Tourniquet Use for Short Hand Surgery Procedures Done Under Local Anesthesia Without Epinephrine.

Purpose: Wide-awake local anesthesia no tourniquet (WALANT) is an increasingly popular surgical technique. However, owing to surgeon preference, patient factors, or hospital guidelines, it may not be feasible to inject patients with solutions containing epinephrine the recommended 25 minutes prior to incision. The purpose of this study was to assess pain and patient experience after short hand surgeries done under local anesthesia using a tourniquet rather than epinephrine for hemostasis.

Socioeconomic Status Negatively Affects HCAHPS Scores in Orthopedic Patients The Results of 15,789 Patients at a Single Institution.

Background: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a nationally reported survey of patients' perspectives of hospital care that is used for hospital comparison and reimbursement. Although the survey attempts to correct for many factors that may affect scoring, socioeconomic factors are not considered in score weighting. The purpose of this study was to analyze the effect of socioeconomic status on HCAHPS scores.

Does a Learning Curve Exist for the Surgical Treatment of Proximal Humerus Fractures?

Background: The complication rate of locked plating for proximal humerus fractures remains stubbornly high. The purpose of this study was to determine if a learning curve exists with the operative treatment of proximal humerus fractures.

Methods: We prospectively followed 161 consecutive patients with proximal humerus fractures treated by a single surgeon with locked plates from 2005 to 2016.

The outcome of patients with cultured pathogens at time of nonunion surgery.

The purpose of this study is to evaluate incidence, preoperative laboratory markers, and outcomes of patients who positively cultured pathogens (PCP) at time of surgery for long bone fracture nonunion. Two-hundred and eighty-eight patients were enrolled in a trauma study on long bone nonunion. Two-hundred and sixteen of those 288 patients were cultured at the time of fracture nonunion surgery.

Management of Pisotriquetral Instability.

Pisotriquetral instability is an often-overlooked condition that can lead to ulnar-sided wrist pain and dysfunction. Various case series and biomechanical studies have been published regarding the diagnosis and treatment of this condition. We review current methods for examining, diagnosing, and treating pisotriquetral instability.

Arthroscopic Cortical Button Stabilization of Isolated Acute Neer Type II Fractures of the Distal Clavicle.

Neer type II distal clavicle fractures are inherently unstable. The purpose of this study was to review the outcome of Neer type II distal clavicle fractures arthroscopically treated using a suspensory cortical button technique. Between 2008 and 2012, a total of 17 Neer type IIB fractures were managed operatively at the authors' institution.

Nature's wrath-The effect of weather on pain following orthopaedic trauma.

Background: Despite frequent complaints by orthopaedic trauma patients, to our knowledge there is no data regarding weather's effect on pain and function following acute and chronic fracture. The aim of our study was to investigate the influence of daily weather conditions on patient reported pain and functional status.

Methods: We retrospectively examined prospectively collected data from 2369 separate outpatient visits of patients recovering from operative management of acute tibial plateau fractures, acute distal radius fractures, and chronic fracture nonunions.

Sexual Function Is Impaired After Common Orthopaedic Nonpelvic Trauma.

Objectives: The purpose of this study was to investigate the prevalence and longitudinal improvement of patient reported sexual dysfunction after 5 common nonpelvic orthopaedic traumatic conditions.

Design: Retrospective analysis of prospectively collected data.

Setting: Academic Medical Center.

Older age does not affect healing time and functional outcomes after fracture nonunion surgery.

Introduction: Elderly patients are at risk of fracture nonunion, given the potential setting of osteopenia, poorer fracture biology, and comorbid medical conditions. Risk factors predicting fracture nonunion may compromise the success of fracture nonunion surgery. The purpose of this study was to investigate the effect of patient age on clinical and functional outcome following long bone fracture nonunion surgery.

Sleep disturbance after fracture is related to emotional well-being rather than functional result.

Objectives: The aim of this study was to investigate the rate, longitudinal improvement, and risk factors of sleep disturbance after 4 common orthopaedic traumatic conditions.

Methods: The functional status of 1095 patients was prospectively assessed using validated questionnaires for patients with acute proximal humerus (n = 111), distal radius (n = 440), tibial plateau (n = 109), and ankle fractures (n = 435). Patient reported sleep difficulty was compared with the overall functional and emotional status of each patient at 3, 6, and 12 months after treatment.

Minimally displaced radial head/neck fractures (Mason type-I, OTA types 21A2.2 and 21B2.1): are we "over treating" our patients?

Objective: The purpose of this study was to investigate the nonoperative treatment strategies for Mason-Johnson type-I radial head fractures.

Design And Setting: Retrospective review of every patient with a closed radial head/neck fracture who presented to our tertiary care specialty institution in the past 2 years.

Patients/participants: A search of ICD-9 code 813.

Do elderly patients fare worse following operative treatment of distal femur fractures using modern techniques?

Background: The purpose of this study was to compare the functional outcomes and quality of life of older and younger patients with similarly treated distal femur fractures.

Methods: We conducted an assessment of 57 patients who sustained distal femur fractures (Orthopaedic Trauma Association Type 33B, C) and underwent surgical treatment at our academic medical center. Patients were divided into 2 groups for analysis: an elderly cohort of patients aged 65 or older and a comparison cohort of patients younger than age of 65.

Open reduction internal fixation for proximal humerus fractures indications, techniques, and pitfalls.

Proximal humerus fractures account for approximately 5% of all fractures. It is estimated that due to our aging population, orthopaedic surgeons will see a three-fold increase in proximal humerus fractures over the next 30 years. Internal fixation with locked plating is the current mainstay of treatment for functionally active patients who desire minimal loss of function.

Outcomes After Fixation of Proximal Humerus (OTA Type 11) Fractures in the Elderly Patients Using Modern Techniques.

Purpose: To investigate the effects of age on the clinical, functional, and radiographic outcomes of patients with proximal humerus fractures treated operatively with locking plates.

Methods: Between February 2003 and July 2012, all patients who sustained a proximal humerus fracture who presented to our institution were enrolled into a database. Patients were followed up at 1, 6, 12, 26, and 52 weeks postoperatively with physical examination and radiographs.