Orthopaedic trauma care during a pandemic: initial responses in the United States and Canada.

As in other countries, COVID-19 had a significant impact on the delivery of Orthopaedic trauma care in North America. Both Canada and the United States had similar experiences and responses to the pandemic, while the burden of disease was significantly greater in the United States. There was significant uncertainty in the early phases of the pandemic, fueled by a lack of knowledge of the pathophysiology and spread of COVID-19, questions surrounding screening protocols, lack of guidelines for managing infected patients, and concern over limited supplies of personal protective equipment.

A Reevaluation of the Risk of Infection Based on Time to Debridement in Open Fractures: Results of the GOLIATH Meta-Analysis of Observational Studies and Limited Trial Data.

Background: Open fractures are one of the leading causes of disability worldwide. The threshold time to debridement that reduces the infection rate is unclear.

Methods: We searched all available databases to identify observational studies and randomized trials related to open fracture care.

Technique for Removal of Broken InterTAN Integrated Cephalomedullary Screw.

Pertrochanteric femoral fractures are routinely treated with cephalomedullary nailing, with good success. In the event of nonunion, implant fatigue failure may occur. The Trigen InterTAN system (Smith & Nephew, Memphis, TN) features 2 integrated cephalomedullary screws for improved rotational stability of the proximal segment.

Open fractures with soft-tissue loss: Coverage options and timing of surgery.

Open fractures with soft-tissue loss remain challenging injuries to treat. These often high-energy fractures are at a higher risk of delayed healing and at much higher risk of infection than open fractures with less significant soft-tissue injury. The initial management of the open wound, flap coverage options, and the timing of definitive coverage all remain areas of controversy, which will be discussed in this article.

Ankle Fractures: An Expert Survey of Orthopaedic Trauma Association Members and Evidence-Based Treatment Recommendations.

Objectives: To describe current practice patterns of orthopaedic trauma experts regarding the management of ankle fractures, to review the current literature, and to provide recommendations for care based on a standardized grading system.

Design: Web-based survey.

Participants: Orthopaedic Trauma Association (OTA) members.

Open reduction and internal fixation compared with ORIF and primary subtalar arthrodesis for treatment of Sanders type IV calcaneal fractures: a randomized multicenter trial.

Objectives: To compare long-term health outcome of Sanders type IV calcaneal fractures treated with open reduction and internal fixation (ORIF) versus ORIF plus primary subtalar arthrodesis (PSTA).

Design: Randomized prospective multicenter trial.

Setting: Four Level 1 trauma hospitals in Canada.

Selection of outcome measures for patients with hip fracture.

In designing a study protocol relating to hip fracture treatment and outcomes, it is important to select appropriate outcome instruments. Before beginning the process of instrument selection, investigators must gain a comprehensive understanding of the condition of interest and have a thorough knowledge of the expected benefits and harms of the proposed intervention. Adequate evidence of an intervention's effectiveness includes indication of impact on the patient's health.

Functional outcomes of severe bicondylar tibial plateau fractures treated with dual incisions and medial and lateral plates.

Background: Plate fixation of comminuted bicondylar tibial plateau fractures remains controversial. This retrospective study was performed to evaluate the perioperative results and functional outcomes of medial and lateral plate stabilization, through anterolateral and posteromedial surgical approaches, of comminuted bicondylar tibial plateau fractures.

Methods: Over a seventy-seven-month period, eighty-three AO/OTA type-41-C3 bicondylar tibial plateau fractures were treated with medial and lateral plate fixation through two exposures.

Open clavicle fractures and associated injuries.

Objectives: To describe the associated injuries, demographic distribution, and management of patients sustaining open clavicle fractures.

Design: Retrospective case series.

Setting: A single level-1 trauma center.

The olecranon osteotomy: a six-year experience in the treatment of intraarticular fractures of the distal humerus.

Objectives: The transolecranon exposure for distal humerus fractures is a suggested technique for improving articular visualization, allowing accurate reduction. Significant osteotomy complications such as nonunion and implant prominence have prompted recommendations for alternate exposures. The purposes of this study are to present the techniques and complications of the olecranon osteotomy for the management of distal humerus fractures, and to evaluate the adequacy of distal humeral and olecranon articular reductions.