Management of Elbow Terrible Triad Injuries: A Comprehensive Review and Update.

The "terrible triad" of the elbow, encompassing elbow dislocation, radial head fracture, and coronoid process fracture, remains a formidable challenge in orthopaedic practice. Typically, stabilizing structures in the elbow fail from lateral to medial through a posterolateral rotatory force after a fall onto an outstretched upper extremity. Surgery is often needed to repair the lateral ligamentous complex, replace or fix the radial head, possibly repair the anterior capsule or fix the coronoid, and consider medial repair or application of an internal versus external fixator.

Use of a modified retrograde femoral rod as a custom length tibiotalocalcaneal nail.

There has been increasing interest in the use of hindfoot tibiotalocalcaneal (TTC) nails to treat ankle and distal tibia fractures in select patient populations who are at increased risk for soft tissue complications after open reduction and internal fixation with traditional plate and screw constructs. We describe a technique which uses a retrograde femoral nail as a custom length TTC nail. By using a simple modification of the insertion jig, we are able to achieve safe screw trajectories that allow for robust distal interlocking fixation.

Does Hip Fracture Admitting Service Affect Proper Deep Venous Thrombosis Prophylaxis? An Investigation at a Level 1 Trauma Center.

Objective: To examine if rates of appropriate thromboprophylaxis prescribing at the time of discharge would be higher in patients admitted to the orthopaedic service. Second, to see if improvements could be made in the rates of these missed events after a structured intervention.

Design: Retrospective Cohort Study, Prospective Interventional.

Implementation of a Dedicated Orthopaedic Trauma Room in Hip and Femur Fracture Care: A 17-Year Analysis.

Objective: To examine the effects of implementing a dedicated orthopaedic trauma room (DOTR) on hip and femur fracture care.

Design: A retrospective cohort study. Setting: Level 1 trauma center.

Does seasonal variation in orthopaedic trauma volume correlate with adverse hospital events and burnout?

Introduction: Assessing workload and mitigating burnout risk should be a constant goal within training programs. By using work relative value unit (wRVU) data in a non-elective orthopaedic trauma practice, we investigated seasonal variation in workload on an orthopaedic trauma service at a level I trauma centre. We also investigated whether there was a correlation in seasonal preventable adverse patient safety events (PSEs) and resident Epworth Sleepiness Scale (ESS) scores.

THE USE OF POSTURAL RESTORATION FOR TREATMENT OF CHRONIC ROTATOR CUFF PATHOLOGY: A CASE REPORT.

Background And Purpose: Postural Restoration Institute® (PRI) theories and rehabilitation techniques focus on restoring balance to anatomical systems. Common postural asymmetries can present in athletes as dysfunctions and limitations. The purpose of this case report was to examine the use of PRI exercises and theories to address pelvic alignment, along with core stabilization, during treatment of shoulder dysfunction in a collegiate volleyball player.

Non-displaced Femoral Neck Stress Fractures in Young Adults: 7-Year Outcomes of Prophylactic Fixation Versus Nonoperative Treatment.

Retrospectively compare outcomes of prophylactic fixation to nonoperative treatment of incomplete or non-displaced femoral neck stress fractures (FNSF) in young adults. Outcomes of 82 patients (mean age 21.7 years) who were diagnosed with incomplete or non-displaced FNSFs from 2002 to 2015 were compared.

Percutaneous Pedicle Screws in the Obese: Should the Skin Incision Be More Lateral?

Objective: To determine if the skin incision for lumbar percutaneous pedicle screws should be more lateral in the obese patient.

Methods: This was a retrospective radiographic analysis of 30 obese and non-obese lumbar spine computed tomography (CT) radiographs comparing the depth of soft tissue along the anatomic axis of the pedicle at L4 and L5.

Results: The average distance from the pedicle trajectory on the skin to the lateral border of the pedicle at L4 was 1.

Preoperative Management of Antithrombotics in Arthroplasty.

Antithrombotic therapy is common in the arthroplasty patient population; the preoperative management of chronic antithrombotic medications requires coordination among the medical team. It is estimated that approximately 250,000 or 10% of patients on chronic antithrombotic medication undergo treatment interruption for surgical procedures annually in North America. Although the description of postoperative anticoagulation management after arthroplasty is extensive, orthopaedic literature describing the preoperative management of antithrombotic therapy is lacking.

Angiography and Embolization in the Management of Bleeding Pelvic Fractures.

The use, timing, and priority of angioembolization in the management of bleeding pelvic fractures remain ambiguous. The most common vessels for angioembolization are, in decreasing order, the internal iliac artery and its branches, the superior gluteal artery, the obturator artery, and the internal pudendal artery. Technical success rates for this treatment option range from 74% to 100%.

Unilateral Dislocation of the Posterior Tibialis Tendon (PTT) and Flexor Digitorum Longus Tendon With Contralateral PTT Subluxation in a Patient With Congenitally Shallow Flexor Groove.

Introduction: Flexor tendon dislocation from the flexor tendon groove posterior of the medial malleolus has been previously described, and may be difficult to diagnose initially, but is amendable to surgical treatment with good outcomes. We present a unique case of unilateral dislocation of the posterior tibialis and flexor digitorum longus tendons with contralateral flexor digitorum longus subluxation that was treated surgically with a good outcome.

Case Presentation: A 37-year-old active duty male sustained a dislocation and subluxation of the flexor tendons bilaterally after a forced dorsiflexion injury.