Hybrid screw fixation for femoral neck fractures: Does it prevent mechanical failure?

Introduction: Traditionally, femoral neck fracture fixation has been performed using three partially threaded cancellous screws. However, fracture collapse with femoral neck shortening, and varus deformation frequently occurs due to posterior medial comminution and lack of calcar support. We hypothesize replacing the inferior neck/calcar screw with a fully threaded, length stable, screw will provide improved biomechanical stability, decrease femoral neck shortening and varus collapse.

Risk factors for achilles tendon rupture: A matched case control study.

Purpose: The purpose of this study was to elucidate whether body mass index (BMI), activity level, and other risk factors predispose patients to Achilles tendon ruptures.

Materials And Methods: A retrospective review of 279 subjects was performed (93 with Achilles tendon rupture, matched 1:2 with 186 age/sex matched controls with ankle sprains). Demographic variables and risk factors for rupture were tabulated and compared.

Prevention of inaccurate targeting of proximal screws during reconstruction femoral nailing.

Purpose: The purpose of this study was to identify the underlying cause by simulating the forces involved in a controlled laboratory setting, and then to illustrate some intraoperative tips on how to detect this malalignment and suggest solutions prevent this intraoperative complication.

Methods: The Expert Asian Femoral Nail (A2FN) and Proximal Femoral Nail Antirotation (PFNA) reconstruction nail systems were evaluated to compare the characteristics of each nailing system and their reactions to soft tissue tension at the time of proximal reconstruction screw placement. Soft tissue tension was simulated by placing a fulcrum under the distal drill sleeve and exerting a load on the targeting device via the addition of weights.

Does the OTA Open Fracture Classification Predict the Need for Limb Amputation? A Retrospective Observational Cohort Study on 512 Patients.

Background: Few studies have examined the utility of the Orthopaedic Trauma Association Open Fracture Classification (OTA-OFC) compared to the traditional Gustilo-Anderson classification for prediction of treatment outcomes in patients with open fractures. QUESTIONS/OBJECTIVES:: (1) How do the Gustilo-Anderson classification and OTA-OFC systems compare in accuracy of predicting limb amputation, infection, and need for soft tissue coverage? (2) Is there an OTA-OFC summative threshold score that may guide the discussion and decision-making with regard to limb salvage or amputation?

Design: Retrospective observational cohort study; Level IV evidence.

Setting: Level I trauma center and urban safety-net institution.

Erratum: The Management of Kienböck Disease: A Survey of the ASSH Membership.

[This corrects the article DOI: 10.1055/s-0035-1544225.].

The Management of Kienböck Disease: A Survey of the ASSH Membership.

Background The purpose of this study was to determine the current trends and common practices for the treatment of Kienböck disease at different stages. Question/Purpose To determine the current trends and common practices by hand surgeons for the treatment of Kienböck disease. Methods A survey with hypothetical Kienböck disease cases stratified by the Lichtman staging system was distributed to the American Society for Surgery of the Hand (ASSH) members.

An observational case series of HIV-positive patients treated with open reduction internal fixation for a closed lower extremity fracture.

Objectives: The purpose of this study was to investigate the influence of immune deficiency status of HIV-positive patients on postoperative complication such as surgical site infection and nonunions.

Design: Retrospective observational cohort study: Level III.

Setting: Level I trauma center.

Custom-made antibiotic cement nails: a comparative study of different fabrication techniques.

Introduction: The management of intramedullary long bone infections remains a challenge. Placement of antibiotic cement nails is a useful adjuvant to the antibiotic treatment of osteomyelitis. However, fabrication of antibiotic cement nails can be arduous.

Osteoporosis and the orthopaedic surgeon: basic concepts for successful co-management of patients' bone health.

Osteoporosis has been recognised as a public health concern for at least three decades but it has been relatively recent that the push has been for orthopaedic surgeons to take a more active role in the diagnosis and treatment of patients with decreased bone mineral density (BMD). Most often these patients are encountered after they have suffered a fracture making secondary prevention the area where orthopaedists may exert the greatest influence on patient care. The purpose of this article is to provide a succinct framework for the diagnosis and treatment of patients with decreased BMD.

The epidemiology and injury patterns of acetabular fractures: are the USA and China comparable?

Background: Acetabular fractures are rare injuries in heterogeneous patient groups, making it difficult to develop adequately powered prospective single-center clinical trials in the USA or Europe. Chinese trauma centers treat a high volume of these injuries, and if the patient population and injury patterns are comparable to those in the USA, this might support development of multicenter studies in Level I trauma centers in the two countries.

Questions/purposes: We determined whether the following parameters were similar between operative acetabular fractures treated at Chinese and US trauma centers: (1) epidemiology of injured patients, (2) mechanism of injuries and fracture types, and (3) hospital stay parameters, including symptomatic postoperative deep vein thrombosis (DVT) rate.

Balloon tibioplasty: pearls and pitfalls.

Methods of tibial plateau fracture fixation have evolved over the last decades; however the techniques used to reduce these fractures have remained relatively unchanged. Balloon tibioplasty, a minimally invasive novel technique used in the reduction of depressed tibial plateau fractures, has been gaining popularity. This technique offers a slow controlled expansion of the balloon with multidirectional force vectors and a large surface area allowing for more bone to be elevated simultaneously.

Osteoporotic ankle fractures: an approach to operative management.

The incidence of osteoporosis is increasing as the elderly population grows. Because these patients remain active, fragility fractures of the ankle are becoming more common. The literature indicates a relatively high complication rate for non-operative management of ankle fractures in this patient cohort, leading surgeons to face challenges unique to patients with poor bone and skin quality.

Age and genetic strain differences in response to chronic methylphenidate administration.

Methylphenidate hydrochloride (MPD) is a psychostimulant used in the treatment of attention deficit hyperactive disorder (ADHD) in adolescents and adults alike. Adolescence involves a period of neural development that is highly susceptible to environmental and pharmacological influence. Exposure to a psychostimulant like MPD during this crucial time period may cause permanent changes in neuronal function and formation.