Does Screw Location Affect the Risk of Subtrochanteric Femur Fracture After Femoral Neck Fixation? A Biomechanical Study.

Background: Case reports suggest that there is an increased risk of subtrochanteric femur fracture after femoral neck fixation with cannulated screws when the distal-most screw is placed distal to the lesser trochanter. However, to our knowledge, there are no biomechanical data supporting this observation.

Questions/purposes: (1) Is there an increased risk of subtrochanteric femur fracture after femoral neck fixation with cannulated screws in normal density and osteoporotic Sawbones when the distal-most screw is started distal to the lesser trochanter? (2) Does the screw starting point position after femoral neck fixation with cannulated screws affect load to failure when normal density and osteoporotic Sawbones are loaded through their mechanical axis?

Methods: Normal density and osteoporotic Sawbones femora were instrumented with three cannulated screws in a triangular apex distal configuration with the distal-most screw starting either proximal to, at, or distal to the level of the lesser trochanter.

Posterolateral clamp placement on the pelvic brim provides optimal reduction of transtectal acetabular fractures fixed through the anterior intrapelvic approach.

Purpose: To determine the optimal position of reduction clamps applied to reduce transtectal transverse acetabular fractures approached through the anterior intrapelvic route.

Methods: Transtectal transverse fractures were created in sawbone hemipelvis models. Fractures were reduced and held with a large pointed reduction clamp with one tine centered on the quadrilateral plate and the other placed in one of nine various positions on the pelvic brim accessible from the anterior intrapelvic (AIP) approach.

Quality and Variability of Online Available Physical Therapy Protocols From Academic Orthopaedic Surgery Programs for Anterior Cruciate Ligament Reconstruction.

Purpose: To assess the quality and variability found across anterior cruciate ligament (ACL) rehabilitation protocols published online by academic orthopaedic programs.

Methods: Web-based ACL physical therapy protocols from United States academic orthopaedic programs available online were included for review. Main exclusion criteria included concomitant meniscus repair, protocols aimed at pediatric patients, and failure to provide time points for the commencement or recommended completion of any protocol components.

Early Characterization of Blast-related Heterotopic Ossification in a Rat Model.

Background: Heterotopic ossification (HO) affects the majority of combat-related lower extremity wounds involving severe fracture and amputation. Defining the timing of early osteogenic-related genes may help identify candidate prophylactic agents and guide the timing of prophylactic therapy after blast and other combat-related extremity injuries.

Questions/purposes: Using a recently developed animal model of combat-related HO, we sought to determine (1) the timing of early chondrogenesis, cartilage formation, and radiographic ectopic bone development; and (2) the early cartilage and bone-related gene and protein patterns in traumatized soft tissue.