Refined Techniques in Tibial Nailing.

Intramedullary nail fixation of unstable tibial diaphyseal fractures is commonly used with excellent clinical results. Indications for nailing have rapidly expanded over recent years, allowing for more difficult fractures to be addressed with "extreme nailing." Despite its widespread use, evolution of newer nailing systems and varying techniques for insertion bring new difficulties with tibial fracture reduction, and malalignment occurs with relative frequency.

Pathoanatomy of the anterior column-posterior hemitransverse acetabular fracture.

Purpose: To define the pathoanatomy of the anterior column-posterior hemitransverse (ACPHT) subtype of acetabulum fractures and assess the morphologic variation therein.

Methods: Retrospective cohort study including 50 patients age greater than 60 with an ACPHT acetabular fracture managed operatively over an 11-year period at an ACS Level 1 Trauma center. Cross-sectional CT images were reviewed for anterior column/wall comminution, anterior column fracture exit point, completeness of the anterior column and posterior column fractures, articular impaction and quadrilateral surface continuity with the posterior column.

Chronic social stress induces p16-mediated senescent cell accumulation in mice.

Life stress can shorten lifespan and increase risk for aging-related diseases, but the biology underlying this phenomenon remains unclear. Here we assessed the effect of chronic stress on cellular senescence-a hallmark of aging. Exposure to restraint stress, a psychological non-social stress model, increased p21 exclusively in the brains of male, but not female mice, and in a p16-independent manner.

Standardization and Reproducibility of Dynamic Stress Testing for Occult Pelvic Ring Instability.

Introduction: Examination under anesthesia (EUA) (stress fluoroscopy) is commonly done after pelvic ring injury to identify occult instability because unstable disruptions may displace causing morbidity. The force applied during EUA for these injuries has not been standardized. The purpose of this study was to examine the forces used during the EUA by experienced orthopaedic trauma pelvic surgeons.

Treatment Failure After Repair of Displaced Femoral Neck Fractures in Patients Compared by "Decade of Life": An Analysis of 565 Cases in Adults Less Than 60 years of Age.

Objectives: To study the results of displaced femoral neck fractures (FNFs) in adults less than 60 years of age by comparing patients, injury, treatment, and the characteristics of treatment failure specifically according to patients' age at injury, that is, by their "decade of life" [ie, "under 30" (29 years and younger), "the 30s" (30-39 years), "the 40s" (40-49 years), and "the 50s" (50-59 years)].

Design: Multicenter retrospective comparative cohort series.

Setting: Twenty-six North American Level 1 Trauma Centers.