Background: The systemic inflammatory response syndrome (SIRS) is a clinical reaction that can occur due to a variety of stimuli. Reamed intramedullary femoral nailing is a common orthopedic surgery that has been shown to induce SIRS. To date, no nationwide analyses have been performed to evaluate the incidence, risk factors, and economic burdens of SIRS following intramedullary femoral nailing for femoral shaft fractures.
View Article and Find Full Text PDFBackground: A surgical site infection (SSI) rate of 4%-8% has been reported in patients who undergo open reduction and internal fixation (ORIF) for acetabular fractures. Studies have identified risk factors for SSI, but none have performed a nationwide analysis of SSI in surgically managed acetabular fracture patients.
Methods: The National Inpatient Sample (NIS) database was queried for patients who underwent ORIF for acetabular fractures from 2016 to 2019.
Case: A fifteen-year-old male patient sustained a posteriorly dislocated right capital femoral Delbet type Ib epiphyseal fracture-separation and a right acetabular posterior column fracture after a low-energy trip and fall. The capital femoral epiphysis was closed reduced and fixed with cannulated screws on an urgent basis. He underwent acetabular osteosynthesis via a Kocher-Langenbeck approach two days thereafter.
View Article and Find Full Text PDFBackground: Injuries of the tarsometatarsal joint complex ranging from purely ligamentous to multidirectionally unstable midfoot fracture-dislocations are anatomically fixed to minimize long-term sequelae including post-traumatic arthritis, pes planus deformity, and chronic pain. Lateral column disruption is commonly treated with temporary Kirschner wire (K-wire) fixation, maintaining alignment during healing and allowing resumption of physiologic motion after hardware removal. More unstable fracture patterns may require temporary cortical screw fixation to maintain adequate reduction.
View Article and Find Full Text PDFCase: A 70-year-old woman pedestrian struck by a motor vehicle presented with multiple orthopaedic injuries including a humeral head fracture dislocation with a large segment of humeral head located in the mediastinum. Thoracic surgery personnel performed a minimally-invasive video-assisted thoracoscopic extraction of the humeral head, and the patient underwent subsequent reverse total shoulder arthroplasty.
Conclusion: Intramediastinal displacement of the humeral head is a rare, yet serious traumatic injury that necessitates early recognition and comanagement with cardiothoracic or thoracic surgery.
The objective of this study was to understand postoperative resorption of the anterior osseous fragment following closed reduction and percutaneous pinning (CRPP) of pediatric supracondylar humerus fractures and its effect on final range of motion (ROM). Eighty-six patients that underwent CRPP had sagittal and or axial plane deformities resulting in an anterior fragment. Humerocapitellar angle (HCA), anterior humeral line (AHL) and angle of rotation (AoR) were measured.
View Article and Find Full Text PDFBackground: The incidence and risk factors for post-traumatic cervical epidural hematoma are not well described in the current literature. Our aim was to determine the incidence and associated risk factors for post-traumatic cervical spine epidural hematoma (SEH).
Methods: We performed a retrospective review of our institution's prospectively collected data submitted to the state trauma registry, using ICD-9 codes, for all patients activated as a trauma with cervical spine injuries, between the years 2010 and 2014.
Combined fractures of the acetabulum and pelvic ring are more common than previously believed, with an incidence as high as 15.7%. Recent series that include combined injuries indicate that the incidence of lateral compression and anteroposterior compression pelvic ring injuries is similar and that transverse and both-column acetabular fractures are the most common acetabular fracture patterns.
View Article and Find Full Text PDFJ Bone Joint Surg Am
February 2010
Background: A variety of treatment options exist for open pilon fractures of the distal end of the tibia. In this study, we evaluated the use of a staged protocol designed to minimize the risk of soft-tissue complications and to allow for optimal reduction of the fracture.
Methods: Sixty-eight patients presenting with an open pilon fracture were identified from a prospectively maintained database of 186 consecutive patients.
Objective: The purpose of our study was to analyze the outcomes of patients treated with combined open reduction internal fixation (ORIF) and primary total hip arthroplasty (THA) for selected cases of acetabular fractures.
Design: Retrospective case series.
Setting: University Medical Center.
Objectives: To assess the wound complications and reductions achieved in a cohort of patients with pilon fractures who were treated using a novel lateral approach.
Design: Retrospective review.
Setting: Two level 1 trauma centers affiliated with academic institutions.