Cervical Spinal Immobilization: A Head-to-Head Comparison of a One-Step Spray-on Foam Splint Versus Structural Aluminum Malleable Splint Immobilization.

Introduction: Cervical spine immobilization in a low-resource environment is difficult secondary to limited equipment, prolonged transportation, and secondary complications. A structural aluminum malleable (SAM) splint is commonly utilized because of its availability and multipurpose intention. A one-step spray-on foam immobilization technique (Fast Cast) has been shown to be effective in lower-extremity splinting.

Fracture Gap Closure and Reduction Are Affected by the Orientation of the Headless Compression Screw.

Background: We evaluated the impact of a variable-pitch headless screw's angle of insertion relative to the fracture plane on fracture gap closure and reduction.

Methods: Variable-pitch, fully threaded headless screws were inserted into polyurethane blocks of "normal" bone model density using a custom jig. Separate trials were completed with a 28-mm screw placed perpendicular and oblique/longitudinal to varying fracture planes (0°, 15°, 30°, 45°, and 60°).

Does a Reported Penicillin Allergy Affect Outcomes Following Elective Posterior Lumbar Fusions?

Background: Patients with a reported penicillin allergy (PA) receive alternative antibiotics that may not be as effective as cephalosporins for surgical site infection (SSI) prophylaxis. While patient-reported PA has been correlated to increased complications in other fields, this has not been conclusively shown in spine surgery. We investigate the impact of PA on 90-day complications and inpatient charges/costs after elective posterior lumbar fusion between PA and non-PA cohorts.

Social Media Use Among Academic Hand Surgeons.

Purpose: Social media has become increasingly prevalent among the general population in the past decade. We examined the current prevalence of social media use among academic orthopedic-trained and plastic surgery-trained hand surgeons in the United States.

Methods: All publicly available hand surgery faculty across the nation were analyzed for their public social media usage, including Instagram, Facebook, Twitter, LinkedIn, and personal websites.

Patient-specific factors, but neither regional anesthesia nor hip-specific cryotherapy, predict postoperative opioid requirements after hip arthroscopy for femoroacetabular impingement (FAI) syndrome.

Background: We sought to determine whether regional nerve block, cryotherapy variant, or patient-specific factors predict postoperative opioid requirements and pain control following hip arthroscopy.

Methods: 104 patients underwent hip arthroscopy with (n = 31) or without (n = 73) regional block and received cryotherapy with a universal pad [joint non-specific; no compression (n = 60)] or circumferential hip/groin wrap with intermittent compression (n = 44). Outcomes included total opioid prescription amounts, requests for refills, and unplanned clinical encounters for postoperative pain within 45 days of surgery.

Role of Dynamic Stabilizers of the Elbow in Radiocapitellar Joint Alignment: A Prospective In Vivo Study.

Purpose: To investigate the effect of dynamic stabilizers of the elbow on radiocapitellar joint alignment, before and after the administration of regional anesthesia.

Methods: At a single institution, 14 patients were prospectively enrolled in a study using a within-subjects control design. Before performing a supraclavicular regional block, 10 fluoroscopic images (1 anteroposterior and 9 lateral views) of the elbow were obtained for each patient.

The Effect of Derotational Kirschner Wires on Fracture Gap Reduction With Variable-Pitch Headless Screws.

Purpose: We evaluated the impact of angled derotational Kirschner wires (K-wires) on fracture gap reduction with variable-pitch headless screws.

Methods: Fully threaded variable-pitch headless screws (20 and 28 mm) were inserted into "normal" bone models of polyurethane blocks. In separate trials, derotational K-wires were inserted at predetermined angles of 0°, 15°, 30°, and 40° and compared with each other, with no K-wire as a control.

The effect of patient factors on opioid use after anatomic and reverse shoulder arthroplasty.

Background: Prolonged opioid use can lead to suboptimal outcomes after total shoulder arthroplasty (TSA), and thus, reduced consumption is desirable. Our primary aims were to determine if differences in total morphine equivalent doses existed owing to (1) age less than or greater than 65 years, (2) sex, and (3) TSA type - reverse or anatomic total shoulder arthroplasty. We also characterized potential risk factors for (1) visiting another provider for pain, (2) pain control 6 weeks postoperatively, and (3) needing an opioid refill.

The Effect of Patient and Surgical Factors on Opioid Prescription Requests Following Arthroscopic Rotator Cuff Repair.

Purpose: To determine whether differences in total morphine equivalent doses (MEDs) prescribed after arthroscopic rotator cuff repair (RCR) existed because of age younger than or older than 55 years and sex and to characterize potential risk factors for needing an opioid medication refill, visiting a provider other than the surgeon (either in the emergency department or ambulatory settings), and postoperative pain control requiring opioids approximately 6 weeks from the date of surgery.

Methods: A retrospective cohort study of 100 patients who underwent arthroscopic RCR between July 1, 2018, to November 30, 2018, in a single institution was performed. Data including demographics, perioperative treatments, and postoperative opioid prescriptions were recorded.

Inpatient and outpatient opioid requirements after total joint replacement are strongly influenced by patient and surgical factors.

Aims: Currently, there is no single, comprehensive national guideline for analgesic strategies for total joint replacement. We compared inpatient and outpatient opioid requirements following total hip arthroplasty (THA) versus total knee arthroplasty (TKA) in order to determine risk factors for increased inpatient and outpatient opioid requirements following total hip or knee arthroplasty.

Methods: Outcomes after 92 primary total knee (n = 49) and hip (n = 43) arthroplasties were analyzed.

Surgical Correction of Finger Malrotation Secondary to Proximal Phalanx Malunions.

Proximal phalanx malunions resulting in malrotation can be functionally limiting to patients. Surgical correction allows for improvement in range of motion, function, and cosmesis. This video demonstrates surgical correction of finger malrotation secondary to a proximal phalanx malunion.

Dorsal Approach for Dorsal Impaction Distal Radius Fracture-Visualization, Reduction, and Fixation Made Simple.

Distal radius fractures with dorsal articular surface impaction comprise a difficult fracture pattern to operatively reduce using a standard volar approach. Distal radius open reduction internal fixation using a dorsal approach allows direct visualization and reduction. The surgical technique video presented demonstrates technical pearls for optimal visualization, reduction, and fixation.

Lift-Off Screw Results in Accurate Sagittal Tilt Correction in a Distal Radius Fracture Model.

Purpose: To determine the accuracy of a distal-first open reduction internal plate fixation technique in achieving correction of volar tilt in dorsally angulated distal radius fractures.

Methods: Twenty foam radius models were divided evenly into groups N (normal) and O (osteoporotic). Dorsally angulated extra-articular distal radius fractures were then created.

Fracture Gap Reduction With Variable-Pitch Headless Screws.

Purpose: Fully threaded, variable-pitch, headless screws are used in many settings in surgery and have been extensively studied in this context, especially in regard to scaphoid fractures. However, it is not well understood how screw parameters such as diameter, length, and pitch variation, as well as technique parameters such as depth of drilling, affect gap closure.

Methods: Acutrak 2 fully threaded variable-pitch headless screws of various diameters (Standard, Mini, and Micro) and lengths (16-28 mm) were inserted into polyurethane blocks of "normal" and "osteoporotic" bone model densities using a custom jig.