Journal of Orthopaedic Trauma

OBJECTIVE: Calculate the minimal clinically important differences (MCID) of Patient Reported Outcome Information System Physical Function (PROMIS PF) scores for patients with operatively treated tibial shaft fractures. DESIGN: Retrospective Cohort Study. SETTING: A Level 1 trauma center. PATIENTS: All operatively treated tibial shaft fractures identified by Current Procedural Terminology codes. INTERVENTION: Enrolled patients treated acutely with operative fixation of their tibia...

OBJECTIVES: To assess factors affecting loss of reduction (LOR) in a large cohort of children with Salter-Harris II (SH II) distal radius physeal fractures treated with closed reduction. DESIGN: Retrospective chart review. SETTING: Pediatric Level I Trauma CenterPatients/Participants: A total of 141 pediatric patients (73% male, average age: 12.15 ± 2.55 years) that had undergone closed reduction and casting for distal radius physeal fractures from 2006-2019 were included in this study...

BACKGROUND: Removal of orthopaedic intramedullary implants can be difficult and time-consuming. Instrumentation for implant removal is frequently deficient for effective removal. The purpose of this study is to compare the efficiency of a C-type jig with a standard slap hammer attachment. We hypothesize that a C-type jig will be a more energy efficient method of implant removal. METHODS: An IM nail removal was simulated in a series of 10 tests using 40 PCF Sawbones bone blocks with drilled holes and custom-made IM nails...

OBJECTIVES: To determine the infection and non-union rates for open tibia fracture treatment over the last four decades since the introduction of the Gustilo-Anderson (GA) open fracture classification. DATA SOURCES: PubMed, Scopus, CINAHL, and Cochrane databases were reviewed using the PRISMA checklist for articles between 1977 and September 2018. STUDY SELECTION: 161 articles meeting the following inclusion criteria: English language, published between 1977-2018, reported infection rates, reported nonunion rates and fractures classified by the GA open fracture criteria were selected...

No abstract text is available yet for this article.

OBJECTIVES: Describe rate of post-operative heterotopic ossification (HO) after acetabular surgery for patients that received external beam radiation (XRT) as HO prophylaxis. DESIGN: Retrospective. SETTING: Level I trauma center.Patients/participants: Consecutive series of patients that presented to a single level I academic trauma center over a 10-year period (2008-2018) for surgical fixation of an acetabular fracture. Patients eligible for inclusion were those that underwent surgical fixation of an acetabular fracture via a posterior (Kocher-Langenbeck), combined anterior and posterior, or extensile exposure...

A total of 2711 publications were screened for eligibility, after exclusion a total of 723 papers were included. There is a focus on retrospective studies investigating mortality and complications. Studies are often small in terms of sample size, and there are relatively few prospective studies and RCTs study patient reported outcomes and quality of life. Patients with cognitive impairment are selectively excluded from clinical studies, and no consensus exists on how cognitive impairment is diagnosed.This review identified pitfalls and provides recommendations to navigate these issues for future studies...

OBJECTIVE: Evaluate the species distribution and resistance patterns of bacterial pathogens causing surgical site infection (SSI) after operative fracture repair, with and without the use of intrawound powdered antibiotic (IPA) prophylaxis during the index surgery. DESIGN: Retrospective cohort study. SETTING: Academic, level 1 trauma center, 2018-2020.Patients/Participants: 59 deep SSIs were identified in a sample of 734 patients with 846 fractures (IPA [n=320], control [n=526]; open [n=157], closed fractures [n=689]) who underwent orthopaedic fracture care...

INTRODUCTION: Online educational materials have become a fundamental resource for orthopaedic surgery patients; however, they are frequently written at a high level of reading ability and are too complicated for some patients to understand. The aim of this study was to appraise the readability of the Orthopaedic Trauma Association (OTA) patient education materials. METHODS: All forty-one articles on the OTA patient education website (https://ota.org/for-patients) were analyzed for readability...

OBJECTIVES: To assess the effects of Krackow suture technique on the vascularity of the patellar tendon. METHODS: Six fresh-frozen matched pair cadaveric knee specimens were utilized. The superficial femoral arteries were cannulated in all knees. The experimental knee underwent an anterior approach, patellar tendon transection from the inferior pole of the patella, four-strand Krackow stitch placement, patellar tendon repair via 3-bone tunnels, and standard skin closure...

OBJECTIVES: To determine the effect of linking the intramedullary nail and the laterally applied locking plate bone to treat comminuted distal femur fractures and allow for immediate weight bearing.. METHODS: comminuted extra-articular distal femur fractures were created in 16 synthetic osteoporotic femurs and split into two groups: linked vs. unlinked. In the linked construct, in addition to standard plate bone fixation and proximal locking of the nail, two non-threaded locking bolts (prototypes) were placed through both the plate and the nail...

OBJECTIVES: To assess the utility of chest x-rays following open reduction internal fixation of clavicle fractures. Particularly in terms of detection of acute postoperative pneumothorax and cost- effectiveness of obtaining routine chest x-rays post-operatively. DESIGN: A retrospective cohort study. SETTING: Level I trauma centerPatients 236 patients who underwent ORIF from 2013 to 2020 between the ages of 12 and 93. INTERVENTION: Chest x-ray performed post-operatively...

OBJECTIVES: This study aims to investigate surgeon accuracy in prediction of the stability of posterior wall acetabular fractures by comparing "examination under anesthesia" (EUA) findings to submitted estimations on the basis of radiograph and computed tomography (CT) imaging across a range of experience in Orthopaedic surgeons and trainees. METHODS: Records of patients who underwent EUA after presenting with posterior wall acetabular fractures at 2 different institutions were pooled for data collection, totaling 50 cases...

OBJECTIVE: To compare fracture patterns and associated injuries for young patients with high-versus low-energy intertrochanteric hip fractures and to report on factors associated with complications after surgical fixation of high-energy fractures. DESIGN: Retrospective comparative study. SETTING: Academic Level 1 Trauma Center. PATIENTS: A total of 103 patients < 50 years old were included: 80 high-energy fractures and 23 low-energy fractures...

ObjectivesTo report the results of retrograde intramedullary nailing (RIMN) for the treatment of extremely proximal femur fracturesDesignRetrospective cohortSettingLevel I trauma centerPatients/ParticipantsSixty-three femoral shaft fractures involving the anatomic region within ten centimeters of the inferior border of the lesser trochanter that were treated with RIMNInterventionRetrograde intramedullary femoral nailMain Outcome MeasurementsTime to union, nonunion, malunion, and unplanned reoperationResultsBetween 2009 and 2020, sixty-three fractures were followed to fracture union, reoperation, or a minimum of one year clinically...

OBJECTIVES: Network meta-analysis to compare the efficacy of different dosages of intravenous(IV) acid(TXA) in the treatment of traumatic hip fractures against the control group of no TXA. DATA SOURCES: This study utilized the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to perform a network meta-analysis on the use of TXA for the treatment of hip fractures. The study team utilized Ovid MEDLINE, Cochrane Reviews, Scopus, Embase, and Web of Science databases to perform the search...

OBJECTIVES: To synthesize all-cause complications and reoperations data, as well as secondary clinical, functional and radiographic outcomes following the management of very distal ulna fractures (VDUFs) either nonoperatively or operatively. DATA SOURCES: MEDLINE, Embase and Web of Science, were searched for English-language articles from inception to February 17, 2022. STUDY SELECTION: Studies reporting the nonoperative or operative management of VDUFs were eligible for inclusion...

OBJECTIVE: We aimed to characterize the association between BMI as a continuous variable and 30-day postoperative outcomes following hip fracture surgery through:1)30-day readmission and reoperation; 2)local wound-related; and 3)systemic complications. METHODS: The National Surgical Quality Improvement Program(NSQIP) database(January 2016-December,2019) was queried for patients undergoing hip fracture ORIF. Baseline patient demographics, comorbidities, and patient outcomes were recorded...

No abstract text is available yet for this article.

OBJECTIVES: To define the rate and primary drivers behind early and late amputation following flap-based limb salvage in the setting of combat extremity trauma. DESIGN: Retrospective review. SETTING: Level II trauma center. PATIENTS: Three hundred seven (303 men, 4 women) patients who underwent flap-based limb salvage treatment between 2003-2014. INTERVENTION: We reviewed patient medical records, radiographs, and clinical photographs...