Distraction Osteogenesis of the Fibula to Correct Ankle Valgus in Multiple Hereditary Exostoses.

Gradual distal fibula lengthening (DFL), in conjunction with other procedures, was used to correct ankle valgus and short fibulae in three pediatric patients with multiple hereditary exostoses (MHE). The average amount of DFL was 15 mm with a mean follow-up of 2.9 years.

Addressing the Hill-Sachs Lesion Humeral Head Bone Loss and Glenohumeral Instability.

Osseous injuries affecting the posterosuperolateral aspect of the humeral head, also known as the Hill-Sachs lesion, are common and can pose a difficult problem for the operating surgeon. Hill-Sachs lesions can lead to recurrent shoulder instability if not identified and addressed. This review will focus on osseous defects of the humeral head and address the pathoanatomy, diagnosis, indications, and surgical techniques for the treatment of these lesions.

Regional anesthesia improves outcome in patients undergoing proximal humerus fracture repair.

Background: The purpose of this study was to examine functional outcomes following ORIF of displaced proximal humerus fractures in patients who received brachial plexus blocks compared to those who underwent general anesthesia.

Methods: We retrospectively reviewed prospectively collected data on 92 patients. Patients were grouped according to anesthesia type: regional interscalene brachial plexus block, with or without general anesthesia, or general anesthesia alone.

Applying quality principles to orthopaedic surgery.

The unsustainable rising cost of medical care is creating financial pressures that will critically alter the way that health care is paid for and delivered. Limited resources dictate that physicians must become more efficient at providing high quality care. In an effort to provide financial incentive for delivering quality care, the federal government instituted value-based purchasing to transform Medicare from a passive payer of claims to an active purchaser of medical care.

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.

Outcomes of open reduction and internal fixation of proximal humerus fractures managed with locking plates.

We conducted a study to evaluate the outcomes and complications of open reduction and internal fixation (ORIF) of 2-, 3-, and 4-part proximal humerus fractures using a standard management protocol with locking plates. Of 72 patients with acute proximal humerus fractures managed with ORIF and locking plates, 63 were available at the minimum follow-up of 1 year and met the inclusion criteria. At each follow-up, radiographs were reviewed for healing, hardware failure, osteonecrosis, shoulder range of motion, and DASH (Disabilities of the Arm, Shoulder, and Hand) scores; any complications were recorded.

Using magnetic resonance imaging to determine preoperative autograft sizes in anterior cruciate ligament reconstruction.

Purpose: Accurate prediction of autograft size for anterior cruciate ligament reconstruction can assist in preoperative planning and decision-making regarding graft choices. This study seeks to determine the accuracy of MRI measurements by comparing intraoperative measurements of the patella, semitendinosis, and gracilis tendons while correlating these measurements with patient anthropometric data such as gender, height, and weight.

Methods: A series of 20 consecutive patients were enrolled who underwent a magnetic resonance imaging study of the knee and proceeded with surgical reconstruction of the anterior cruciate ligament.

Surgical technique: arthroscopic treatment of heterotopic ossification of the hip after prior hip arthroscopy.

Background: The incidence of heterotopic ossification (HO) after hip arthroscopy reportedly ranges from less than 1.0% to 6.3%.

Fracture site augmentation with calcium phosphate cement reduces screw penetration after open reduction-internal fixation of proximal humeral fractures.

Background: We sought to examine fracture settling and screw penetration after open reduction-internal fixation of 2-, 3-, and 4-part proximal humeral fractures and determine whether the use of calcium phosphate cement reduced these unwanted complications.

Methods: We performed a retrospective study of prospective data. Inclusion criteria included patient age of 18 years or older and an acute traumatic fracture of the proximal humerus that was treated with open reduction-internal fixation with a locked plate.

Three- and four-part fractures have poorer function than one-part proximal humerus fractures.

Background: Locking plates have become a commonly used fixation device in the operative treatment of three- and four-part proximal humerus fractures. Examining function in patients treated nonoperatively and operatively should help determine whether and when surgery is appropriate in these difficult-to-treat fractures.

Questions/purposes: We compared functional scores, ROM, and radiographs in patients with one-part proximal humerus fractures treated nonoperatively to those in patients with displaced three- and four-part proximal humerus fractures treated with open reduction and internal fixation using locking plates.

Early complications in proximal humerus fractures (OTA Types 11) treated with locked plates.

Purpose: To examine our incidence of early complications that occur using the Proximal Humeral Internal Locking System (PHILOS) and to determine the contributing factors.

Setting: Academic medical center.

Patients: Fifty-one consecutive patients treated with a proximal humerus locking plate.