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Journal of Orthopaedic Trauma

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https://www.readbyqxmd.com/read/27861456/dynamic-stabilization-of-simple-fractures-with-active-plates-delivers-stronger-healing-than-conventional-compression-plating
#1
Michael Bottlang, Stanley Tsai, Emily K Bliven, Brigitte von Rechenberg, Philipp Kindt, Peter Augat, Julia Henschel, Daniel C Fitzpatrick, Steven M Madey
OBJECTIVES: Active plates dynamize a fracture by elastic suspension of screw holes within the plate. We hypothesized that dynamic stabilization with active plates delivers stronger healing relative to standard compression plating. METHODS: Twelve sheep were randomized to receive either a standard compression plate (CP) or an active plate (ACTIVE) for stabilization of an anatomically reduced tibial osteotomy. In the CP group, absolute stabilization was pursued by interfragmentary compression with six cortical screws...
November 16, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27798553/misuse-of-opioids-in-orthopaedic-post-operative-patients
#2
Gangavalli Anup, Malige Ajith, Terres George, Rehman Saqib, Nwachuku Chinenye
OBJECTIVE: In light of the recent uptrend in the prescription of opioids, this study seeks to identify patterns of opioid misuse among orthopaedic post-operative patients and principal external sources in obtaining these medications. DESIGN: Ten-month survey based study. SETTING: Two Level-I trauma centers (urban and suburban). PATIENTS/PARTICIPANTS: 207 patients between the ages of 18 to 89 years who underwent surgical fixation of fractures involving the pelvis, long bones or peri-articular regions of the knee, ankle, elbow and wrist...
October 26, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27798552/positional-change-in-displacement-of-midshaft-clavicle-fractures-an-aid-to-initial-evaluation
#3
Awais Malik, Ehsan Jazini, Xuyang Song, Herman Johal, Nathan O'Hara, Gerard Slobogean, Joshua M Abzug
OBJECTIVES: To determine how change in position affects displacement of midshaft clavicle fractures. DESIGN: Retrospective review. SETTING: Level I Trauma Center. PATIENTS: Eighty patients with displaced midshaft clavicle fractures and presence of supine and semi-upright/upright chest radiographs taken within 2 weeks of each other. INTERVENTION: Supine, semi-upright and upright chest radiographs...
October 26, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27775999/invited-commentary
#4
James J Hutson
No abstract text is available yet for this article.
October 19, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27755334/reliability-and-reproducibility-of-the-ota-ao-classification-for-humeral-shaft-fractures
#5
Kiran C Mahabier, Esther M M Van Lieshout, Boyd C Van Der Schaaf, Gert R Roukema, Bas J Punt, Michael H J Verhofstad, Dennis Den Hartog
OBJECTIVES: This study aimed to determine inter-observer reliability and intra-observer reproducibility of the OTA/AO classification for humeral shaft fractures, and to evaluate differences between fracture types, fracture groups, and surgical specializations. METHODS: 30 observers (25 orthopedic trauma surgeons and five general orthopedic surgeons) independently classified 90 humeral shaft fractures according to the OTA/AO classification. Patients of 16 years and older were included...
October 13, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27755333/biomechanical-evaluation-of-the-femoral-neck-system-in-unstable-pauwels-iii-femoral-neck-fractures-a-comparison-to-the-dynamic-hip-screw-and-cannulated-screws
#6
Karl Stoffel, Ivan Zderic, Florian Gras, Christoph Sommer, Ursula Eberli, David Mueller, Martin Oswald, Boyko Gueorguiev
OBJECTIVES: To evaluate the biomechanical performance of Femoral Neck System (FNS) in comparison to established methods for fixation of femoral neck fractures in a cadaveric model. METHODS: Twenty pairs of fresh-frozen human cadaveric femora were instrumented either with DHS-Screw, DHS-Blade, 3CS or with FNS in a partially paired design. The specimens were randomized to two paired treatment groups based on the BMD, namely DHS-Screw/DHS-Blade and FNS/3CS. A reduced unstable femoral neck fracture with postero-caudal comminution, AO/OTA 31-B2...
October 13, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27755332/the-debilitating-effects-of-femoral-nonunion-on-health-related-quality-of-life
#7
Mark R Brinker, Akash Trivedi, Daniel P O'Connor
OBJECTIVE: The purpose of this study is to report the extent of the effects of femoral nonunion on health-related quality of life. DESIGN: Retrospective cohort. SETTING: Tertiary referral center. PATIENTS/PARTICIPANTS: 187 consecutive patients (85 women, age 55.9 ± 16.9 years; 102 men, age 42.8 ± 16.1 years) with 188 nonunions of the femur, excluding those involving the hip or knee articular surfaces. INTERVENTION: Average nonunion duration was 28...
October 13, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27755331/the-effect-of-varying-tension-of-a-suture-button-construct-in-fixation-of-the-tibiofibular-syndesmosis-evaluation-using-stress-computed-tomography
#8
John Morellato, Hakim Louati, Andrew Bodrogi, Andrew Stewart, Steven Papp, Allan Liew, Wade Gofton
BACKGROUND/PURPOSE: There have been no studies assessing the optimal biomechanical tension of suture button constructs. The purpose of this study was to assess optimal tensioning of suture button fixation and its ability to maintain reduction under loaded conditions using a stress computed tomography (CT) model. METHODS: Ten cadaveric lower limbs disarticulated at the knee were used. The limbs were placed in a modified ankle load frame that allowed for the application of sustained torsional axial, or combined torsional/axial loads...
October 13, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27755340/allg%C3%A3-wer-donati-versus-vertical-mattress-suture-technique-impact-on-perfusion-in-ankle-fracture-surgery-a-randomized-clinical-trial-using-intra-operative-angiography
#9
Steven F Shannon, Matthew T Houdek, Cody C Wyles, Brandon J Yuan, William W Cross, Joseph R Cass, Stephen A Sems
OBJECTIVE: The purpose of this study was to evaluate which primary wound closure technique for ankle fractures affords the most robust perfusion as measured by laser-assisted indocyanine green angiography (LA-ICGA): Allgöwer-Donati or vertical mattress. DESIGN: Prospective, randomized. SETTING: Level 1 Academic Trauma Center. PATIENTS/PARTICIPANTS: Thirty patients undergoing open reduction internal fixation (ORIF) for ankle fractures were prospectively randomized to Allgöwer-Donati (n=15) or vertical mattress (n=15) closure...
October 7, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27755339/institutional-and-seasonal-variations-in-the-incidence-and-causative-organisms-for-post-traumatic-wound-infections-and-osteomyelitis-after-open-fractures
#10
H Claude Sagi, David Donohue, Seth Cooper, David P Barei, Justin Siebler, Michael T Archdeacon, Marcus Sciadini, Michelle Romeo, Patrick F Bergin, Thomas Higgins, Hassan Mir
OBJECTIVES: The current literature focuses on wound severity, time to debridement and antibiotic administration with respect to risk of infection after open fracture. The purpose of this analysis was to determine if either the incidence of post-traumatic infection or causative organism varies with treating institution or the season in which the open fracture occurred. DESIGN: Retrospective review. SETTING: Seven level-one regional referral trauma centers located in each of the seven climatic regions of the continental United States (Northwest; High Plains; Midwest/Ohio Valley; New England/Mid-Atlantic; Southeast; South; and Southwest)...
October 7, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27755338/effectiveness-of-treatment-for-distal-tibial-nonunions-with-associated-complex-deformities-utilizing-a-hexapod-external-fixator
#11
John Arvesen, J Tracy Watson, Heidi Israel
OBJECTIVE: To determine the efficacy of a hexapod external fixator (TSF) and its ability to perform six-axis correction in restoring deformities associated with distal tibial nonunions. DESIGN: Consecutive retrospective case review. SETTING: St. Louis University Hospital. Level One Trauma Center. PATIENTS/PARTICIPANTS: 37 patients with distal tibial nonunion with greater than 5 degrees of deformity in any plane. Patients were excluded who were less than 18 years of age, had tibial deformities less than 5 degrees, had proximal or middle tibial deformities or had less than one year of follow up...
October 7, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27755337/incidence-risk-factors-and-location-of-articular-malreductions-of-the-tibial-plateau
#12
Brad Meulenkamp, C Ryan Martin, Nicholas Desy, Paul Duffy, Rob Korley, Shannon Puloski, Richard Buckley
OBJECTIVES: To define the incidence, risk factors and anatomic location of articular malreductions in operatively treated lateral tibial plateau fractures DESIGN:: Prospective Cohort Study SETTING:: Academic Level 1 Trauma CentrePatients/Participants: Study subjects were patients entered into a prospective cohort study of tibial plateau fractures. INTERVENTIONS: Surgical Fixation of tibial plateau fractures and post-operative computed tomography (CT) scans. MAIN OUTCOME MEASURES: The primary outcome was incidence of articular malreduction...
October 7, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27755336/apc-injuries-with-symphyseal-fixation-what-affects-outcome
#13
Kyle Lybrand, Anthony Bell, Deirdre Rodericks, David Templeman, Paul Tornetta
OBJECTIVE: To evaluate the influence of the symphyseal position at union, implant failure, and the type of posterior ring injury on validated outcome measures. DESIGN: Retrospective review with prospectively collected validated outcome data SETTING:: Two academic Level 1 trauma centersPatients/Participants: We evaluated 54 patients with operatively treated anterior-posterior compression (APC) type 2 and 3 injuries. INTERVENTION: Thirty-five APC type 2 and 19 APC type 3 injuries were reviewed at a minimum of 2 years after surgery...
October 7, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27755335/fat%C3%A4-gue-fa%C3%A4-lure-in-extra-art%C3%A4-cular-prox%C3%A4-mal-t%C3%A4-b%C3%A4-a-fractures-lock%C3%A4-ng-%C3%A4-ntramedullary-na%C3%A4-l-vs-double-lock%C3%A4-ng-plates
#14
Utku Kandemir, Safa Herfat, Mary Herzog, Paul Viscogliosi, Murat Pekmezci
OBJECTIVES: The goal of this study is to compare the fatigue strength of a locking intramedullary nail (LN) construct to a double locking plate (DLP) construct in comminuted proximal extra-articular tibia fractures. METHODS: Eight pairs of fresh frozen cadaveric tibias with low bone mineral density (Age: 80 ± 7 (SD) years, T-score: -2.3 ± 1.2) were used. One tibia from each pair was fixed with LN while the contralateral side was fixed with DLP for complex extra-articular multifragmentary, metaphyseal fractures (simulating OTA41-A3...
October 7, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27749508/comparison-of-outcomes-and-complications-of-isolated-acetabular-fractures-and-acetabular-fractures-with-associated-non-acetabular-injuries
#15
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
https://www.readbyqxmd.com/read/27763961/no-incidence-of-postoperative-knee-sepsis-with-suprapatellar-nailing-of-open-tibia-fractures
#16
Phillip M Mitchell, Benjamin M Weisenthal, Cory A Collinge
OBJECTIVE: To evaluate the incidence of knee sepsis following suprapatellar nailing of open tibia fractures. DESIGN: Retrospective SETTING:: ACS Level 1 trauma centerPatients/Participants: We reviewed 139 open tibia fractures that underwent suprapatellar nailing as definitive treatment over a five-year period (January 1, 2011 to January 1, 2016). The majority of patients (90%, n=126) underwent intramedullary nailing at the time of their initial surgery. We defined knee sepsis as intra-articular infection requiring operative debridement, either open or arthroscopically, within one month's time...
October 1, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27763960/does-a-staged-posterior-approach-have-a-negative-effect-on-ota-43c-fracture-outcomes
#17
Daniel S Chan, Paul M Balthrop, Brian White, David Glassman, Roy W Sanders
OBJECTIVE: To determine whether multiple approaches pose an increased risk to fracture healing when compared to a standard single approach in the treatment of pilon (OTA 43C) fractures. DESIGN: Retrospective review of a prospective database. SETTING: Level I academic trauma center and level II community trauma center. METHODS: From January 1, 2005 to December 31, 2011, all records of patients treated for OTA 43C fractures of the distal tibia were reviewed...
October 1, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27763959/mortality-following-surgical-management-of-vancouver-b-periprosthetic-fractures
#18
Ida Leah Gitajn, Marilyn Heng, Michael J Weaver, Natalie Casemyr, Collin May, Mark S Vrahas, Mitchel B Harris
OBJECTIVES: The goals of this study are to evaluate mortality after Vancouver B periprosthetic fractures and determine predictors of mortality; compare mortality among patients with loose femoral stems treated with revision arthroplasty versus fixation alone; compare mortality among patients with radiographically "indeterminate" fractures treated with revision or fixation; evaluate the rate of return to surgery for patients who underwent revision compared to fixation. DESIGN: Retrospective study SETTING:: Three academic level 1 trauma centersPatients/Participants: 203 patients treated for Vancouver B periprosthetic fractures INTERVENTION:: N/A MAIN OUTCOME MEASUREMENTS:: The primary outcome measure was mortality...
October 1, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27763958/a-multi-centre-randomized-control-trial-comparing-a-novel-intramedullary-device-intertan-versus-conventional-treatment-sliding-hip-screw-of-geriatric-hip-fractures
#19
David Sanders, Dianne Bryant, Christina Tieszer, Abdel Lawendy, Mark MacLeod, Steven Papp, Liew Allan, Viskontas Darius, Coles Chad, Gurr Kevin, Carey Tim, Gofton Wade, Bailey Chris, Bartley Debra, Andrew Trenholm, Stone Trevor, Leighton Ross, Julia Foxall, Mauri Zomar, Kelly Trask
OBJECTIVES: To compare outcomes in elderly patients with intertrochanteric hip fractures treated with either the sliding hip screw (SHS) or InterTAN intramedullary device (IT). DESIGN: Prospective, randomized, multi-centre clinical trial SETTING:: Five level 1 trauma centresPatients/Participants: 249 patients aged 55 years or older with AO/OTA 31A1 (43) and OA/OTA 31A2 (206) fractures were prospectively enrolled and followed for 12 months. INTERVENTION: Computer generated randomization to either IT (n=123) or SHS (n=126)...
September 30, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27682020/use-of-inlet-obturator-oblique-view-leeds-view-for-placement-of-posterior-wall-screws-in-acetabular-fracture-surgery
#20
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
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