The Highly Reliable, Patient-Centered Sports Medicine Practice.

Patient-centered care is safe and eliminates preventable patient harm. Sports medicine teams that understand and apply the principles of high reliability, as demonstrated by high-performing communities in the US Navy, will provide safer, higher-quality care. Sustaining high-reliability performance is challenging.

An Outbreak of Covid-19 on an Aircraft Carrier.

Background: An outbreak of coronavirus disease 2019 (Covid-19) occurred on the U.S.S.

Dental Patient Safety in the Military Health System: Joining Medicine in the Journey to High Reliability.

Introduction: Delivering consistent high quality care in a safe environment is the goal of the modern dental delivery system. Preventable adverse events, however, are still commonplace in dentistry. As has been demonstrated in the medical field, a concerted and persistent effort will be required to objectively understand and begin to eliminate the sources of dental error.

A Guide to Understanding Reimbursement and Value-Based Care in the Military Health System.

Introduction: With the continued rise in the cost of U.S. health care, there is an increased emphasis on value-based care methodologies.

Biomechanical comparison of four different fixation techniques for pediatric tibial eminence avulsion fractures.

Background: Several different methods have been used to repair tibial eminence avulsion fractures. It is not clear which is the best stabilization method. The purpose of this study was to compare the biomechanical stability of tibial eminence avulsion fractures using suture, resorbable screw, resorbable nail, and metal screw techniques.

Orthopedic manifestations and management of patients with von Willebrand disease.

Von Willebrand Disease is the most common inherited bleeding disorder and can present challenges to orthopedic surgeons in managing perioperative bleeding and treating orthopedic problems that manifest as a result of the disease. Appropriate history taking is essential to identify these patients prior to surgery. The most effective management of von Willebrand disease will be achieved with close consultation between the surgeon, anesthesiologist, internist or pediatrician, hematologist, and patient.

Tactical surgical intervention with temporary shunting of peripheral vascular trauma sustained during Operation Iraqi Freedom: one unit's experience.

Background: Rapidly restoring perfusion to injured extremities is one of the primary missions of forward military surgical teams. The austere setting, limited resources, and grossly contaminated nature of wounds encountered complicates early definitive repair of complex combat vascular injuries. Temporary vascular shunting of these injuries in the forward area facilitates rapid restoration of perfusion while allowing for deferment of definitive repair until after transport to units with greater resources and expertise.

The experience of the US Marine Corps' Surgical Shock Trauma Platoon with 417 operative combat casualties during a 12 month period of operation Iraqi Freedom.

Background: The Forward Resuscitative Surgical System (FRSS) is a small, mobile trauma surgical unit designed to support modern US Marine Corps combat operations. The experience of two co-located FRSS teams during 1 year of service in Operation Iraqi Freedom is reviewed to evaluate the system's efficacy.

Methods: Between March 1, 2004, and February 28, 2005, two FRSS teams and a shock trauma platoon were co-located in a unit designated the Surgical Shock Trauma Platoon (SSTP).

Early onset idiopathic scoliosis.

Children with early onset scoliosis typically present before age 5 years. Radiographic criteria help to distinguish progressive cases from those that will spontaneously resolve. Severe cardiopulmonary problems may occur in untreated progressive cases.

Small bowel perforation from unit rod posterior spinal fusion.

An unusual complication of bowel perforation after unit rod posterior spinal fusion and anterior spine release via a retroperitoneal approach is described. This complication has not been previously described. The pediatric surgical specialist should be aware of this consideration in the differential diagnosis of abdominal pain after unit rod posterior spinal fusion.

Localized pigmented villonodular synovitis: three cases of intra-articular knee involvement.

Pigmented villonodular synovitis (PVNS) is a relatively uncommon, benign hypertrophy of synovial tissue that mimics numerous intra-articular derangements or neoplasms. Patients with PVNS present with a variety of symptoms. Pigmented villonodular synovitis may exist in other orthopedic pathology, making it a difficult diagnosis without histologic examination.

Fixed subtalar subluxation in a pediatric patient: an unusual entity.

Atraumatic, fixed subluxation of the subtalar joint in the pediatric population has not been described. This report describes such a case in a skeletally immature boy.

Risk of refracture through unicameral bone cysts of the proximal femur.

The authors determined the results after traction or traction and hip spica treatment of the initial fractures through unicameral bone cysts of the proximal femur in 20 children. All of the eight displaced fractures healed, but with coxa vara and avascular necrosis in one, coxa vara in a second, and coxa breva in a third. Spontaneous healing of the cyst occurred in three of the eight children; satisfactory healing was achieved and maintained after intralesional corticosteroid injections in four of the eight children.