Treatment of Extra-Articular Distal Humerus Fractures: Current Concepts and Systematic Review.

Background: Acute extra-articular distal humerus fractures (DHFs) continue to pose a treatment challenge for many orthopedic surgeons. The aim of this study was to provide a comprehensive review of treatment principles, while reporting union rates, time to union, complication rates, and outcome measures following operative and non-operative management.

Methods: A systematic review was conducted utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.

Mixing Metals During Operative Fixation and Reconstruction in the Appendicular Skeleton: Does Theoretical In Vivo Galvanization Cause Clinically Detrimental Outcomes?

Objective: Traditional training and teaching have advised against mixing varying metal types to avoid the potential for in vivo galvanization and corrosion. The objective of this study was to retrospectively analyze patients who have undergone operative reconstruction with mixed metal (MM) constructs to report any related complications.

Methods: Design: Retrospective case series.

No difference in early outcomes comparing intramedullary versus extramedullary fibular fixation in operative ankle fractures.

Introduction: The purpose of this study was to compare postoperative complications and outcomes of minimally invasive intramedullary fixation (IMF) versus plate fixation (PF) in the treatment of distal fibular fractures.

Materials And Methods: A retrospective review was performed from identifying all consecutive ankle fracture patients aged ≥18-years-old surgically managed between August 2017 to September 2022 at a tertiary care center with minimum 6 months clinical follow-up. Patients were grouped into those receiving intramedullary versus extramedullary fibular fixation.

Intramedullary Fixation Versus Plate Fixation of Distal Fibular Fractures: A Systematic Review.

Introduction: The purpose of this systematic review and meta-analysis was to provide an update of the recent literature comparing clinical outcomes of surgically treated fibular fractures using intramedullary nailing (IMN) with open reduction and internal plate fixation (ORIF).

Methods: A literature search reporting clinical outcomes after IMN or ORIF of the distal fibula was conducted on PubMed. Inclusion criteria consisted of original studies; studies focusing on clinical outcomes after IMN or IMN and ORIF published before May 11, 2022; studies with at least 5 patients; and studies reporting union rates, complication rates, and patient-reported outcomes such as American Orthopaedic Foot and Ankle Society (AOFAS) and Olerud-Molander scores.

Does a delay to surgery for preoperative echocardiogram affect outcomes in patients with hip fracture?

Introduction: Delay to surgery >24 hours has been shown to correlate with mortality rates in patients with hip fracture when left untreated. Many of these patients have multiple comorbidities, including aortic stenosis (AS), and undergo workup for operative clearance, which may delay time to surgery. The purpose of this study was to examine whether preoperative echocardiogram workup affects time to surgery, complications, and mortality after operative fixation for hip fracture.

Maximizing Adherence and Minimizing Time to Antibiotics: A Multidisciplinary Institutional Trauma Bay Protocol for Single Antibiotic Prophylaxis in Open Fractures.

Objectives: To determine if a multidisciplinary institutional protocol can optimize the time to antibiotic (Abx) administration for open fractures (openFx) and improve compliance with the administration of Abx prophylaxis during trauma activation.

Design: Retrospective pre-post study design.

Setting: Single Level II Trauma Center.

Comparison of Outcomes After Reverse Total Shoulder Arthroplasty in Patients With Proximal Humerus Fractures Versus Rotator Cuff Arthropathy.

Introduction: Indications for reverse total shoulder arthroplasty (rTSA) has expanded to encompass complex proximal humerus fractures (PHFs) in recent years. The purpose of this study was to report and assess whether PHF patients treated with rTSA could achieve similar functional outcomes and short-term survivorship to patients who underwent rTSA for rotator cuff arthropathy (RTCA).

Methods: All consecutive patients with a preoperative diagnosis of PHF or RTCA, 18 years or older, treated with rTSA at a single academic institution between 2018 and 2020 with a minimum 2-year follow-up were retrospectively reviewed.

Early versus Standard Weight Bearing Following Operative Treatment of Tibial Plateau Fractures: Do We Really Have to Wait So Long?

Postoperative management of tibial plateau fractures classically involves a prolonged period between 10 and 12 weeks of nonweight bearing or partial weight bearing. In recent years, there has been some support for earlier weight-bearing protocols although this remains controversial. The goal of this study was to investigate the difference in outcomes between early weight-bearing (EWB) and traditional weight-bearing (TWB) protocols.

Reverse Total Shoulder Arthroplasty for Younger Patients: A Comparable Analysis of Patients Older and Younger Than 65 Years.

Introduction: Reverse total shoulder arthroplasty (rTSA) has become a popular option for the surgical management of rotator cuff arthropathy and complex fractures of the proximal humerus. However, there is a paucity of studies evaluating outcomes, especially between patients of different age groups. The purpose of this study was to compare functional outcomes and survivorship between patients older than 65 years (o65) and those 65 years and younger (y65).

Distal femur: nail plate combination and the linked construct.

Operative fixation of distal femur fractures in patients with osteoporotic bone can be challenging. Treatment with either lateral locking plate or retrograde intramedullary nail alone may not provide adequate fixation to allow for early mobilization. Rather, fixation using the nail plate combination (NPC) to treat distal femur fractures in the elderly may offer improved biomechanical stability to achieve immediate weight-bearing, especially in the setting of complex fracture patterns and osteoporosis.

Response to Letter to the Editor: Comparing Intramedullary Nailing Versus Locked Plating in the Treatment of Native Distal Femur Fractures: Is One Superior to the Other?

We would like to thank the editors for the opportunity to respond to their letter regarding our study, "Comparing Intramedullary Nailing Versus Locked Plating in the Treatment of Native Distal Femur Fractures: Is One Superior to the Other?" published in the Indian Journal of Orthopaedics. The authors greatly appreciate the insight and thoughtful feedback regarding the findings of our study, which may be skewed by heterogenous data and/or technical aspects of surgical plating and intramedullary nailing. We agree with the editors and believe that higher level randomized trials along with specific studies focused on studying modes and causes for treatment failure are necessary to further elucidate the heterogenous data.

Scapulothoracic Dissociation: A Review of an Orthopedic Emergency.

Scapulothoracic dissociation is a rare and devastating injury that is considered an orthopedic emergency. It is critical to recognize this injury early based on mechanism, physical examination, and radiographic parameters. Initial management should be focused on resuscitation and evaluation for potential limb-threatening ischemia.

Comparing Intramedullary Nailing Versus Locked Plating in the Treatment of Native Distal Femur Fractures:

Introduction: Distal femur fractures make up < 1% of all fractures and 3-6% of all femur fractures. In the literature, both intramedullary nailing (IMN) and locked plating (LP) have shown favorable results, but there is no consensus on a gold standard. The purpose of this systematic review is to compare outcomes of native distal femur fractures treated via IMN versus LP in an effort to determine if one is superior to the other.