Experience as an Orthopaedic Patient as a Motivating Factor for Pursuing a Career in Orthopaedic Surgery.

Introduction: The purpose of this study was to investigate the influence a personal experience with an orthopaedic injury or condition has on applicants' decisions to pursue orthopaedic surgery and to investigate current applicant motivations for pursuing orthopaedic surgery.

Methods: This was a cross-sectional survey study of orthopaedic surgery applicants during the 2023 to 2024 application cycle who applied to the residency program at a single academic institution.

Results: Of the 290 respondents (38.

Open Reduction and Internal Fixation of Femoral Head Fracture After Firearm Injury: A Case Report.

Case: A 21-year-old man presented with a femoral head (FH) fracture from a firearm injury. The FH had a comminuted, minimally displaced fracture with intertrochanteric extension and a retained bullet. This patient was treated with surgical hip dislocation (SHD) and open reduction internal fixation (ORIF).

Long bone fractures with associated vascular injury: Who should go first?

Objectives: Long bone fractures with concomitant vascular injury have the potential to be life and limb threatening injuries, with increased risk for limb loss. There is currently no established surgical order of operations for orthopaedic and vascular intervention. This study compares injury classification, warm ischemia time and patient outcomes in patients with long bone fractures and associated vascular injury after orthopaedic versus vascular primary intervention.

Management of Grade 1 Open Distal Radius Fractures: A Survey of Practicing Surgeons.

Introduction Standard of care management for open fractures historically mandates emergent systemic antibiotic administration, followed by urgent irrigation and debridement in the operating room, regardless of injury severity. However, significant controversy exists regarding the specific implementation and importance of these commonly accepted guidelines. We aimed to define differences in the management of grade 1 open distal radius fractures.

Supra-acetabular Pin Placement Without Fluoroscopy in Anterior Pelvic External Fixation Application.

High-energy pelvic ring injuries are associated with a significant rate of mortality and may require urgent stabilization with anterior pelvic external fixation. The iliac crest can be used for pin placement, but supra-acetabular pin placement is biomechanically superior. Traditionally, supra-acetabular pin placement is performed in the operating room, with time-consuming imaging techniques.

Excessively long interfragmentary screws for posterior wall acetabular fractures can predict intra-articular penetration.

Background: The fixation of posterior wall acetabular fractures often utilizes interfragmentary screws with varying length. Intricate pelvic anatomy and overhanging greater trochanter make obtaining proper screw trajectory difficult. A large measurement may represent aberrant trajectory and breach of the articular surface.

Unnecessary Preoperative Cardiology Evaluation and Transthoracic Echocardiogram Delays Time to Surgery for Geriatric Hip Fractures.

Objective: Delays to surgery for patients with geriatric hip fracture are associated with increased morbidity and mortality. The American Heart Association (AHA) and American College of Cardiology (ACC) Clinical Practice Guidelines (CPG) were created to standardize preoperative cardiology consultation and transthoracic echocardiogram (TTE). This study's purpose is to determine if these practices are over used and delay time to surgery at a safety net hospital.

Safety of Early Weight Bearing Following Fixation of Bimalleolar Ankle Fractures.

Ankle fractures are common orthopedic injuries. Although operative indications and subsequent stabilization of these fractures have not significantly changed, postoperative protocols remain highly variable. Effects of early weight bearing (EWB) on fracture characteristics in operatively stabilized bimalleolar and bimalleolar equivalent ankle fractures remain poorly publicized.

Bilateral Acetabular Fractures Associated with Seizures: A Report of 2 Cases.

Cases: Two elderly women with significant medical comorbidities presented to a community hospital setting after new-onset generalized seizure activity while in bed without a history of trauma. Both were diagnosed by computed tomography scan with bilateral acetabular fractures. Owing to altered mental status from a postictal period, both were unable to be reliably assessed for pain, which resulted in a diagnostic delay.

High-Energy Fractures of the Pelvis and Acetabulum in Pediatric Patients.

Fractures of the pelvis and acetabulum, although uncommon in the pediatric cohort, represent a range of injuries with similarities to those seen in the adult cohort but with key differences that are important for the treating physician to be aware of to allow for systematic evaluation and management of these potentially life-threatening injuries. As the pediatric skeleton matures, changes in anatomy and physiology influence injury pattern, diagnosis, treatment, and complications. High-energy fractures of the pediatric pelvis are particularly concerning given the reported mortality rates ranging from 3.

Fascia Iliaca Block Decreases Hip Fracture Postoperative Opioid Consumption: A Prospective Randomized Controlled Trial.

Objectives: To determine the efficacy of a preoperative fascia iliaca compartment block in decreasing postoperative pain and improving functional recovery after hip fracture surgery.

Design: Randomized prospective Level 1 therapeutic.

Setting: Academic Level 1 trauma center.

Functional Outcomes After Muscle-Sparing Fixation of Flail Chest Injuries.

Objectives: To present outcomes in a multicenter review of a large number of flail chest patients.

Design: Retrospective case series.

Setting: One urban Level I and 1 urban Level II trauma center.

Difficulty of Total Hip Arthroplasty Following Open Reduction and Internal Fixation of Acetabular Fractures.

Background: The incidence of posttraumatic arthrosis after acetabular fractures is significant, and patients frequently require secondary total hip arthroplasty. Conversion arthroplasty is more technically difficult, and there is higher risk than with routine primary total hip arthroplasty. The goal of this study was to identify the challenges and risks of secondary total hip arthroplasty compared to primary total hip arthroplasty.

Trochanteric entry femoral nails yield better femoral version and lower revision rates-A large cohort multivariate regression analysis.

Introduction: Intramedullary nailing (IMN) has become the standard of care for the treatment of most femoral shaft fractures. Different IMN options include trochanteric and piriformis entry as well as retrograde nails, which may result in varying degrees of femoral rotation. The objective of this study was to analyze postoperative femoral version between three types of nails and to delineate any significant differences in femoral version (DFV) and revision rates.

Operative Fixation of Rib Fractures Indications, Techniques, and Outcomes.

Rib fractures are extremely common injuries and vary in there severity from single nondisplaced fractures to multiple segmental fractures resulting in flail chest and respiratory compromise. Historically, rib fractures have been treated conservatively with pain control and respiratory therapy. However this method may not be the best treatment modality in all situations.

Transosseous-Equivalent Repair for Distal Patellar Tendon Avulsion.

Extensor mechanism disruptions are relatively uncommon injuries involving injury to the quadriceps tendon, patella, or patellar tendon. Patellar tendon avulsions from the tibial tubercle in adults are rare; as such, little technical information has been written regarding surgical management of this injury in the adult. Transosseous-equivalent repairs have been described in the management of several types of tendon ruptures, including rotator cuff and distal triceps tendon ruptures, but not previously in patellar injuries.

Can Tibial Shaft Fractures Bear Weight After Intramedullary Nailing? A Randomized Controlled Trial.

Objective: To examine the potential benefits and risks associated with weight-bearing after intramedullary (IM) nailing of unstable tibial shaft fractures.

Design: Randomized controlled trial.

Setting: Two New York State level 1 trauma centers, one level 2 trauma center, and 1 tertiary care orthopaedic hospital in a large urban center in New York City.

Does Brachial Plexus Blockade Result in Improved Pain Scores After Distal Radius Fracture Fixation? A Randomized Trial.

Background: Distal radius fractures are very common injuries and surgical treatment for them can be painful. Achieving early pain control may help improve patient satisfaction and improve functional outcomes. Little is known about which anesthesia technique (general anesthesia versus brachial plexus blockade) is most beneficial for pain control after distal radius fixation which could significantly affect patients' postoperative course and experience.

Preoperative Planning in Orthopaedic Surgery. Current Practice and Evolving Applications.

Preoperative planning is an essential prerequisite for the success of orthopaedic procedures. Traditionally, the exercise has involved the written down, step by step "blueprint" of the surgical procedure. Preoperative planning of the technical aspects of the orthopaedic procedure has been performed on hardcopy radiographs using various methods such as copying the radiographic image on tracing papers to practice the planned interventions.

Continuous Popliteal Sciatic Nerve Block Versus Single Injection Nerve Block for Ankle Fracture Surgery: A Prospective Randomized Comparative Trial.

Objectives: To compare rebound pain and the need for narcotic analgesia after ankle fracture surgery for patients receiving perioperative analgesia through either a continuous infusion or a single injection nerve block.

Design: Prospective randomized controlled trial.

Settings: Surgeries were performed at 2 hospitals affiliated with a large urban academic medical center.

The evaluation and management of cartilage lesions affecting the patellofemoral joint.

Patellofemoral chondral lesions are unique and difficult-to-treat entities often affecting a young and active patient population. Recent advances in our understanding of cartilage injuries, surgical techniques, and surgical technology have provided treatment options for symptomatic patients with lesions of the patellofemoral compartment. A number of surgical treatment options are available, including surgical microfracture, autologous or juvenile chondrocyte implantation, osteochondral autograft transfer, and osteochondral allograft implantation.