bioinformatic analysis. Read More

BMC Musculoskelet Disord 2022 Jun 22;23(1):601. Epub 2022 Jun 22.

Department of Operation Room, The Second Affiliated Hospital and Yuying Children's Hospital of WenZhou Medical University, WenZhou, 325000, ZheJiang, China.

Background: Displacement of the lesser trochanter (LT) is not uncommon after managing intertrochanteric femoral fractures and the influence of nonunion of the LT-fragment on clinical outcomes remains controversial. This study aimed to investigate the relationship between the displacement distance and union of the LT-fragment and evaluate the influence of LT-fragment nonunion on hip function and complications.

Methods: This retrospective study included patients with intertrochanteric fractures and displaced LT treated with intramedullary fixation at Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from June 2015 to July 2017. Read More

Eur Rev Med Pharmacol Sci 2022 Jun;26(11):3872-3877

Department of Orthopedics, Dafeng People's Hospital, Yancheng, Jiangsu, China.

Objective: To explore the clinical effect of bone cement-enhanced Asian proximal femoral anti-rotation intramedullary nail (APFN) internal fixation in the treatment of elderly osteoporotic intertrochanteric fractures of the femur and provide it as a more robust treatment to elderly patients with osteoporotic intertrochanteric femoral fractures.

Patients And Methods: Between January 2017 and January 2019, 42 patients with osteoporotic intertrochanteric fractures in our hospital were selected. All patients were randomly divided into the proximal femoral anti-rotation intramedullary nail (PFNA) group and APFN group. Read More

Zhongguo Gu Shang 2022 Jun;35(6):520-6

Division of Sports Medicine and Adult Reconstructive Surgery, the Affiliated Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing 210000, Jiangsu, China.

Objective: To evaluate effectiveness of self-designed adjustable cannulated screw guide, and to provide an effective auxiliary tool for inverted triangular arrangement of compression cannulated screws in clinical treatment for transcervical femoral neck fractures.

Methods: The sketch of instrument was drawn with Solidworks software, and physical product was obtained after production. The data were obtained by Mimics software. Read More

Zhongguo Gu Shang 2022 Jun;35(6):512-20

The Second Department of Orthopaedics, Luonan County Hospital, Shangluo 726100, Shaanxi, China.

Objective: To analyze clinical characteristics and cost-effectiveness of different final surgical options for treating patients with open tibial fractures.

Methods: A retrospective analysis was conducted by enrolling 55 surgically treated patients with open tibial fractures from January 2018 to June 2019. All the patients were categorized in intramedullary nailing (IMN) group and locking compression plate(LCP) group according to the final fixation option. Read More

Zhongguo Gu Shang 2022 Jun;35(6):503-5

Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Wuhan, China.

Cochrane Database Syst Rev 2022 06 21;6:CD000434. Epub 2022 Jun 21.

Centre for Evidence-Based Orthopaedics, Zealand University Hospital and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

Background: Fractures of the proximal humerus, often termed shoulder fractures, are common injuries, especially in older people. The management of these fractures varies widely, including in the use of surgery. This is an update of a Cochrane Review first published in 2001 and last updated in 2015. Read More

Comput Assist Surg (Abingdon) 2022 Dec;27(1):84-90

Department of Orthopedic Surgery, Yokohama City University, Yokohama, Japan.

Planning a three-dimensional (3D) osteotomy using computed tomography (CT) data is useful especially in cases with complex deformities. Furthermore, CT-based navigation system allows the preoperative virtual planning to be replicated in actual surgery. However, one disadvantage when using navigation systems is that when osteotomies are performed on tracker-attached bone, the bone fragments on the side that were cut away cannot be tracked. Read More

J Orthop Trauma 2022 Jul;36(7):e260-e264

Department of Orthopaedics, Medical University of South Carolina, Charleston, SC.

Objectives: To evaluate the utility and complications of using carbon fiber implants (CFIs) compared with standard titanium alloy (TI) intramedullary implants for stabilization of impending or existing pathologic fractures.

Design: Retrospective comparison.

Patients/participants: Ninety-four patients undergoing intramedullary fixation of 100 impending or existing pathologic fractures between 2014-2019 were identified for inclusion. Read More

J Orthop Trauma 2022 Jul;36(7):321

Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center, New Orleans, LA.

Objective: To examine the impact of instituting a dedicated orthopaedic trauma operating room (DOTOR) at a Level I trauma center on diaphyseal femur fracture management.

Design: Retrospective cohort study.

Setting: Regional, university-based Level I trauma center. Read More

Injury 2022 Jun 7. Epub 2022 Jun 7.

Division of Orthopaedic Surgery, The Ottawa Hospital/University of Ottawa, Ontario, Canada. Electronic address:

Introduction: Cephalomedullary (CMN) implants are commonly used to address elderly intertrochanteric hip fractures. Multiple CMN implant systems exist with subtle variation between manufacturers. Multiple modes of CMN failure have been described in the literature. Read More

J Hand Surg Eur Vol 2022 Jun 19:17531934221106968. Epub 2022 Jun 19.

Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

Brachydactyly Type D is a congenital condition of the thumb in which there is a short and broad thumbnail. Although the thumb function is often unaffected, some patients seek surgery for cosmetic improvement. This study aimed to describe our method of distraction lengthening to correct nail deformity in brachydactyly Type D. Read More

Pan Afr Med J 2022 16;41:218. Epub 2022 Mar 16.

NH MMI Narayana Superspeciality Hospital, Raipur, India.

Medicine (Baltimore) 2022 Jun 17;101(24):e29331. Epub 2022 Jun 17.

Department of Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

Rationale: Fat embolism syndrome (FES) is composed of a triad of symptoms, including respiratory distress, neurologic deficit, and petechiae. Respiratory distress usually presents first before the other symptoms. Thrombotic pulmonary embolism (TPE) is a differential diagnosis of FES. Read More

SICOT J 2022 16;8:26. Epub 2022 Jun 16.

Department of Orthopedic Surgery and Traumatology, Faculty of Medicine, Cairo University, 11562 Cairo, Egypt.

Background: Tibial shaft fractures are usually treated by interlocking nails or plates. The ideal implant choice depends on many variables.

Aim: To assess the mechanical behavior of interlocking nails and plates in the treatment of closed comminuted midshaft fractures of the tibia using finite element analysis. Read More

Injury 2022 Jun 8. Epub 2022 Jun 8.

ORSI Academy, Melle, Belgium; School of Medicine, Faculty of Life and Health Sciences, Ulster University, Northern Ireland, UK; Faculty of Medicine, KU Leuven, Leuven, Belgium. Electronic address:

Introduction: Identifying objective performance metrics for surgical training in orthopedic surgery is imperative for effective training and patient safety. The objective of this study was to determine if an internationally agreed, metric-based objective assessment of video recordings of an unstable pertrochanteric 31A2 intramedullary nailing procedure distinguished between the performance of experienced and novice orthopedic surgeons.

Materials And Methods: Previously agreed procedure metrics (i. Read More

J Orthop Trauma 2022 06;36(6):e255-e259

Department of Orthopaedic Surgery, Atrium Health Carolinas Medical Center, Charlotte, NC.

Summary: Antibiotic-coated implants are increasing in prevalence in the treatment of fracture-related infections. Coated plates may be desirable in certain anatomic locations or to augment nail fixation. We describe a simple, reproducible technique for the fabrication of antibiotic-coated plates and our initial results of a small case series. Read More

Acta Orthop Traumatol Turc 2022 05;56(3):236-237

West China Hospital, Sichuan University, Chengdu, China.