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Journal of Orthopaedic Trauma

Ong-Art Phruetthiphat, Michael Willey, Matthew D Karam, Yubo Gao, Brian O Westerlind, J Lawrence Marsh
OBJECTIVE: To compare patients with acetabular fractures that are isolated (acetabular fracture alone) and acetabular fracture presenting with additional non-acetabular injury using functional outcomes, complications, and readmissions. DESIGN: Retrospective review SETTING:: Level 1 Trauma CenterPatients/Participants: 215 patients underwent open surgical treatment for acetabular fracture between 2003 and 2012 with age ≥18 years and minimum one year follow-up inclusive of functional scores and complications...
October 5, 2016: Journal of Orthopaedic Trauma
Theodoros H Tosounidis, Peter V Giannoudis
Posterior wall (PW) fractures are the most common fractures requiring surgical fixation in acetabular surgery. Extra-articular screw placement must be confirmed intra-operatively. Herein we describe the use of the Inlet and Obturator Oblique view (the "Leeds view") for screw placement in elementary PW and in Associated Both Column with Posterior Wall (ABC/PW) fractures. We highlight our steps to ensure accurate placement in a small series of patients.
September 24, 2016: Journal of Orthopaedic Trauma
Christopher Hein, Serkan Inceoglu, David Juma, Lee Zuckerman
OBJECTIVES: Cortical bone drilling for preparation of screw placement is common in multiple surgical fields. The heat generated while drilling may reach thresholds high enough to cause osteonecrosis. This can compromise implant stability. Orthopedic drill bits are several orders more expensive than their similarly sized, publicly available industrial counterparts. We hypothesize an industrial bit will generate less heat during drilling, and the bits will not generate more heat after multiple cortical passes...
September 24, 2016: Journal of Orthopaedic Trauma
Justin F Lucas, Milton L Chip Routt, Jonathan G Eastman
Stabilization of posterior pelvic ring injuries is increasingly performed using percutaneously placed iliosacral and transiliac-transsacral screws. Understanding the unique and specific anatomical variations present in each patient is paramount. Multiple methods of evaluating potential osseous fixation pathways for screw placement exist, but many require specific imaging protocols, specialized software, or modification of data. Not all surgeons and institutions have access to these options for a variety of reasons...
September 20, 2016: Journal of Orthopaedic Trauma
James Wilkerson, Ebrahim Paryavi, Hyunchul Kim, Anand Murthi, Raymond A Pensy
OBJECTIVES: Although most clavicular fractures are amenable to nonoperative management, metadiaphyseal fractures are considerably more complex, with rates of suboptimal healing as high as 75% when treated nonoperatively. The poor results are ascribed to the deforming forces on the distal clavicle from the surrounding muscles and the weight of the arm. It recently has been noted that some operative fixations of these fractures are also failing when a standard superiorly placed plate is used...
September 20, 2016: Journal of Orthopaedic Trauma
Nikita Lakomkin, Parth Kothari, Ashley C Dodd, Jacob P VanHouten, Mahesh Yarlagadda, Cory A Collinge, William T Obremskey, Manish K Sethi
OBJECTIVES: The purpose of this study was to explore the relationship between pre-operative Charlson Comorbidity Index (CCI) and post-operative length of stay (LOS) for lower extremity and hip/pelvis orthopaedic trauma patients. DESIGN: Retrospective SETTING:: Urban level 1 trauma center PATIENTS/PARTICIPANTS:: 1,561 patients treated for isolated lower extremity and pelvis fractures between 2000 and 2012 INTERVENTIONS:: Surgical intervention for fractures MAIN OUTCOME MEASUREMENTS:: The main outcome metric was LOS...
August 31, 2016: Journal of Orthopaedic Trauma
James F Kellam
No abstract text is available yet for this article.
August 30, 2016: Journal of Orthopaedic Trauma
Muayad Kadhim, Larry Holmes, Martin G Gesheff, Janet D Conway
OBJECTIVES: To determine which reconstruction treatment of long bones nonunion with segmental bone defects (SBD) is effective to restore bone length and union with good function. DATA SOURCES: PubMed was utilized to identify published literature on treatment of SBD caused by fracture nonunion regardless of infection between January 1975 and December 2014. STUDY SELECTION: We included retrospective cohort studies with minimum sample size of 10 consecutive patients with minimum follow up of 18 months and available data on radiographic and functional outcome...
August 30, 2016: Journal of Orthopaedic Trauma
Dustin S Hambright, Kempland C Walley, Amber Hall, Paul T Appleton, Edward K Rodriguez
Patella fractures with comminution, osteoporotic bone, and/or previously failed fixation are exceedingly difficult to reduce and fix. Moreover, the risk of symptomatic constructs and patients that are poorly compliant with postoperative activity restrictions can make these complex fracture patterns an even more challenging scenario. Although there is an array of techniques described for comminuted patella fractures, there lacks an accepted surgical technique for these difficult cases. In this clinical series, we describe an enhancement to the traditional tension band construct that utilizes additional wires and multiple tension bands to gather and fix comminuted fracture patterns in non-transverse planes, bolster osteoporotic bone, and secure fractures in patients undergoing a revision and/or have potential to be poorly compliant with postoperative activity restrictions...
August 24, 2016: Journal of Orthopaedic Trauma
Alexander B Christ, Elizabeth B Gausden, Stephen J Warner, Andrew M Nellestein, Ryan Thacher, Dean G Lorich
Antegrade intramedullary nails are an established, effective method of fixation for humeral shaft fractures. One significant limitation of this technique is chronic post-operative shoulder pain, which is likely related to the standard approach that involves splitting the rotator cuff to gain access to the nail starting point. Furthermore, mounting evidence suggests that both the intra-articular portion of the biceps tendon and the extra-articular portion in the bicipital groove can scar down after trauma, causing pain and limiting shoulder range-of-motion...
August 23, 2016: Journal of Orthopaedic Trauma
Robert J Wetzel, Laurence B Kempton, Edwin S Lee, Michal Zlowodzki, Todd O McKinley, Walter W Virkus
OBJECTIVES: We hypothesized that negligible surgical material cost variation exists between traumatolgists for treatment of bimalleolar ankle and bicondylar tibial plateau fractures. DESIGN: Retrospective medical record review. SETTING: Academic Level 1 Trauma Center; 2-year period. PATIENTS/PARTICIPANTS: Common Procedure Terminology (CPT) codes for open treatment of bimalleolar ankle and bicondylar tibial plateau fractures identified patients...
August 23, 2016: Journal of Orthopaedic Trauma
Katharine I Mangan, Trevor D Kingsbury, Brittney N Mazzone, Marilynn P Wyatt, Kevin M Kuhn
OBJECTIVES: To determine if there is a difference in functional gait outcomes between patients with limb injuries treated with either transtibial amputation or limb preservation with Intrepid Dynamic Exoskeletal Orthosis (IDEO). DESIGN: Retrospective prognostic study. SETTING: Tertiary referral military hospital. PATIENTS: This study included 10 transtibial amputees and ten limb preservation patients using the IDEO who were matched by body mass index after excluding for non-traumatic, proximal ipsilateral, contralateral, spine or traumatic brain injuries...
August 23, 2016: Journal of Orthopaedic Trauma
Meir Marmor, Gudrun Mirick, Amir Matityahu
BACKGROUND: During osteosynthesis standard non locking cortical screws often require reinsertion, raising concern over possible decrease in their effectiveness. This study aims to quantify that potential loss of fixation with reinsertions as well as examine the ability of a cancellous "bailout screw" to regain insertion torque in a previously stripped screw hole. METHODS: Four different types of bone surrogates were chosen to represent normal cortical bone, osteoporotic cortical bone, high density (normal) cancellous bone and low density (osteoporotic) cancellous bone; non locked 3...
August 23, 2016: Journal of Orthopaedic Trauma
Douglas S Weinberg, Heather A Vallier, Gregory A Gaumer, Daniel R Cooperman, Raymond W Liu
OBJECTIVES: Recent data has challenged the historical precedent of non-operative care for many clavicle fractures; clinical and biomechanical studies have shown altered joint-contact forces occur in the glenohumeral joint (GHJ) following fracture and shortening of the clavicle. However, to date, there have been no analyses documenting the long-term effects of these altered shoulder-girdle mechanics on the GHJ. METHODS: The clavicles of 2899 cadaveric skeletons were manually inspected for evidence of fracture...
August 11, 2016: Journal of Orthopaedic Trauma
Jamal Ahmad, Kennis Jones
OBJECTIVE: This study's objective is to compare outcomes of bioabsorbable versus steel screws for treating Lisfranc injuries. DESIGN: This research was conducted in a prospective and randomized manner between September 2008 and December 2013. SETTING: This study was performed in the outpatient setting at a tertiary-level care center in a single surgeon's practice. PATIENTS/PARTICIPANTS: Forty patients with acute Lisfranc injuries, amenable to open reduction and screw fixation, enrolled and presented for final follow-up...
August 5, 2016: Journal of Orthopaedic Trauma
Dafang Zhang, Matthew Tarabochia, Stein Janssen, David Ring, Neal Chen
OBJECTIVE: The management of terrible triad injuries has evolved over the last two decades to include routine radial head fixation or replacement, reattachment of the LCL, with or without coronoid fixation. Our objective was to determine the likelihood of and factors associated with subluxation or dislocation after operative treatment of terrible triad injuries among a large group of surgeons using current techniques. DESIGN: Retrospective cohort study SETTING:: Two Level I trauma centers PATIENTS/PARTICIPANTS:: A total of 107 patients with operatively treated terrible triad injuries from January 2000 to June 2015...
July 29, 2016: Journal of Orthopaedic Trauma
Robert-Jan O de Muinck Keizer, Diederik T Meijer, Bonheur A T D van der Gronde, Teun Teunis, Sjoerd A S Stufkens, Gino M Kerkhoffs, J Carel Goslings, Job N Doornberg
OBJECTIVES: Despite advanced imaging techniques, classic measurements of fracture reduction have not been revisited to date.The purpose of this study was to evaluate reliability of innovative measurement techniques to quantify operative fragment reduction of posterior malleolar fractures by quantification of three-dimensional computed tomography (Q3DCT). METHODS: Twenty-eight ankle fractures including a posterior malleolar fragment (AO/OTA type 44) were evaluated using 2DCT and Q3DCT to postoperatively quantify fragment reduction...
July 29, 2016: Journal of Orthopaedic Trauma
Catherine L Ward, Beth E Pollot, Stephen M Goldman, Sarah M Greising, Joseph C Wenke, Benjamin T Corona
OBJECTIVES: The traumatic loss of muscle tissue, defined as volumetric muscle loss (VML) injury, has no definitive therapy. The purposes of this study were: 1) to develop a porcine model of VML and 2) to investigate autologous minced muscle grafts (1mm pieces of muscle) as a potential therapeutic. Minced grafts were evaluated because they have promoted fiber regeneration and functional recovery in rat VML models and do not require FDA approval for clinical use. METHODS: In five female Yorkshire Cross pigs, ≈5 grams (≈20%) of tissue were excised from the peroneous tertius (PT) muscle (≈3cm x 3cm x 1...
July 27, 2016: Journal of Orthopaedic Trauma
Stefano Muscatelli, Hayley Spurr, Nathan N O'Hara, Lyndsay M O'Hara, Sheila A Sprague, Gerard P Slobogean
OBJECTIVES: This study aims to systematically assess the existing literature and to derive a pooled estimate of the prevalence of depression and post-traumatic stress disorder (PTSD) in adult patients following acute orthopaedic trauma. DATA SOURCES: A comprehensive search of databases including MEDLINE, Embase, PsycINFO, and Cochrane Central Register of Controlled Trials (CENTRAL) databases was conducted through June 2015. STUDY SELECTION: We included studies that assessed the prevalence of depression or PTSD in patients who experienced acute orthopedic trauma to the appendicular skeleton or pelvis...
July 26, 2016: Journal of Orthopaedic Trauma
(no author information available yet)
No abstract text is available yet for this article.
October 2016: Journal of Orthopaedic Trauma
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