Tularemia Proximal Interphalangeal Joint Septic Arthritis: A Case Report.

Case: A case of Francisella tularensis finger proximal interphalangeal joint septic arthritis secondary to feral cat bite is presented. The patient underwent operative debridement on presentation. On postoperative day 5, a gram-negative rod resembling F.

Orthopaedic Disaster Course: Preparing for the Worst/Best Moment in the Operating Room.

Orthopaedic surgeons perform a variety of procedures where life-threatening or limb-threatening clinical scenarios or complications are relatively rare. Because these devastating complications and disaster presentations are infrequent, the occurrence can lead to concerns regarding training and preparedness. This chapter will provide a general knowledge base of common intraoperative disasters as well as life-threatening and/or limb-threatening conditions related to the upper extremity, pelvis, and lower extremity.

Traumatic Arthrotomy.

Evaluation of periarticular traumatic wounds for joint penetration is a common clinical concern for orthopaedic surgeons. Wounds that violate the joint capsule can result in deep infection and sepsis. Understanding the anatomic landmarks and capsular extensions of the major joints is key to proper evaluation.

Lariat sign: An MRI finding associated with common peroneal nerve rupture.

Traumatic knee dislocation represents a catastrophic orthopedic injury with potentially devastating vascular and neurologic injuries. We report a case of common peroneal nerve rupture sustained during a knee dislocation with novel radiographic findings that we describe as a lariat sign. At the site of rupture, the distal nerve loops back on itself forming a lasso shape or lariat.

The radiocapitellar synovial fold: a lateral anatomic landmark for sizing radial head arthroplasty.

Background: Successful radial head arthroplasty relies on reproduction of anatomy. We hypothesized that the radiocapitellar synovial fold could serve as a reference point in radial head prosthesis sizing. Our study aimed to define the relationship between the synovial fold and the radial head in elbows with and without lateral ulnar collateral ligament (LUCL) injury.

Forearm-Based Turnover Muscle Flaps for Elbow Soft-Tissue Reconstruction: A Comparison of Regional Coverage Based on Distal Flap Perfusion.

Background: Elbow wounds pose a reconstructive challenge. Prior studies have described the vascular anatomy of both the brachioradialis and flexor carpi ulnaris muscle flaps. The goal of this study was to describe the distal flap perfusion of the flexor carpi radialis, with a direct comparison of the brachioradialis, flexor carpi ulnaris, and flexor carpi radialis muscle flaps for coverage around the elbow.

Ulnar Neuropathy in Cyclists.

The form and function of the cyclist exposes the ulnar nerve to both traction and compressive forces at both the elbow and wrist. Prevention of ulnar neuropathy and treatment of early symptoms include bike fitting, avoidance of excessive or prolonged weight-bearing through the hands, and the use of padded gloves. For persisting or progressive symptoms, a thorough history and physical examination is essential to confirm the diagnosis and to rule out other sites of nerve compression.

A Novel Cast Removal Training Simulation to Improve Patient Safety.

Objective: Cast application and removal are essential to orthopedics and performed by providers of variable training. Simulation training and practice of proper cast application and removal may reduce injury, optimize outcomes, and reduce health care costs. The purpose of this educational initiative was to develop, validate, and implement a novel simulation trainer and curriculum to improve safety during cast removal.

Mortality Rates Associated With Odontoid and Subaxial Cervical Spine Fractures.

Cervical spine fractures can lead to many devastating consequences. However, mortality rates of older individuals with odontoid or subaxial spine fractures have not been definitively established. We conducted a retrospective review of all patients who underwent computed tomography of the cervical spine in the emergency department of a level I trauma center over 9 years to compare mortality rates after odontoid and subaxial fractures in elderly persons with those of the general population.

Application of epoxy resin to a solid-foam pelvic model: creating a dry-erase pelvis.

The value of preoperative planning and templating has been well-established in fracture surgery. We have found that using 3-dimensional (3-D) models in preoperative planning aids in the understanding of anatomy, fracture-reduction techniques, and fixation methods, particularly in pelvic and acetabular fractures. To facilitate the correction of errors and reuse for future cases, we coat pelvic models with dry-erase epoxy resin.

The incidence of noncontiguous spinal fractures and other traumatic injuries associated with cervical spine fractures: a 10-year experience at an academic medical center.

Study Design: Retrospective medical record review.

Objective: The purpose of this study was to describe the incidence of other injuries that commonly occur in conjunction with cervical spine fractures and dislocations.

Summary Of Background Data: Cervical spine fractures are often associated with other significant traumatic conditions, which may also require prompt diagnosis and management.

Pediatric supracondylar fractures of the distal humerus.

Supracondylar fractures of the humerus are a common pediatric elbow injury that are historically associated with morbidity due to malunion, neurovascular complications, and compartment syndrome. True anteroposterior and lateral radiographs are essential not only for an accurate diagnosis, but also for creating a treatment plan for these injuries. A staging system (based on the lateral radiograph) for classifying the severity of the fracture helps guide definitive management.