Characteristics of Intravenous Fluid Infiltration and Factors Associated With Adverse Events: A Multicenter Retrospective Study.

Background: Peripheral intravenous (PIV) infiltration and extravasation are common complications of intravenous fluid administration. Here, we aim to investigate risk factors associated with major adverse events following PIV infiltration, which may help risk stratify those who require early surgical consultation.

Methods: Retrospectively, patients were identified who had a documented PIV infiltration or extravasation event at 3 academic hospitals between 2015 and 2022.

The utility of low-cost negative pressure wound therapy in Cameroon.

Musculoskeletal injuries are common in Cameroon. Negative pressure wound therapy (NPWT) can effectively manage complex wounds including open fractures, however high cost and unavailability prevent its widespread use. We sought to evaluate the feasibility and efficacy in Cameroon of a low-cost NPWT (LCNPWT) device built from an aquarium pump costing less than $100.

A computational model that integrates unrestricted callus growth, mechanobiology, and angiogenesis can predict bone healing in rodents.

We present a computational model that integrates mechanobiological regulations, angiogenesis simulations and models natural callus development to simulate bone fracture healing in rodents. The model inputs include atomic force microscopy values and micro-computed tomography on the first-day post osteotomy, which, combined with detailed finite element modeling, enables scrutinizing mechanical and biological interactions in early bone healing and throughout the healing process. The model detailed mesenchymal stem cell migration patterns, which are essential for tissue transformation and vascularization during healing, indicating the vital role of blood supply in the healing process.

Unplanned Postoperative Emergency Department Visits After Upper Extremity Fracture Surgery.

Objectives: This study aimed to determine whether outpatient upper extremity fracture surgery was associated with increased postoperative emergency department (ED) visits and identify related risk factors.

Design: Retrospective cohort.

Setting: This multicenter study was conducted within a single academic institution, encompassing two Level 1, two Level 2, and one Level 3 trauma centers.

Tuning the Biodegradation Rate of Silk Materials via Embedded Enzymes.

Conventional thinking when designing biodegradable materials and devices is to tune the intrinsic properties and morphological features of the material to regulate their degradation rate, modulating traditional factors such as molecular weight and crystallinity. Since regenerated silk protein can be directly thermoplastically molded to generate robust dense silk plastic-like materials, this approach afforded a new tool to control silk degradation by enabling the mixing of a silk-degrading protease into bulk silk material prior to thermoplastic processing. Here we demonstrate the preparation of these silk-based devices with embedded silk-degrading protease to modulate the degradation based on the internal presence of the enzyme to support silk degradation, as opposed to the traditional surface degradation for silk materials.

Electrical impedance myography for the early detection of muscle ischemia secondary to compartment syndrome: a study in a rat model.

Acute Compartment Syndrome (ACS) is one of the most devastating orthopedic conditions, affecting any of the body's many compartments, which, if sufficiently severe, may result in disability and amputation. Currently, intra-compartmental pressure measurements serve as the gold standard for diagnosing ACS. Diagnosing limbs at risk for ACS before irreversible damage to muscle and nerve is critical.

Effect of intraarticular pressure on glenohumeral kinematics during a simulated abduction motion: a cadaveric study.

Background: The current understanding of glenohumeral joint stability is defined by active restrictions and passive stabilizers including naturally-occurring negative intraarticular pressure. Cadaveric specimens have been used to evaluate the role of intraarticular pressure on joint stability, although, while the shoulder's negative intraarticular pressure is universally acknowledged, it has been inconsistently accounted for.

Hypothesis: During continuous, passive humeral abduction, releasing the native intraarticular pressure increases joint translation, and restoring this pressure decreases joint translations.

Longitudinal Changes in Serum Markers of Bone Metabolism and Bone Material Strength in Premenopausal Women with Distal Radial Fracture.

Background: Markers of bone metabolism (MBM) play an important role in fracture evaluation, and changes have been associated with increased fracture risk. The purpose of the present study was to describe changes in MBM in premenopausal women with distal radial fractures.

Methods: Premenopausal women with distal radial fractures (n = 34) and without fractures (controls) (n = 39) were recruited.

Outcomes After Operative Fixation of Vancouver B2 and B3 Type Periprosthetic Fractures.

Objectives: The incidence of periprosthetic femur fracture in the setting of total hip arthroplasty is steadily increasing. Although the traditional dogma is that loose femoral components must be revised, we propose that in a frail geriatric population, anatomic reduction and fixation of Vancouver B2 and B3 periprosthetic fracture variants can restore stem stability and provide similar outcomes as revision arthroplasty.

Design: Retrospective cohort study.

3D Bioprinted Bacteriostatic Hyperelastic Bone Scaffold for Damage-Specific Bone Regeneration.

Current strategies for regeneration of large bone fractures yield limited clinical success mainly due to poor integration and healing. Multidisciplinary approaches in design and development of functional tissue engineered scaffolds are required to overcome these translational challenges. Here, a new generation of hyperelastic bone (HB) implants, loaded with superparamagnetic iron oxide nanoparticles (SPIONs), are 3D bioprinted and their regenerative effect on large non-healing bone fractures is studied.

Comparison of Patellofemoral Kinematics and Stability After Medial Patellofemoral Ligament and Medial Quadriceps Tendon-Femoral Ligament Reconstruction.

Background: There is a lack of evidence regarding the optimum extensor-sided fixation method for medial patellofemoral ligament (MPFL) reconstruction. There is increased interest in avoiding patellar drilling via soft tissue-only fixation to the distal quadriceps, thus reconstructing the medial quadriceps tendon-femoral ligament (MQTFL). The biomechanical implications of differing extensor-sided fixation constructs remain unknown.

Effect of rotator cuff muscle activation on glenohumeral kinematics: A cadaveric study.

Healthy shoulder function requires the coordination of the rotator cuff muscles to maintain the humeral head's position in the glenoid. While glenohumeral stability has been studied in various settings, few studies have characterized the effect of dynamic rotator cuff muscle loading on glenohumeral translation during shoulder motion. We hypothesize that dynamic rotator cuff muscle activation decreases joint translation during continuous passive abduction of the humerus in a cadaveric model of scapular plane glenohumeral abduction.

"Age Is Just a Number": Distal Radius Fractures in Patients Over 75.

Management of distal radius fractures in patients over 65 is a topic of significant study, but there are variations within this group in terms of independence and activity level. This study compares the outcomes of operative distal radius fracture treatment in patients over 75 with those aged 65 to 74, to evaluate the effects of patient demand and advanced age on outcome. A retrospective review of a single-institution distal radius fracture database was performed.

Complications After Upper Extremity Surgery in Solid Organ Transplant Patients.

Purpose: To determine the rate of and risk factors for complications in solid organ transplant (SOT) patients who have had surgery of the upper extremity.

Methods: All SOT recipients who had an upper extremity procedure performed by 1 of 6 surgeons at our institution were identified from 2006 to 2018. Demographic data, transplant date and type, upper extremity surgery procedure and date, antirejection medications, American Society of Anesthesiologists Physical Status Classification System (ASA) score, and complications were recorded.

Thermoplastic moulding of regenerated silk.

Early insights into the unique structure and properties of native silk suggested that β-sheet nanocrystallites in silk would degrade prior to melting when subjected to thermal processing. Since then, canonical approaches for fabricating silk-based materials typically involve solution-derived processing methods, which have inherent limitations with respect to silk protein solubility and stability in solution, and time and cost efficiency. Here we report a thermal processing method for the direct solid-state moulding of regenerated silk into bulk 'parts' or devices with tunable mechanical properties.

Tendon lengthening after achilles tendon rupture-passive effects on the ankle joint in a cadaveric pilot study simulating weight bearing.

Background: In recent years, primary Achilles tendon ruptures have increased due to the aging population's participation in physically demanding activities. These injuries commonly occur during recreational sports and frequently lead to a long-term reduction in activity despite treatment. Non-operative methods of treatment for Achilles tendon ruptures may result in the Achilles healing in a lengthened position compared to the pre-injury state.

Outcomes and Complications Following Volar and Dorsal Osteotomy for Symptomatic Distal Radius Malunions: A Comparative Study.

Purpose: To compare patient-reported outcomes, functional outcomes, radiographic alignment, and complications of volar versus dorsal corrective osteotomies as the treatment for symptomatic distal radius malunions.

Methods: We performed a retrospective review of all patients who underwent a distal radius corrective osteotomy with either a volar or dorsal approach and plating at 1 of 3 institutions between 2005 and 2017. Demographic data, type of surgical treatment, and radiographs were examined.

The utility of post-operative hip radiographs in patients treated with hip hemiarthroplasty for femoral neck fractures.

Background: Patients treated with hip hemiarthroplasty for low energy femoral neck fractures routinely undergo hip radiographs at each postoperative clinic visit regardless of history and physical findings. No studies to date have evaluated the effectiveness of this accepted practice. The goal of this study was to identify the postoperative utility of both history and physical (H/P) and hip radiographs in the treatment course of patients treated with hip hemiarthroplasty for low energy femoral neck fractures.

Diagnostic Modalities for Acute Compartment Syndrome of the Extremities: A Systematic Review.

Importance: Acute compartment syndrome (ACS) can cause catastrophic tissue damage leading to permanent muscle and nerve loss. Acute compartment syndrome is a clinical diagnosis, with intracompartmental pressure (ICP) used in equivocal cases. There are no reliable diagnostic methods.

The Effect of Gentamycin in the Irrigating Solution to Prevent Joint Infection after Anterior Cruciate Ligament (ACL) Reconstruction.

Background: Arthroscopic reconstruction of ACL is an effective method to restore knee stability after ACL rupture. Postoperative septic arthritis (SA) is very uncommon while the incidence of serious complications range between 0.14% and 1.

Comparative Efficacy and Safety of Nonsurgical Treatment Options for Enthesopathy of the Extensor Carpi Radialis Brevis: A Systematic Review and Meta-analysis of Randomized Placebo-Controlled Trials.

Background: Numerous treatment options have been proposed for enthesopathy of the extensor carpi radialis brevis (eECRB).

Purpose: To (1) compare the efficacy and safety of nonsurgical treatment options for eECRB described in randomized placebo-controlled trials at short-term, midterm, and long-term follow-up and (2) evaluate outcomes in patients receiving placebo.

Study Design: Systematic review and meta-analysis.

Rat Model of Adhesive Capsulitis of the Shoulder.

This proposal aims to create an in vivo rat model of adhesive capsulitis for researching potential treatment options for this condition and other etiologies of comparable arthrofibrosis. The model includes extra-articular fixation of the shoulder in rats via scapular to humeral suturing, resulting in a secondary contracture without invading the intra-articular space and resulting in decreased rotational ROM and increased joint stiffness. We used 10 Sprague-Dawley rats for the purpose of this study.

Pressure Distribution in the Ankle and Subtalar Joint With Routine and Oversized Foot Orthoses.

Background: Foot orthoses are used to treat many disorders that affect the lower limb. These assistive devices have the potential to alter the forces, load distribution, and orientation within various joints in the foot and ankle. This study attempts to quantify the effects of orthoses on the intra-articular force distribution of the ankle and subtalar joint using a cadaveric testing jig to simulate weight bearing.