When Is a Clay-Shoveler's Fracture, Not a Clay-Shoveler's Fracture?: A Case Report.

Case: A 71-year-old man with a history of C5-7 anterior cervical discectomy and fusion (ACDF) sustained a C7 spinous process fracture after falling from a ladder. He was initially managed nonoperatively but developed anterolisthesis and kyphosis at C7-T1 with left hand weakness over the course of 11 days. Surgical treatment included spinous process wiring and C5-T3 posterior fusion.

Fibromyalgia Increases Post-operative Healthcare Utilization Following total Hip Arthroplasty.

Background: Preoperative factors can complicate the postoperative course and increase health care utilization following total hip arthroplasty (THA). Fibromyalgia is not generally recognized as a modifiable risk factor prior to THA. The aim of this investigation was to assess the effect of fibromyalgia on postoperative health care utilization following THA.

Enhanced Recovery After Primary Total Hip and Knee Arthroplasty: A Systematic Review.

Background: Enhanced Recovery After Surgery (ERAS) has become increasingly implemented to reduce costs, to increase efficiency, and to optimize patient outcomes after a surgical procedure. This study aimed to systematically review the effect of ERAS after primary elective total hip arthroplasty (THA) or total knee arthroplasty (TKA) on hospital length of stay, total procedure-related morbidity, and readmission.

Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and with guidance from the Cochrane Handbook for Systematic Reviews of Interventions.

The flipped third fragment in femoral shaft fractures: A reason for open reduction?

Objectives: First introduced by Kuntscher in the 1940s, closed intramedullary nailing of femoral shaft fractures has become the standard of care, with reported union rates up to 99% in some series. However, fractures with large intercalary segments, which are present in 10-34% of femoral shaft fractures, present unique challenges. In particular, how to treat flipped intercalary segments has remained controversial, with some advocating open reduction of these fractures.

Does Adherence to Preoperative Surgical Selection Criteria Reduce the Rate of Prosthetic Joint Infection in Primary and Revision Total Knee Arthroplasties?

Background: There has been recent increased focus on the importance of modifiable risk factors that can affect the risk of potentially avoidable complications such as prosthetic joint infection (PJI). We aimed to assess the relationship between adherence to a preoperative optimization protocol at our institution and its influence on the rate of PJI after primary and revision total knee arthroplasty (TKA).

Methods: A single-institution, retrospective study was conducted on all elective primary and revision TKAs performed over a 2-year period.

Surgical selection criteria compliance is associated with a lower risk of periprosthetic joint infection in total hip arthroplasty.

Background: Periprosthetic joint infection (PJI) is a devastating complication of total hip arthroplasty (THA). Patient optimization represents an important target for PJI prevention. Unfortunately, best practice screening guidelines are not consistently followed by all surgeons.