Are Drains Associated With Infection After Operative Fixation of High-Risk Tibial Plateau and Pilon Fractures?

Objectives: To determine the association between closed suction drainage and postoperative infection in patients with tibial plateau or pilon fractures. Secondarily, this study assessed whether intrawound vancomycin powder modified the association of closed surgical drains with infection.

Design: Secondary analysis of the Effect of Intrawound Vancomycin Powder in Operatively Treated High-risk Tibia Fractures: A Randomized Clinical Trial (VANCO).

The Use of External Beam Radiation Therapy for Heterotopic Ossification Prophylaxis After Surgical Fixation of Acetabular Fractures: A Randomized Controlled Trial.

Objectives: To determine the effect of external beam radiation (XRT) on preventing severe heterotopic ossification (HO) after acetabular surgery.

Design: Randomized controlled trial.

Setting: Two level I academic trauma centers.

Frequency and Characteristics of Posterior Labral Injuries in Operative Acetabular Fractures Treated Through a Posterior Approach: A Prospective Observational Study.

Objectives: The association between labral injuries and acetabular fractures is unknown. This study aimed to identify the frequency and characteristics of labral injuries in operatively treated acetabular fractures that cannot be identified on preoperative imaging.

Design: Prospective observational cohort.

The impact of heterotopic ossification prophylaxis after surgical fixation of acetabular fractures: national treatment patterns and related outcomes.

Background: Heterotopic ossification (HO) is a common complication after surgical fixation of acetabular fractures. Numerous strategies have been employed to prevent HO formation, but results are mixed and optimal treatment strategy remains controversial. The purpose of the study was to describe current national heterotopic ossification (HO) prophylaxis patterns among academic trauma centers, determine the association between prophylaxis type and radiographic HO, and identify if heterogeneity in treatment effects exist based on outcome risk strata.

Is External Beam Radiation Therapy Really Associated With Low Rates of Heterotopic Ossification After Acetabular Surgery?

Objectives: Describe rate of postoperative heterotopic ossification (HO) after acetabular surgery in patients who received external beam radiation (XRT) as HO prophylaxis.

Design: Retrospective.

Setting: Level I trauma center.

The Impact of Frailty on Outcomes Following Primary Total Hip Arthroplasty in Patients of Different Sex and Race: Is Frailty Equitably Detrimental?

Background: Whether frailty impacts total hip arthroplasty (THA) patients of different races or sex equally is unknown. This study aimed to assess the influence of frailty on outcomes following primary THA in patients of differing race and sex.

Methods: This is a retrospective cohort study utilizing a national database (2015-2019) to identify frail (≥2 points on the modified frailty index-5) patients undergoing primary THA.

The Impact of Increased Time to Surgery in Geriatric Patients With Acetabular Fractures.

Objectives: To explore the association between time to surgery (TTS) and postoperative complications in geriatric patients with acetabular fractures.

Design: Retrospective cohort study.

Setting: Level I trauma center.

Opioid Prescribing Behavior in the Emergency Department During Routine Orthopedic Manipulations.

Background: The emergency department (ED) often represents the first exposure orthopedic trauma patients have to prescription opioids and thus a critical opportunity for prevention of potential long-term opioid use. This study will analyze the impact of opioid prescribing patterns among both ED providers and orthopedic surgery residents on the utilization of opioids during routine orthopedic trauma manipulations.

Materials And Methods: This retrospective study reviewed opioid utilization among patients with an ankle or distal radius fracture at a large, urban, level 1 trauma center.

Impact of Intraoperative Hypothermia on Transfusion Requirements in Patients With Pelvic and Acetabular Trauma.

Objectives: To explore the association between intraoperative hypothermia and perioperative blood loss and blood transfusion requirements in patients with operative pelvic and acetabular fractures.

Design: Retrospective review.

Setting: Single, Level 1 trauma center in Atlanta, Georgia.

Infection After Open Long Bone Fractures: Can We Improve on Prophylaxis?

Introduction: Current standards recommend antibiotic prophylaxis administered after open fracture injury. The purpose of this study was to assess culture results in patients with open fracture-associated infections, hypothesizing that cultures obtained do not vary by Gustilo-Anderson (GA) classification.

Methods: We examined cultured bacterial species from patients with open long bone fractures that underwent irrigation and debridement at a Level 1 trauma center (2008-2016), evaluating our current and two hypothetical antibiotic protocols to assess whether they provided appropriate coverage.

Fully threaded sacroiliac lag screws have higher load to failure when compared to partially threaded screws: A biomechanical study.

The purpose of this study is to compare biomechanical properties of fully and partially threaded iliosacral screws. We hypothesise that fully threaded screws will have a higher yield force, and less deformation than partially threaded screws following axial loading. Twenty sawbone blocks were uniformly divided to simulate vertical sacral fractures.

Release of the Tibialis Posterior Muscle Osseofascial Sheath Improves Results of Deep Exertional Compartment Syndrome Surgery: A Comparative Analysis and Long-term Results.

Background: Success rates for surgical management of chronic exertional compartment syndrome (CECS) are historically lower with release of the deep posterior compartment compared with isolated anterolateral releases. At our institution, when a deep posterior compartment release is performed, we routinely examine for a separate posterior tibial muscle osseofascial sheath and release it if present.

Purpose: Within the context of this surgical approach, the aim of the current study was to compare long-term patient satisfaction and activity levels in patients who underwent 2-compartment fasciotomy versus a modified 4-compartment fasciotomy for CECS.

Resource Utilization for Patients With Distal Radius Fractures in a Pediatric Emergency Department.

Importance: Improvement of clinician understanding of acceptable deformity in pediatric distal radius fractures is needed.

Objective: To assess how often children younger than 10 years undergo a potentially unnecessary closed reduction using procedural sedation in the emergency department for distal radial metaphyseal fracture and the associated cost implications for these reduction procedures.

Design, Setting, And Participants: This retrospective cross-sectional study included 258 consecutive children younger than 10 years who presented to a single, level I, pediatric emergency department and who had a distal radius fracture with or without ulna involvement between January 1, 2016, and December 31, 2017.

Fusions ending at the thoracolumbar junction in adolescent idiopathic scoliosis: comparison of lower instrumented vertebrae.

Study Design: Retrospective cohort study.

Objective: To compare clinical outcomes and radiographic parameters between patients treated with a posterior spinal fusion that had a lower instrumented vertebra at T11, T12, and L1.

Background: Posterior instrumented fusions are well established for treating patients with adolescent idiopathic scoliosis (AIS).

Impact of Frailty on 30-Day Morbidity and Mortality of Patients With Intertrochanteric Femur Fractures.

The aim of this study was to evaluate the association between frailty and 30-day morbidity and mortality in patients with intertrochanteric femur fractures. Furthermore, the authors sought to identify a specific frailty index score that would help identify high-risk patients. This retrospective study evaluated 229 consecutive patients 50 years or older who presented to a single level I trauma center for surgical fixation of an intertrochanteric femur fracture.

Impact of Prolonged Skeletal Traction in Patients With Acetabular Fractures.

Objectives: To explore the association between increased time in traction and in-hospital pulmonary complications in patients with acetabular fractures.

Design: Retrospective.

Setting: Level I trauma center.

Impact of closed suction drainage after surgical fixation of acetabular fractures.

Introduction: The purpose of the present study was to evaluate the prevalence of closed suction drainage after a Kocher-Langenbeck (K-L) approach for surgical fixation of acetabular fractures and to determine the impact of closed suction drainage on patient outcomes.

Methods: This retrospective study reports on 171 consecutive patients that presented to a single level I trauma center for surgical fixation of an acetabular fracture. Medical records were reviewed to evaluate the use of closed suction drains.

Frailty and Malnutrition Are Associated With Inpatient Postoperative Complications and Mortality in Hip Fracture Patients.

Objective: To examine the relationship of nutrition parameters with the modified frailty index (mFI) and postoperative complications in hip fracture patients.

Design: Retrospective observational cohort study.

Setting: Urban, American College of Surgeons-Verified, Level-1, Trauma Center.

The Effect of Season and Weather on Orthopaedic Trauma: Consult Volume Is Significantly Correlated with Daily Weather.

Introduction: On-call orthopedic clinicians have long speculated that daily consult volume is closely correlated with weather. While prior studies have demonstrated a relationship between weather and certain fracture types, the effect of weather on total orthopaedic consult volume has not yet been examined. The aim of this study was to investigate this relationship.

A Validated Single-View Radiographic Alternative to Computed Tomography for the Measurement of Femoral Anteversion: A Method-Comparison Study.

Background: Although preoperative templating in total hip arthroplasty is helpful to ensure appropriate component position, there is no single-view radiographic method to determine femoral anteversion (FA) preoperatively. The aim of the present study was to validate the use of radiographic measurement of FA using a modified Budin view.

Methods: This prospective study reports on 105 limbs from 65 patients.

Association of hip and pelvic geometry with tibiofemoral osteoarthritis: multicenter osteoarthritis study (MOST).

Objective: Lateral tibiofemoral osteoarthritis (OA) is overall less common than medial tibiofemoral OA, but it is more prevalent in women. This may be explained by sex differences in hip and pelvic geometry. The aim of this study is to explore sex differences in hip and pelvic geometry and determine if such parameters are associated with the presence of compartment-specific knee OA.

No difference in survivorship after unicompartmental knee arthroplasty with or without an intact anterior cruciate ligament.

Purpose: Anterior cruciate ligament deficiency (ACLD) has been considered a contraindication for Oxford unicompartmental knee arthroplasty (UKA) because of the reported higher incidence of failure when implanted in ACLD knees. However, given the potential advantages of UKA over total knee arthroplasty (TKA), we have performed UKA in a limited number of patients with ACL deficiency and end-stage medial compartment osteoarthritis (OA) over the past 11 years. The primary aim of this study was to establish the clinical outcome of this cohort; the secondary aim was to compare both clinical and radiographic data with a matched cohort of ACL-intact (ACLI) patients who have undergone UKA for anteromedial OA.

Auditory processing disorders, verbal disfluency, and learning difficulties: a case study.

This case study reports the findings of auditory behavioral and electrophysiological measures performed on a graduate student (identified as LN) presenting verbal disfluency and learning difficulties. Results of behavioral audiological testing documented the presence of auditory processing disorders, particularly temporal processing and binaural integration. Electrophysiological test results, including middle latency, late latency and cognitive potentials, revealed that LN's central auditory system processes acoustic stimuli differently to a reference group with normal hearing.

Perception of genuine and masking smiles in children and adults: sensitivity to traces of anger.

The authors examined children's and adults' sensitivity to traces of anger in masking smiles by presenting participants with short video excerpts of smiles that differed by the intensity of an anger component. Fifty-two children, aged 6 to 12 years, and 26 adults were asked to judge whether a stimulus person was really happy or pretending to be happy. Six- and 7-year-old children were found to be sensitive to traces of anger, but less so than older children and adults.