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Journal of Orthopaedic Trauma

Natalie C Rollick, Jessica Bear, Owen Diamond, David S Wellman, David L Helfet
No abstract text is available yet for this article.
January 9, 2019: Journal of Orthopaedic Trauma
Sung-Weon Jung, Dong-Hee Kim, Seung-Hoon Kang, Yil-Ju Eho, Seong-Wook Yang, Gwang-Eun Lee
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. PATIENTS/PARTICIPANTS: Seventy-six patients who were surgically treated for terrible triad injury of the elbow. INTERVENTION: Review of charts and standardized X-ray images before surgery and 2 years after surgery...
January 9, 2019: Journal of Orthopaedic Trauma
Karan Rao, Kevin Dibbern, Molly Day, Natalie Glass, J Lawrence Marsh, Donald D Anderson
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...
January 8, 2019: Journal of Orthopaedic Trauma
Dane J Brodke, Saam Morshed
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. PARTICIPANTS: Two hundred forty thousand three hundred seventy-six patients who underwent open reduction and internal fixation (ORIF) of a fracture of the radius/ulna, tibia/fibula, or humerus between 2006 and 2010 in Texas or New York, or between 2010 and 2014 in California or Florida...
January 8, 2019: Journal of Orthopaedic Trauma
Jason Shah, Alexander J Titus, Robert V O'Toole, Marcus F Sciadini, Christina Boulton, Renan Castillo, Stephen Breazeale, Carrie Schoonover, Peter Berger, I Leah Gitajn
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...
January 8, 2019: Journal of Orthopaedic Trauma
Alexander L Kuzma, T David Luo, Michael De Gregorio, Grayson D Coon, Kerry Danelson, Jason J Halvorson, Eben A Carroll, Arun Aneja
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. Absolute screw force is the final screw force...
January 8, 2019: Journal of Orthopaedic Trauma
Allison Binkley, Charles Mehlman, Ellen Freeh
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...
January 8, 2019: Journal of Orthopaedic Trauma
Jinhee Park, Yunsik Cha, Michael Seungcheol Kang, Soo-Sung Park
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...
January 8, 2019: Journal of Orthopaedic Trauma
Paul Baldwin, Deborah J Li, Darryl A Auston, Hassan S Mir, Richard S Yoon, Kenneth J Koval
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. Soft tissue from the humerus was dissected away, leaving only the triceps tendon and ulnar insertions intact...
January 8, 2019: Journal of Orthopaedic Trauma
Paul Baldwin, Deborah J Li, Darryl A Auston, Hassan S Mir, Richard S Yoon, Kenneth J Koval
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...
January 8, 2019: Journal of Orthopaedic Trauma
Malcolm R DeBaun, Michael J Chen, Julius A Bishop, Michael J Gardner, Robin N Kamal
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. DATA EXTRACTION: Clinical practice guidelines were included as candidate quality measures if their development was in accordance with the Institute of Medicine criteria for development of clinical practice guidelines, were based on consistent clinical evidence including at least one Level I study, and carried the strongest possible recommendation by the developing body...
January 7, 2019: Journal of Orthopaedic Trauma
Sean T Campbell, Liam C Bosch, Steven Swinford, Derek F Amanatullah, Julius A Bishop, Michael J Gardner
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. SETTING: All patients underwent TKA at a large university hospital. INTERVENTION: Standard length pre-contoured distal femur locking plates from four manufacturers were digitally templated onto each patient's pre- and post-TKA radiographs...
January 3, 2019: Journal of Orthopaedic Trauma
Jonathan G Eastman, Jacob H Fennessy, Bradley Deafenbaugh, Milton L Chip Routt
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...
January 2, 2019: Journal of Orthopaedic Trauma
Kenton Panas, Jonathan Wojcik, Spencer Falcon, Kimberly Hollabaugh, Lindsay Hickerson
OBJECTIVES: To assess possible breaches of sterility during the initial gowning step. DESIGN: Observational study. 27 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. The lower portion of the technician's gown was coated with resin powder prior to the gowning process to simulate contamination. SETTING: Single-institution level 1 trauma center...
January 1, 2019: Journal of Orthopaedic Trauma
Jacob M Wilson
OBJECTIVE: To examine the relationship of nutrition parameters with the modified frailty index (mFI) and post-operative complications in hip fracture patients. DESIGN: Retrospective Observational Cohort Study SETTING:: Urban, American College of Surgeons (ACS) Verified Level 1 Trauma CenterPatients/Participants: 377 consecutive patients with isolated hip fractures. INTERVENTION: N/A MAIN OUTCOME MEASUREMENT:: Admission albumin and total lymphocyte count (TLC) levels and complication data was collected...
December 13, 2018: Journal of Orthopaedic Trauma
Lyubomir Rusimov, Ivan Zderic, Daniel Ciric, Jan P Barcik, Dian Enchev, Mihail Rashkov, Mariya Hadzhinikolova, R Geoff Richards, Boyko Gueorguiev, Asen Baltov
OBJECTIVES: To investigate the biomechanical competence of locked plating augmented with supplemental intramedullary graft in comparison to conventional locked plate fixation in proximal humerus fractures METHODS:: Complex four-part proximal humerus fractures were set in thirty artificial humeri assigned to three study groups (n=10 in each group). Group 1 was characterized by loss of medial support, group 2 - by simulated severe cancellous bone damage due to osteoporosis and group 3 - by combination of the two features...
December 13, 2018: Journal of Orthopaedic Trauma
Louis R Lewandowski, Benjamin K Potter, Clinton K Murray, Joseph Petfield, Daniel Stinner, Margot Krauss, Amy C Weintrob, David R Tribble
OBJECTIVES: What are the risk factors for osteomyelitis development in United States military personnel with combat-related, open femur fractures? DESIGN: Retrospective observational case-control study. SETTING: U.S. military regional hospital in Germany and tertiary care hospitals in United States (2003-2009). PATIENTS/PARTICIPANTS: One hundred and three patients with open femur fractures who met diagnostic osteomyelitis criteria (medical record review verification) were classified as cases...
December 13, 2018: Journal of Orthopaedic Trauma
Annika Willems
OBJECTIVES: Nonunions after bone fractures are usually treated surgically with risk of infections and failure of osteosynthesis. A noninvasive alternative is extracorporeal shock wave treatment (ESWT), which potentially stimulates bone regeneration. Therefore this review investigates whether ESWT is an effective and safe treatment for delayed-unions and nonunions. DATA SOURCES:, Medline ovid, Cochrane, Web-of-science, Pubmed publisher and Google scholar were systematically searched...
December 13, 2018: Journal of Orthopaedic Trauma
Ishaq Ibrahim, Andrew Johnson, Edward K Rodriguez
OBJECTIVE: To systematically review the existing literature to determine if knee pain and function following intramedullary nailing of tibial shaft fractures differs significantly by surgical technique - specifically with semi-extended nailing versus traditional infrapatellar approaches. DATA SOURCE: A comprehensive search of Pubmed/MEDLINE, EMBASE and the Cochrane Database was conducted on August 15, 2018. STUDY SELECTION: We included level I to level III studies that examined outcomes of tibial intramedullary nailing utilizing a semi-extended technique...
December 13, 2018: Journal of Orthopaedic Trauma
Abhiram R Bhashyam, Matthew Basilico, Michael J Weaver, Mitchel B Harris, Marilyn Heng
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...
December 12, 2018: Journal of Orthopaedic Trauma
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