Complications after low-velocity ballistic femur fractures: a series of 104 patients at a level 1 trauma center.

Objectives: To report outcomes and risk factors of complications following low-velocity ballistic fractures of the femur.

Design: Retrospective case series.

Setting: Academic Level I trauma center.

Deep infections after low-velocity ballistic tibia fractures are frequently polymicrobial and recalcitrant.

Objectives: To identify risk factors for developing a fracture-related infection in operatively treated ballistic tibia fractures and to report the microbiologic results of intraoperative cultures.

Design: Retrospective review.

Setting: Level 1 trauma center.

Outcomes of Distal Third Femur Fractures in Patients 18 Years and Older: A Pilot Study.

Introduction: The selection of the most optimal fixation method for fractures of the distal femur, whether intramedullary nail (NL), lateral locking plate (PL), or nail/plate (NP) is not always clear. This study retrospectively evaluates surgical patients with distal femur fractures and introduces a pilot study using cluster analysis to identify the most optimal fracture fixation method for a given fracture type.

Methods: This is a retrospective cohort study of patients 18 years and older with an isolated distal femur fracture who presented to our Level-1 trauma center between January 1, 2012, and December 31, 2022, and obtained NL, PL, or NP implants.

Do Transtibial Amputations Outperform Amputations of the Hind- and Midfoot Following Severe Limb Trauma?: A Secondary Analysis of the OUTLET Study.

Background: The purpose of this study was to compare 18-month clinical and patient-reported outcomes between patients with severe lower-limb injuries treated with a transtibial amputation or a hind- or midfoot amputation. Despite the theoretical benefits of hind- and midfoot-level amputation, we hypothesized that patients with transtibial amputations would report better function and have fewer complications.

Methods: The study included patients 18 to 60 years of age who were treated with a transtibial amputation (n = 77) or a distal amputation (n = 17) and who were enrolled in the prospective, multicenter Outcomes Following Severe Distal Tibial, Ankle, and/or Foot Trauma (OUTLET) study.

Proximal humerus fractures: Postoperative protocols and factors affecting treatment decisions among shoulder and elbow and orthopedic trauma surgeons.

Background: Proximal humerus fractures (PHFs) can lead to functional decline in geriatric and polytraumatized patients. Treatment of PHFs is an area of much debate and much variability between practitioners.

Objectives: We surveyed orthopedic trauma (OT) and shoulder and elbow (SE) surgeons to evaluate differences in postoperative protocols when treating acute PHFs with open reduction internal fixation (ORIF), intramedullary nailing (IMN), or hemi or reverse shoulder arthroplasty (rTSA).

Impact of an Educational Intervention on the Opioid Knowledge and Prescribing Behaviors of Resident Physicians.

Objectives: The opioid epidemic is a multifactorial issue, which includes pain mismanagement. Resident physician education is essential in addressing this issue. We aimed to analyze the effects of an educational intervention on the knowledge and potential prescribing habits of emergency medicine (EM), general surgery (GS), and internal medicine residents (IM).

Survivorship, complications, and outcomes following distal femoral arthroplasty for non-neoplastic indications.

Aims: Endoprosthetic reconstruction with a distal femoral arthroplasty (DFA) can be used to treat distal femoral bone loss from oncological and non-oncological causes. This study reports the short-term implant survivorship, complications, and risk factors for patients who underwent DFA for non-neoplastic indications.

Methods: We performed a retrospective review of 75 patients from a single institution who underwent DFA for non-neoplastic indications, including aseptic loosening or mechanical failure of a previous prosthesis (n = 25), periprosthetic joint infection (PJI) (n = 23), and native or periprosthetic distal femur fracture or nonunion (n = 27).

Scaphotrapezoid Assessment during Thumb Carpometacarpal Arthroplasty: A Cadaveric Study.

 Due to limited sensitivity of radiographs for scaphotrapeziotrapezoid (STT) arthritis and the high rate of concurrence between thumb carpometacarpal (CMC) and STT arthritis, intraoperative visualization of the STT joint is recommended during CMC arthroplasty.  We quantified the percentage of trapezoid facet of the scaphotrapezoid (ST) joint that could be visualized during this approach, and compared it to the degree of preoperative radiographic STT arthritis.  We performed dorsal surgical approach to the thumb CMC joint after obtaining fluoroscopic anteroposterior, lateral, and oblique wrist radiographs of 11 cadaver wrists.

Effects of Upper Extremity Elevation on Intra-Cast Pressure and Digital Perfusion in a Fiberglass Short-Arm Cast Model.

The goal of this study was to determine the relationship of digital artery pressure to arm position and forearm skin surface pressure using a short-arm cast experimental setup, to ascertain the safest position for the injured casted upper extremity. A total of 27 volunteers were placed in bilateral short-arm fiber-glass casts with an empty 50-mL bladder bag under the cast and attached to a pressure transducer. Digital systolic pressure (P), and skin surface pressure under the cast (P) were assessed in 4 positions.

Immediate Weight-Bearing and Range of Motion After Internal Fixation of Selected Malleolar Fractures: A Retrospective Controlled Study.

Objectives: We studied the safety of immediate weight-bearing as tolerated (IWBAT) and immediate range of motion (IROM) after open reduction internal fixation (ORIF) of selected malleolar ankle fractures (defined as involving bony or ligamentous disruption of 2 or more of the malleoli or syndesmosis without articular comminution) and attempted to identify risk factors for complications.

Design: Retrospective case-control study.

Setting: Level 1 Urban Trauma Center and multiple community hospitals, orthopedic specialty hospitals, and outpatient surgicenters within one metropolitan area.

On Emerging Technology: What to Know When Your Patient Has a Microchip in His Hand.

Radio-frequency identification (RFID) technology uses an antenna to respond to an incoming signal by sending an outgoing message. This technology has been in use for over 50 years and is common in daily activities such as tapping a credit card to a reader, swiping an ID badge to open a door, paying highway tolls, and operating keyless entry cars. This technology can be implanted, such as in the microchips used to identify domestic pets.

The Optimal Position for Arthrodesis of the Proximal Interphalangeal Joints of the Border Digits.

Purpose: This study aimed to determine the functional characteristics of various arthrodesis angles of the proximal interphalangeal (PIP) joints of the border fingers.

Methods: The dominant hands of 48 volunteers were tested using custom orthoses to simulate PIP joint arthrodesis. For the index finger (IF), orthoses were made in 25°, 40°, and 55° of flexion (IF25, IF40, and IF55).

Coronal Shear Fractures of the Distal Humerus: A Review of Diagnosis, Treatment, and Outcomes.

Fractures of the capitellum and trochlea are uncommon fractures of the elbow and can be challenging to treat due to their size, location, and articular nature. Because of their intra-articular nature and predilection toward displacement, these fractures are typically treated operatively. Furthermore, capitellum fractures have high rates of associated injuries, including radial head fractures or lateral collateral ligament injury in ~30% to 60% of patients.

Cutaneous Basal Cell Carcinoma with Bone Metastases: An Orthopaedic Case Report.

Basal cell carcinoma (BCC) is the most common skin cancer, and its incidence is increasing. Though metastatic BCC (mBCC) is uncommon, the literature demonstrates a 0.0028%-0.