Suprapatellar Tibial Nailing: Future or Fad?

Over the last hundred years, there have been significant advancements in the way the Orthopaedic community treats tibial fractures. More recently, the focus of Orthopaedic trauma surgeons has been comparing the different techniques of insertion for tibial nails, specifically suprapatellar (SPTN) versus infrapatellar. The existing literature is convincing that there does not appear to be any clinically significant differences between suprapatellar and infrapatellar tibial nailing, with some apparent benefits of SPTN.

Conceptualizing Biological Aging and Frailty in Orthopaedics: A Framework for Clinical Practice.

➤: Biological aging can best be conceptualized clinically as a combination of 3 components: frailty, comorbidity, and disability.

➤: Despite advancements in the understanding of senescence, chronological age remains the best estimate of biological age. However, a useful exercise for practitioners is to look beyond chronological age in clinical and surgical decision-making.

Improving outcomes after hip fracture at a safety net hospital with a standardised hip fracture protocol.

Introduction: standardised protocols for the care of geriatric hip fractures demonstrate improved patient outcomes with decreased cost. The purpose of this study is to evaluate outcomes of a standardised hip fracture protocol at an urban safety-net hospital.

Methods: All trauma patients presenting to our urban safety-net hospital are included in a trauma database and inpatient outcomes recorded.

Management of Pain Associated with Fractures.

Purpose Of Review: The purpose is to review current literature on pain management strategies from initial presentation to postoperative care on common fracture types.

Recent Findings: - Hip fractures benefit from use of multimodal pain control for early mobility and decreased narcotic requirement. - Distal radius fracture pain during reduction can be managed with hematoma block.

Second physician review of radiographs after wrist and ankle reductions offers limited utility to clinical management.

Purpose: The purpose of this study is to determine the clinical utility of second-physician review of radiographs obtained after reduction of distal radius and ankle fractures.

Methods: Fifty consecutive ankle and distal radius fractures requiring reduction were reviewed. The time from post-reduction radiograph to second-physician interpretation was obtained.