Predictors of quality of life, economic impact, and loss to follow-up after open tibial shaft fractures in Ghana.

Objectives: Open tibia fractures are associated with substantial morbidity and impact on quality of life. Despite increasing incidence in low-resource settings, most open tibia fracture research comes from high-resource settings. This study aimed to assess the impact of socioeconomic status on treatment modality and evaluate predictors of health-related quality of life following open tibia fractures in Ghana.

A Randomized Clinical Trial of Direct Anterior Versus Mini-Posterior Total Hip Arthroplasty: Small, Early Functional Differences Did Not Lead to Meaningful Clinical Differences at 7.5 Years.

Background: Our previously reported randomized clinical trial of direct anterior approach (DAA) versus mini-posterior approach (MPA) total hip arthroplasty showed slightly faster initial recovery for patients who had a DAA and no differences in complications or clinical or radiographic outcomes beyond 8 weeks. The aims of the current study were to determine if early advantages of DAA led to meaningful clinical differences beyond 5 years and to identify differences in midterm complications.

Methods: Of the 101 original patients, 93 were eligible for follow-up at a mean of 7.

COVID-19 Stay-at-home mandates impacts daily ambulatory bout intensity and duration in elementary school-aged children: A wearable sensor based analysis.

Introduction: SARS COVID-19 pandemic resulted in major changes to how daily life was conducted. Health officials instituted policies to decelerate the spread of the virus, resulting in changes in physical activity patterns of school-aged children. The aim of this study was to utilize a wearable activity monitor to assess ambulatory activity in elementary-school aged children in their home environment during a COVID-19 Stay-at-Home mandate.

New Ceramic Heads With Titanium Sleeves on Retained Femoral Components: Results of Over 500 Revision Total Hip Arthroplasties.

Background: Ceramic heads are frequently combined with titanium sleeves in revision total hip arthroplasties (THAs), ostensibly to protect the ceramic head from existing damage to the retained trunnion. Although widely adopted, data on the performance and safety of this construct are minimal. The purpose of this study was to describe implant survivorships, radiographic results, and clinical outcomes of patients who underwent revision THA with a ceramic head and titanium sleeve on a retained femoral component.

Development of GO Move: A Website for Children With Unilateral Cerebral Palsy.

It is unknown if an online tool is wanted by therapists and parents of individuals with unilateral cerebral palsy (UCP) to support implementation of goal-directed home programs, and if wanted, the recommended features for the tool. The objective was to explore the experiences of therapists and parents who have implemented home programs, seek guidance on translating a paper-based home program toolbox into a mobile website, and develop the website. Qualitative descriptive methodology guided data collection using semi-structured interviews and thematic analysis, validated with field notes and member checking.

Combined Anteversion Technique for Total Hip Arthroplasty With Handheld Accelerometer-Based Navigation System.

Unlabelled: Aiming for a combined cup and stem anteversion within a target range is one way to assess appropriate prosthetic component orientation and restoration of functional range of motion. We describe a surgical technique that allows the surgeon to assess the combined anteversion using a handheld accelerometer-based navigation system for total hip arthroplasty through a posterior approach. The femur is prepared first, at which time the femoral version is estimated by the surgeon.

Healthcare Disparities in Orthopaedic Surgery: A Comparison of Anterior Cruciate Ligament Reconstruction Incidence Proportions With US Census-Derived Demographics.

Introduction: Disparities exist and affect outcomes after anterior cruciate ligament (ACL) injury. The purpose of this study was to investigate the association between race, ethnicity, and insurance type on the incidence of ACL reconstruction in the United States.

Methods: The Healthcare Cost and Utilization Project database was used to determine demographics and insurance types for those undergoing elective ACL reconstruction from 2016 to 2017.

Syringe Services Programs to Reduce Intravenous Disease Transmission in Substance Use Disorders.

Syringe services programs (SSPs) are evidence-based programs. SSPs are integral in preventing bloodborne diseases while increasing access to care and reducing drug overdose deaths. SSPs are often the only source of health care for people who use drugs.

Taking the Long Way to Care: Who is Traveling Farthest to Undergo Elective Total Hip Arthroplasty?

Background: Disparities in access to total hip arthroplasty (THA) exist. The purpose of this study is to examine how distance traveled to undergo elective THA correlates with sociodemographic variables and postoperative outcomes.

Material And Methods: The Healthcare Cost and Utilization Project New York and Florida state inpatient databases were used to identify patients who underwent elective THA between 2006 and 2014.

Outcomes of Intramedullary Nailing and External Fixation of Open Tibial Fractures: Three to Five-Year Follow-up of a Randomized Clinical Trial.

Background: While surgeons in low and middle-income countries have increasing experience with intramedullary nailing (IMN), external fixation (EF) continues to be commonly used for the management of open tibial fractures. We examined outcomes with extended follow-up of the participants enrolled in a clinical trial comparing these treatments.

Methods: Adults who were ≥18 years old with acute AO/OTA type-42 open tibial shaft fractures were randomly assigned to statically locked, hand-reamed IMN or uniplanar EF.

Demographics of Patients Traveling Notable Distances to Receive Total Knee Arthroplasty.

Introduction: Although disparities exist in patient access to and outcomes after total knee arthroplasty (TKA), there are limited data regarding the relationship between travel distance and patient demographics or postoperative complications.

Methods: We identified patients who underwent TKA in Florida and New York between 2006 and 2014 using the Healthcare Cost and Utilization Project State Inpatient Databases. The American Hospital Association and UnitedStatesZipCodes.

Host Perspectives of High-Income Country Orthopaedic Resident Rotations in Low and Middle-Income Countries.

Background: International orthopaedic resident rotations in low and middle-income countries (LMICs) are gaining popularity among high-income country (HIC) residency programs. While evidence demonstrates a benefit for the visiting residents, few studies have evaluated the impact of such rotations on the orthopaedic surgeons and trainees in LMICs. The purpose of this study was to further explore themes identified in a previous survey study regarding the local impact of visiting HIC resident rotations.

Disparity in Built Environment and Its Impacts on Youths' Physical Activity Behaviors During COVID-19 Pandemic Restrictions.

Objectives: Guided by the social ecological model, this study aimed to examine the relations of built environments (i.e., walking/cycling infrastructure, recreation facilities, neighborhood safety/crime), youth's transition abilities, and changes of youth's physical activity (PA) and play behaviors due to COVID-19-based restrictions.

Racial and Socioeconomic Differences in Distance Traveled for Elective Hip Arthroplasty.

Introduction: There are data that disparities exist in access to total hip arthroplasty (THA). However, to date, no study has examined the relationship between distance traveled to undergo THA and patient demographic characteristics, such as race, insurance provider, and income level as well as postoperative outcomes.

Methods: Data from the Healthcare Cost and Utilization Project, American Hospital Association, and the United States Postal Service were used to calculate the geographic distance between 211,806 patients' population-weighted zip code centroid points to the coordinates of the hospitals at which they underwent THA.

International Orthopaedic Volunteer Opportunities in Low and Middle-Income Countries.

Globally, the burden of musculoskeletal conditions continues to rise, disproportionately affecting low and middle-income countries (LMICs). The ability to meet these orthopaedic surgical care demands remains a challenge. To help address these issues, many orthopaedic surgeons seek opportunities to provide humanitarian assistance to the populations in need.

The Initial Economic Burden of Femur Fractures on Informal Caregivers in Dar es Salaam, Tanzania.

Background: Femur fracture patients require significant in-hospital care. The burden incurred by caregivers of such patients amplifies the direct costs of these injuries and remains unquantified.

Aim: Here we aim to establish the in-hospital economic burden faced by informal caregivers of femur fracture patients.

Intramedullary nailing versus external fixation for open tibia fractures in Tanzania: a cost analysis.

Objectives: Open tibia fractures pose a clinical and economic burden that is disproportionately borne by low-income countries. A randomized trial conducted by our group showed no difference in infection and nonunion comparing 2 treatments: external fixation (EF) and intramedullary nailing (IMN). Secondary outcomes favored IMN.

Assessment of clinical and radiographic outcomes following retrograde versus antegrade nailing of infraisthmic femoral shaft fractures without the use of intraoperative fluoroscopy in Tanzania.

Unlabelled: To compare clinical and radiographic outcomes following antegrade versus retrograde intramedullary nailing of infraisthmic femoral shaft fractures.

Design: Secondary analysis of prospective cohort study.

Setting: Tertiary hospital in Tanzania.

Prophylactic Topical Antibiotics in Fracture Repair and Spinal Fusion.

Introduction: The objective of this systematic review with meta-analysis is to determine whether prophylactic local antibiotics prevent surgical site infections (SSIs) in instrumented spinal fusions and traumatic fracture repair. A secondary objective is to investigate the effect of vancomycin, a common local antibiotic of choice, on the microbiology of SSIs.

Methods: An electronic search of PubMed, EMBASE, and Web of Science databases and major orthopedic surgery conferences was conducted to identify studies that (1) were instrumented spinal fusions or fracture repair and (2) had a treatment group that received prophylactic local antibiotics.

Orthopaedic Trauma Research Priorities in Latin America: Developing Consensus Through a Modified Delphi Approach.

Background: Despite a substantial burden of musculoskeletal injury, orthopaedic trauma studies in Latin America are lacking. The purpose of the present study was to identify research priorities among orthopaedic trauma surgeons in Latin America.

Methods: Research questions were solicited from members of the Asociación de Cirujanos Traumatólogos de las Américas.

Constraint Induced Movement Therapy in Infants and Toddlers with Hemiplegic Cerebral Palsy: A Scoping Review.

Cerebral Palsy (CP) is the leading cause of motor disability in childhood. Recent studies have investigated the effectiveness of constraint induced movement therapy (CIMT) as an early intervention for infants and toddlers with hemiplegic CP. This scoping review aims to identify current evidence for CIMT protocols for children 3 months to 5 years 11 months as well as clinical applications for practice and gaps in research.