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Journal of Orthopaedic Trauma

Phillip M Mitchell, Cory A Collinge, David E O'Neill, Jesse E Bible, Hassan R Mir
OBJECTIVES: To determine whether sarcopenia is an independent predictor of mortality in geriatric acetabular fractures. DESIGN: Retrospective cohort. SETTING: ACS Level I trauma center. PATIENTS/PARTICIPANTS: One hundred and forty-six patients over the age 60 with acetabular fractures treated at our institution over a 12-year period. MAIN OUTCOME MEASUREMENTS: The primary outcome was 1-year mortality, collected using the Social Security Death Index...
March 5, 2018: Journal of Orthopaedic Trauma
Christopher M Daniels, Gabriel J Pavey, Jacob Arthur, Michael Noller, Jonathan A Forsberg, Benjamin K Potter
OBJECTIVES: We sought to determine what proportion of residual limbs formed heterotopic ossification (HO) in amputations sustained by US service members, the injury profile of these amputations, and what effect the number of limb amputations sustained has on resource utilization. DESIGN: Retrospective review. SETTING: A tertiary military medical center. PATIENTS: Four-hundred seventy-one consecutive patients with 714 combat-related amputations were treated at our institution between September 2009 and August 2014...
March 5, 2018: Journal of Orthopaedic Trauma
Mohammed Saquib Hussain, Steven Kyle Dailey, Frank R Avilucea
With an aging population, treatment of interprosthetic femur fractures continues to pose a challenge to the orthopedic surgeon. Retrograde IMN combined with open reduction internal fixation utilizing a tissue-preserving plating technique was used in our series of 9 patients with non-comminuted, distal femur fractures. No interfragmentary screws, cables, cerclage wires, or supplemental bone grafts of any type were used. Each patient initiated weight-bearing as tolerated following operative intervention. Every fracture healed at an average of 20 weeks (range 18 to 24 weeks)...
February 23, 2018: Journal of Orthopaedic Trauma
Diederik O Verbeek, Jelle P van der List, Gele B Moloney, David S Wellman, David L Helfet
Quality of reduction following acetabular fracture surgery is an important predictor for clinical outcome. Computed tomography likely superior to plain pelvic radiography for assessment of postoperative reduction but interobserver reliability may be limited in the absence of a widely adopted technique. We describe a standardized digital CT-based method for measuring residual (gap and step) displacement on CT following acetabular fracture surgery. In a selection of patients, we determined the interobserver reliability for measuring displacement and grading quality of reduction on postoperative pelvic radiography and CT with and without the use of this novel technique...
February 23, 2018: Journal of Orthopaedic Trauma
Brett D Crist, Troy D Pashuck
OBJECTIVES: To determine the reliability of a condensed computer-based condensed patient-centered outcome score system versus multiple standard uncondensed validated outcome scores used in orthopaedic trauma. DESIGN: Prospective SETTING:: Level I trauma centerPatients/Participants: One hundred patients older than 18 years with various orthopaedic injuries were evaluated at a Level I trauma clinic. INTERVENTION: Study participants were randomly assigned to complete the paper-based and computer-based versions of the EQ-5D and Musculoskeletal Functional Assessment (MFA) at different times during the same visit...
February 20, 2018: Journal of Orthopaedic Trauma
Tammie Teo, Emily Schaeffer, Anthony Cooper, Kishore Mulpuri
OBJECTIVES: To evaluate whether immediate (0-3 day) postoperative radiography leads to alterations in management for patients post-fracture fixation. DATA SOURCES: Systematic review of English-language articles in the MEDLINE (1946-2016), EMBASE (1974-2016), CDSR (2005-2016), CENTRAL (1948-2016) and Google Scholar databases using PRISMA guidelines. STUDY SELECTION: Randomized or non-randomized controlled trials and prospective or retrospective cohort studies that addressed surgical management of upper extremity, lower extremity or hip fractures were eligible for review...
February 20, 2018: Journal of Orthopaedic Trauma
Duncan C Ramsey, Darin M Friess
OBJECTIVES: To evaluate the cost-effectiveness of suture buttons compared to syndesmotic screws for repair of tibiofibular syndesmotic injuries. METHODS: A decision-tree model was constructed to describe outcomes after syndesmosis repair using suture buttons and syndesmotic screws from the perspective of a capitated healthcare system. Outcomes were uneventful healing, removal of symptomatic implants, deep infection, and persistent diastasis requiring revision. Weighted literature averages were used to estimate variables for a baseline model...
February 20, 2018: Journal of Orthopaedic Trauma
Martin C Jordan, Konrad Fuchs, Timo M Heintel, Hendrik Jansen, Stefanie Hoelscher-Doht, Rainer H Meffert
PURPOSE: To compare fixed- or variable-angle locking screws in calcaneal fracture plates using a sawbones biomechanical model. METHODS: Intra-articular calcaneal fractures were created in synthetic bones. Reduction and stabilization was performed with three different plates. In Group A, a fixed-angle locking plate was used with screws fastened perpendicularly to the plate (3.5 LCP, DePuySynthes). In Groups B and C (2.7 VA-LCP, DePuySynthes and 3.5 Aptus, Medartis, respectively), fracture fixation was performed using variable-angle locking plates...
February 9, 2018: Journal of Orthopaedic Trauma
Ashok S Gavaskar, Naveen C Tummala, Parthasarathy Srinivasan, Hitesh Gopalan, Bhupesh Karthik, S Santhosh
OBJECTIVES: To compare the radiological and clinical results with PFNA - II and InterTan in the treatment of unstable trochanteric fractures in the elderly DESIGN:: Retrospective, multi-center, matched pair SETTING:: 3 tertiary level trauma centres PATIENTS:: 100 elderly patients who underwent intramedullary stabilisation with either the PFNA - II or the InterTan for osteoporotic unstable trochanteric fractures. INTERVENTIONS: 50 matched pairs consisting of AO - A2 and A3 fractures were created from a cohort of 290 patients who underwent internal fixation for unstable trochanteric fractures with the PFNA - II or InterTan nails...
February 9, 2018: Journal of Orthopaedic Trauma
Nathan A Franklin, Ashley Ali, Richard K Hurley, Hassan R Mir, Michael J Beltran
OBJECTIVE: Evaluate the pre-hospital use of Direct Oral Anticoagulant (DOAC) agents on the outcomes of early surgical fixation of a geriatric hip fracture. DESIGN: Case-Control. SETTING: Two academic level 1 trauma centers. INTERVENTION: Early (<48h) surgical fixation of a geriatric proximal femur fracture. PATIENTS: 19 patients receiving Pradaxa (Dabigatran), Eliquis (Apixaban), or Xarelto (Rivaroxaban) who underwent surgery between 2010 and 2015 and 74 control patients...
February 9, 2018: Journal of Orthopaedic Trauma
Gabrielle M Paci, Kali R Tileston, John S Vorhies, Julius A Bishop
OBJECTIVES: After-hours surgery for pediatric supracondylar humerus fractures may be suboptimal due to surgeon fatigue, limited resources, and variations in comfort with pediatric fracture care. This study compared the outcomes of pediatric supracondylar humerus fractures treated during daytime hours to those treated after-hours. DESIGN: Retrospective SETTING:: Academic level I trauma centerPatients/Participants: 298 pediatric patients treated with surgical reduction and fixation of closed supracondylar fractures were included...
February 9, 2018: Journal of Orthopaedic Trauma
Nathaniel T Ondeck, Patawut Bovonratwet, Izuchukwu K Ibe, Daniel D Bohl, Ryan P McLynn, Jonathan J Cui, Michael R Baumgaertner, Jonathan N Grauer
OBJECTIVES: The Charlson Comorbidity Index (CCI), Elixhauser's Comorbidity Measure (ECM), and the modified Frailty Index (mFI) have been associated with mortality following hip fracture. The present study compares the clinically informative discriminative ability of CCI, ECM, and mFI as well as demographic characteristics for predicting in-hospital adverse outcomes following surgical management of hip fractures. METHODS: Patients undergoing hip fracture surgery were selected from the 2013 National Inpatient Sample...
January 30, 2018: Journal of Orthopaedic Trauma
G David Potter, Daniel Mascarenhas, Marcus F Sciadini, Anthony R Carlini, Robert V O'Toole, Raymond A Pensy
OBJECTIVE: To assess whether "center-center" position is ideal starting point for minimum fracture displacement when placing an intramedullary screw in the ulna. METHODS: Thirty-six arms (average age, 82 years) underwent a posterior approach to the olecranon and were randomized into 3 groups: center-center (center in sagittal plane, center in coronal plane), posterior-lateral (posterior in sagittal plane, lateral in coronal plane), posterior-medial (posterior in sagittal plane, medial in coronal plane)...
January 30, 2018: Journal of Orthopaedic Trauma
David Kugelman, Abdullah Qatu, Jack Haglin, Sanjit Konda, Kenneth Egol
OBJECTIVES: To assess the role self-reported treatment for a psychiatric diagnoses may play in long-term functional outcomes following operatively managed tibial plateau fractures. DESIGN: Prospective cohort study. SETTING: Academic medical center. PATIENTS: Over an 11 year period, patients were screened and identified on presentation to the emergency department or in the clinical office for inclusion in an IRB approved registry...
January 30, 2018: Journal of Orthopaedic Trauma
Bryce A Cunningham, Daniel P O'Connor, Mark R Brinker
OBJECTIVE: To evaluate healing rate of aseptic nonunions of the distal third of the tibia treated with Ilizarov slow gradual compression and deformity correction. DESIGN: Retrospective cohort. SETTING: Tertiary referral center. PATIENTS/PARTICIPANTS: 94 consecutive adult patients with 94 distal third tibial aseptic nonunions. INTERVENTION: Ilizarov external fixation and slow gradual compression; most patients also had bone grafting or deformity correction or both prior to initiating compression...
January 30, 2018: Journal of Orthopaedic Trauma
Sanjit Reddy Konda, Abraham Michael Goch, Jack Haglin, Kenneth Andrew Egol
OBJECTIVES: To assess clinical and hospital quality outcomes of patients receiving the previously reported Reduced Effective Dose Using Computed Tomography In Orthopaedic iNjury (REDUCTION) imaging protocol. DESIGN: Retrospective Chart review SETTING:: Level I Trauma Center and affiliated Tertiary Care Hospital CenterPatients/Participants: fifty patients who received this protocol for acute traumatic fracture evaluation and met inclusion criteria were compared to a cohort of fifty patients matched for age and fracture type who previously received conventional CT scanning for acute traumatic fracture evaluation...
January 30, 2018: Journal of Orthopaedic Trauma
James Paul Hovis, Ryan Montalvo, Dimitrius Marinos, Manjari Joshi, Mark Shirtliff, Theodore T Manson, Robert V O'Toole
OBJECTIVES: To evaluate the effectiveness of intraoperative vancomycin powder in prevention of surgical site infection and biofilm formation on implants in a contaminated animal fixation model. METHODS: We created a rabbit surgical model including fixation implants at a tibial surgical site seeded with methicillin-resistant Staphylococcus aureus. Our study cohort included 18 rabbits. Nine received vancomycin powder at the surgical site, and the other 9 did not. Serum vancomycin levels were measured at scheduled time points over 24 hours...
January 30, 2018: Journal of Orthopaedic Trauma
Petra Gheraibeh, Rahul Vaidya, Ian Hudson, Robert Meehan, Frederick Tonnos, Anil Sethi
OBJECTIVES: To prevent leg length discrepancy (LLD) after locked femoral nailing in patients with comminuted femoral shaft fractures. DESIGN: Prospective consecutive case series aimed at quality improvement SETTING:: Level 1 Trauma Center USA PATIENTS:: Ninety-eight consecutive patients with a comminuted femoral shaft fracture underwent statically locked intramedullary nailing with a focused attempt at minimizing LLD during surgery. INTERVENTION: A CT scanogram of both legs was performed on post op day 1 to assess for residual LLD ...
January 30, 2018: Journal of Orthopaedic Trauma
Phillip M Mitchell, David E O'Neill, Bethany Gallagher, Cory A Collinge
OBJECTIVE: To define the pathoanatomy of the tongue type calcaneus fracture and assess the appropriateness of percutaneous techniques in addressing all planes of deformity in this injury. DESIGN: Retrospective cohort. SETTING: ACS Level I trauma center. PATIENTS/PARTICIPANTS: Fifty-six displaced Sanders 2B and 2C tongue type calcaneus fractures identified from an initial cohort of 1118 calcaneus fractures treated over a 16-year period...
January 26, 2018: Journal of Orthopaedic Trauma
Nathan N O'Hara, Gerard P Slobogean, Min Zhan, Michael J Gardner, Michael D McKee, Sharon M Moore, Thomas F Higgins, Robert V O'Toole
OBJECTIVE: To evaluate whether scientific abstracts selected for podium presentation at the Orthopaedic Trauma Association (OTA) Annual Meeting differ based on program committee size and/or the proportion of abstracts each committee member evaluates. METHODS: Abstract scores from the OTA program committee from 2010 through 2016 were obtained. All members (range, 8-9) reviewed each clinical abstract (range, 506-778) each year in a blinded fashion. The 90 top-scoring abstracts were considered "accepted" for this study...
January 26, 2018: Journal of Orthopaedic Trauma
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