Oral vs Intravenous Antibiotics for Fracture-Related Infections: The POvIV Randomized Clinical Trial.

Importance: Fracture-related infection (FRI) is a serious complication following fracture fixation surgery. Current treatment of FRIs entails debridement and 6 weeks of intravenous (IV) antibiotics. Lab data and retrospective clinical studies support use of oral antibiotics, which are less expensive and may have fewer complications than IV antibiotics.

Implementation of a Patient-Specific Opioid Taper Calculator for Total Hip and Knee Arthroplasty: A Pre- and Post-Implementation Study.

Background: Given the association between high opioid use and postoperative complications after total joint arthroplasty, it is important to prescribe opioids responsibly in the postoperative period. While many pain regimen protocols exist to try and limit opioid use, an optimal approach to narcotic prescription for arthroplasty patients is yet to be established. This study evaluated the effects of using an individualized opioid taper calculator for patients undergoing elective primary total hip arthroplasty (THA) and total knee arthroplasty (TKA).

Early Versus Delayed Definitive Fixation Relative to Fasciotomy Closure in High-Energy Tibial Plateau Fractures With Compartment Syndrome.

Objectives: To evaluate the timing of definitive fixation of tibial plateau fractures relative to fasciotomy closure with regard to alignment and articular reduction.

Design: Retrospective case series.

Setting: Four Level I trauma centers.

Incidence of Infection in Operatively Treated Distal Radius Fractures After Conversion From External to Internal Fixation.

Purpose: The purpose of this study was to report the incidence of infection after conversion from external fixation (EF) to internal fixation (IF) of distal radius fractures and to evaluate the relationship between infection and secondary variables, including time to conversion from EF to IF, internal hardware overlapping EF pin sites, and definitive fixation with a dorsal-spanning bridge plate.

Methods: A retrospective review was performed at 2 level 1 trauma centers including all patients aged ≥18 years from 2006 to 2019 with a distal radius fracture treated initially with EF followed by subsequent IF. The patients were excluded from analysis if they had <10 weeks of clinical follow-up, a history of prior distal radius surgery, or evidence of infection before EF to IF conversion.

Does Inpatient Mobilization Predict 1-Year Mortality After Femoral Neck Fracture Treated With Hemiarthroplasty?

Objective: To determine whether inpatient mobilization (defined as ambulation before hospital discharge) is associated with 1-year mortality and 90-day hospital readmission in patients treated with a hip hemiarthroplasty for a femoral neck fracture.

Design: Retrospective case-control.

Setting: Academic Level 1 trauma center.

Open Ankle Fractures: What Predicts Infection? A Multicenter Study.

Objective: To identify the patient, injury, and treatment factors associated with an acute infection during the treatment of open ankle fractures in a large multicenter retrospective review. To evaluate the effect of infectious complications on the rates of nonunion, malunion, and loss of reduction.

Design: Multicenter retrospective review.

Smith-Petersen Versus Watson-Jones Approach Does Not Affect Quality of Open Reduction of Femoral Neck Fracture.

Objective: To compare immediate quality of open reduction of femoral neck fractures by alternative surgical approaches.

Design: Retrospective cohort study.

Setting: Twelve Level 1 North American trauma centers.

Timing of Flap Coverage With Respect to Definitive Fixation in Open Tibia Fractures.

Objectives: We conducted a large, U.S wide, observational study of type III tibial fractures, with the hypothesis that delays between definitive fixation and flap coverage might be a substantial modifiable risk factor associated with nosocomial wound infection.

Design: A retrospective analysis of a multicenter database of open tibial fractures requiring flap coverage.

Gunshot Fractures of the Forearm: A Multicenter Evaluation.

Objectives: To evaluate a large series of open fractures of the forearm after gunshot wounds (GSWs) to determine complication rates and factors that may lead to infection, nonunion, or compartment syndrome.

Design: Multicenter retrospective review.

Setting: Nine Level 1 Trauma Centers.

Factors influencing management of bilateral femur fractures: A multicenter retrospective cohort of early versus delayed definitive Fixation.

Introduction: The purpose of our study was to evaluate the factors that influence the timing of definitive fixation in the management of bilateral femoral shaft fractures and the outcomes for patients with these injuries.

Methods: Patients with bilateral femur fractures treated between 1998 to 2019 at ten level-1 trauma centers were retrospectively reviewed. Patients were grouped into early or delayed fixation, which was defined as definitive fixation of both femurs within or greater than 24 hours from injury, respectively.

Patient-Reported Outcomes of Femoral Head Fractures with a Minimum 10-Year Follow-Up.

Objective: To evaluate the clinical-reported and patient-reported outcomes of patients with femoral head fractures treated at a single level I trauma center with a minimum 10-year follow-up.

Design: Retrospective review.

Setting: Academic Level-1 Trauma Center.

What is the Real Rate of Radial Nerve Injury After Humeral Nonunion Surgery?

Objectives: To determine the radial nerve palsy (RNP) rate and predictors of injury after humeral nonunion repair in a large multicenter sample.

Design: Consecutive retrospective cohort review.

Setting: Eighteen academic orthopedic trauma centers.

Open Reduction Is Associated With Greater Hazard of Early Reoperation After Internal Fixation of Displaced Femoral Neck Fractures in Adults 18-65 Years.

Objectives: To determine (1) which factors are associated with the choice to perform an open reduction and (2) by adjusting for these factors, if the choice of reduction method is associated with reoperation.

Design: Retrospective cohort study with radiograph and chart review.

Setting: Twelve Level 1 North American trauma centers.

Henry Versus Thompson Approach for Fixation of Proximal Third Radial Shaft Fractures: A Multicenter Study.

Objective: To compare the volar Henry and dorsal Thompson approaches with respect to outcomes and complications for proximal third radial shaft fractures.

Design: Multicenter retrospective cohort study.

Patients/participants: Patients with proximal third radial shaft fractures ± associated ulna fractures (OTA/AO 2R1 ± 2U1) treated operatively at 11 trauma centers were included.

Cost Variation in Temporizing External Fixation of Tibial Plateau Fractures.

Background: Rising health care expenditures and declining reimbursements have generated interest in providing interventions of value. The use of external fixation is a commonly used intermediate procedure for the staged treatment of unstable fractures. External fixator constructs can vary in design and costs based on selected component configuration.

Acute total hip arthroplasty versus open reduction internal fixation for posterior wall acetabular fractures in middle-aged patients.

Introduction: Open reduction internal fixation (ORIF) is the standard of care for displaced acetabular fractures, but the inability to achieve anatomic reduction, involvement of the posterior wall, articular impaction, and femoral head cartilaginous injury are known to lead to poorer outcomes. Acute total hip arthroplasty (THA) is a reasonable treatment option for older patients with an acetabular fracture and risk factors for a poor outcome, but it is only described in case series. The purpose of this study is to compare outcomes of ORIF and acute THA in middle-aged patients with an acetabular fracture from a single center.

Pseudo-Volkmann Contracture: A Case Report and Review of the Current Literature.

Background: Unlike the usual Volkmann contracture as a complication of pediatric forearm fracture, pseudo-Volkmann contracture is not a sequela of ischemia, but rather of a mechanical entrapment of the flexor myotendinous units in the fracture or adhesions.

Methods: PubMed search of the English literature was performed using the terminology entrapment and fracture and pseudo-Volkmann.

Results: Thirteen articles were identified that described cases of pseudo-Volkmann contracture in pediatric both-bone forearm fractures.

Association Between 6-Week Postdischarge Risk Classification and 12-Month Outcomes After Orthopedic Trauma.

Importance: Numerous studies have demonstrated that long-term outcomes after orthopedic trauma are associated with psychosocial and behavioral health factors evident early in the patient's recovery. Little is known about how to identify clinically actionable subgroups within this population.

Objectives: To examine whether risk and protective factors measured at 6 weeks after injury could classify individuals into risk clusters and evaluate whether these clusters explain variations in 12-month outcomes.