The neurologically intact patient with TLICS 4 or 5 burst fracture should be given a trial of nonoperative management.

Thoracolumbar burst fracture treatment in neurologically intact patients is controversial with many classification systems to help guide management. Thoracolumbar Injury Classification and Severity score (TLICS) provides a framework, but evidence is limited, and recommendations are primarily based on expert opinion. In this retrospective cohort study, data was reviewed for patients with thoracolumbar burst fractures at a Level-1 Trauma Center in New England from 2013 to 2018.

Surgical versus nonsurgical treatment of acute Achilles ruptures in the high demand patient: Using decision analysis to help clinical decisions.

Background: Recent literature suggests that functional treatment of acute non-insertional Achilles tendon ruptures yields outcomes (re-rupture and function) similar to those of surgery, but does not address the unique issues in treating high performance athletes or other high demand patients.

Methods: Decision analysis was used to develop an estimate of outcome utility for both types of treatment using published Costs and Quality-Adjusted Life Years (QALYs) values. The expected value for either treatment was then calculated for high, intermediate, and normal demand patients, using the specific functional needs of the patients.

Biomechanical comparison of a novel tensioned cable construct versus tension band wiring for transverse patella fracture fixation.

Purpose: Tension band wiring (TBW) is the most widely accepted method for patella fracture fixation. The purpose of our study was to compare the biomechanical efficacy of a novel cable construct to TBW for the fixation of transverse patella fractures. The tensioned cable construct was hypothesized to have less fracture gapping after cyclic flexion-extension loading and greater ultimate load to failure as compared to TBW.

The positive prediction of single photon emission computed tomography/ computed tomography (SPECT/CT) in the outcome of intervention for cervical facet pain.

Background Context: Previous studies have reported that magnetic resonance imaging (MRI) and computed tomography (CT) do not predict response to facet blocks. However, single photon emission computed tomography (SPECT) uptake within facet joints has been shown to correlate with pain relief after intervention in the lumbar spine. There is minimal data regarding the predictive value of single photon emission computed tomography/computed tomography (SPECT/CT) for neck pain.

Intraoperative Comparative Femoral Rotation Imaging: Do not Overlook Parallax.

Objective: To investigate the degree of error due to parallax during intraoperative rotational imaging involving the distal femur.

Methods: Twelve, fresh-frozen, lower-extremity cadaveric specimens were studied. The limbs were positioned supine and rotated until the posterior femoral condyles were superimposed using a C-arm.