Bridge Plating of Proximal Tibial Metaphyseal Fracture by Limited Open Technique.

In this video, we demonstrate application of a bridge plate by limited open technique for fixation of a proximal tibial metaphyseal fracture. Although intramedullary nailing remains our preferred surgical technique for treatment of most extra-articular fractures of the proximal tibia, we find bridge plating by limited open technique to be an important alternative option for select fracture patterns not amenable to intramedullary nailing.

Surgical Fixation of Geriatric Sacral U-Type Insufficiency Fractures: A Retrospective Analysis.

Objectives: To define the incidence of sacral U-type insufficiency fracture and describe management of a consecutive series of patients with this injury.

Design: Retrospective analysis.

Setting: Single Level II trauma center.

A chronically-denervated versus a freshly-harvested autograft for nerve repair in rats.

Objectives: Autologous nerve grafting remains the gold standard for repair of peripheral nerve injuries. Its use, however, is limited by donor nerve availability and donor site morbidity. This is especially problematic after failure of an initial autograft that requires a repeat nerve graft, resulting in a second surgical site with associated morbidity.

Short-term Outcomes of Femoral Neck Fractures Treated With Hemiarthroplasty Using the Anterior Approach.

The direct anterior approach has recently gained popularity for patients undergoing elective total hip arthroplasty. It is unknown whether the reported benefits of the direct anterior approach to elective total hip arthroplasty can be extrapolated to patients undergoing hemiarthroplasty after femoral neck fracture. A retrospective review of 101 patients was performed to compare the outcomes of patients treated with hemiarthroplasty using the direct anterior approach (group 1) with those of patients undergoing the procedure with the posterior, anterolateral, or lateral approach (group 2).

Utility of three-dimensional computed tomography for the surgical management of rib fractures.

Background: Surgical stabilization of flail chest is increasingly recognized as a valid approach to improve pulmonary mechanics in selected trauma patients. The use of two-dimensional (2D) computed tomography (CT) has become almost universal in the assessment of blunt chest trauma and multiple rib fractures. We hypothesized that three-dimensional (3D) CT adds valuable information to the preoperative plan for fixation of rib fractures.

Adverse reaction to metal debris in a patient with acetabular shell loosening 8 years after ceramic-on-metal total hip arthroplasty.

A 41-year-old woman presented 8 years after a left total hip arthroplasty. She complained of progressive groin pain for several months. Radiographs demonstrated a hard-on-hard bearing surface combination and radiolucent lines surrounding the acetabular shell.

Combined proximal nerve graft and distal nerve transfer for a posterior cord brachial plexus injury.

The treatment of patients with prolonged denervation from a posterior cord brachial plexus injury is challenging and no management guidelines exist to follow. The authors describe the case of a 26-year-old man who presented to our clinic for treatment 11 months after suffering a high-energy injury to the posterior cord of the brachial plexus. A combined 9-cm proximal cable nerve graft procedure and a pronator branch to the posterior interosseous nerve transfer were performed.