Open reduction and internal fixation (ORIF) versus ORIF and primary subtalar arthrodesis for complex displaced intraarticular calcaneus fractures: An expected value decision analysis.

Objectives: To determine the optimal patient-oriented treatment between open reduction and internal fixation (ORIF) with or without primary subtalar arthrodesis (PSTA) for patients with displaced intraarticular calcaneus fractures (DIACFs, OTA 82-C3 and C4).

Design: Expected value decision analysis.

Setting: Academic military treatment facility.

Unstable Ankle Fracture Fixation Using Locked Fibular Intramedullary Nail in High-Risk Patients.

Open reduction internal fixation is the gold standard for unstable ankle fracture fixation; however, complications in patients with multiple medical comorbidities are common. Intramedullary nail fixation of the fibula can help to mitigate these difficulties. A retrospective chart review was performed on all patients who underwent fixation for unstable ankle fracture between January 2015 and March 2016 at our level I trauma center.

Management of displaced midshaft clavicle fractures in adolescent patients using intramedullary flexible nails: A case series.

Introduction: Clavicle fractures are common injuries in adolescent patients. In this study we present our technique and results for treating non-comminuted displaced midshaft clavicle fractures using flexible intra medullary nails.

Methods: A retrospective review of prospectively collected data using the electronic medical record was performed.

Anterior Cruciate Ligament Graft Removal Versus Retention in the Setting of Septic Arthritis After Reconstruction: A Systematic Review and Expected Value Decision Analysis.

Purpose: To provide further guidance on the optimal decision between anterior cruciate ligament (ACL) graft removal versus retention in the setting of septic arthritis following reconstruction using an expected value decision analysis.

Methods: A systematic review and expected value decision analysis and sensitivity analyses were performed to quantify the clinical decision. A decision tree was created with 5 outcomes of interest: nonoperative complications, revision surgery, early reoperation, late reoperation, and "well.

Open reduction-internal fixation versus intramedullary nailing for humeral shaft fractures: an expected value decision analysis.

Background: Previous randomized controlled studies and meta-analyses have failed to collectively favor either open reduction-internal fixation (ORIF) or intramedullary nailing (IMN) fixation. The purpose of our investigation was to elucidate the optimal decision between ORIF and IMN for acute traumatic operative humeral shaft fractures through an expected value decision analysis.

Methods: We performed an expected value decision analysis and sensitivity analysis to elucidate the difference between ORIF and IMN fixation for patients with acute traumatic humeral shaft fractures.

Radial Head Arthroplasty in the Active Duty Military Service Member With Minimum 2-Year Follow-Up.

Purpose: Radial head arthroplasty (RHA) is a viable treatment for complex radial head fracture. Whereas elbow stability and function is typically restored at short- to mid-term follow-up, the outcome in higher-demand populations is not well defined. We sought to characterize the functional and occupational outcomes following RHA in an active duty military population with intense upper extremity demands.

Functional Outcomes Following Surgical Management of Femoral Neck Stress Fractures.

The Military Health System Management Analysis and Reporting Tool was queried to identify all active duty US military service members who underwent operative fixation of femoral neck stress fractures from 2011 to 2012. A total of 13 patients with 17 femoral neck stress fractures met the inclusion criteria. Average patient age was 23.

A New Technique for Obtaining Bone Graft in Cases of Distal Femur Nonunion: Passing a Reamer/Irrigator/Aspirator Retrograde Through the Nonunion Site.

Bone grafting is one of the most common orthopedic procedures. We conducted a study to assess the possibility of passing a Reamer/Irrigator/Aspirator (RIA; DePuy Synthes) retrograde through the nonunion site in distal femur cases. This technique would avoid the complications and discomfort associated with a separate entry site for RIA.

Medial Malleolar Fractures and Associated Deltoid Ligament Disruptions: Current Management Controversies.

Operative fixation of medial malleolar fractures, whether isolated or in the setting of bi- or trimalleolar fractures, remains controversial. Increasingly, anatomic reduction and internal fixation is used to treat medial malleolar fractures to avoid long-term sequelae of symptomatic nonunion and posttraumatic osteoarthritis. However, outcomes have not been significantly different between operative and nonoperative cohorts.

Variables Affecting Return to Play After Anterior Cruciate Ligament Injury in the National Football League.

Background: Anterior cruciate ligament (ACL) injuries are common in the National Football League (NFL). Limited literature exists regarding return to play (RTP) and the factors affecting RTP after ACL reconstruction in NFL players.

Purpose/hypothesis: To determine RTP rates after ACL reconstruction in NFL players and to ascertain which variables affect RTP in these players.

New Technique for Tibiotalar Arthrodesis Using a New Intramedullary Nail Device: A Cadaveric Study.

. Ankle arthrodesis is performed in a variety of methods. We propose a new technique for tibiotalar arthrodesis using a newly designed intramedullary nail.

Lower Extremity Limb Salvage: Lessons Learned From 14 Years at War.

American survivability during the current conflicts in Iraq and Afghanistan continues to improve, though the rate of extremity injury remains quite high. The decision to proceed with amputation versus limb salvage remains controversial. Exposure to combat wound with severe high-energy lower extremity trauma during the previous 14 years at war has incited important advances in limb salvage technique and rehabilitation.

Medialized Clavicular Bone Tunnel Position Predicts Failure After Anatomic Coracoclavicular Ligament Reconstruction in Young, Active Male Patients.

Background: Recent radiographic data have suggested that medialized conoid tunnel placement greater than 25% of absolute clavicular length is correlated with early failure after anatomic coracoclavicular ligament reconstructions. A comparison with a larger active duty military cohort of clinical and radiographic outcomes can serve as a basis for standardizing surgical technique.

Purpose: To establish the ideal radiographic tunnel position for anatomic coracoclavicular ligament reconstruction and to elucidate variables associated with early loss of reduction and ability to return to active-duty military service.