Trends in Retraction of Orthopaedic Research Articles.

Background: Despite the use of in-depth peer-review processes, there occasionally are issues with published manuscripts that require retraction. The purpose of the present study was to explore the reasons for the retraction of orthopaedic research articles, with consideration of the journal impact factor and the orthopaedic subspecialty.

Methods: In 2023, a database search was conducted for retracted papers written in the English language in the orthopaedic literature.

Primary Closure of External Fixator Pin Sites Is Safe After Orthopaedic Trauma Surgery.

Objectives: To determine if rates of pin site infection and surgical site infection among patients managed with primary closure after external fixator removal were similar to those allowed to heal secondarily.

Design: Retrospective cohort.

Setting: Urban/Suburban Academic Level I Trauma Center.

Early Outcomes of Proximal Humerus Fractures in Adults Treated With Locked Plate Fixation Compared with Nonoperative Treatment: An Age-, Comorbidity-, and Fracture Morphology-Matched Analysis.

Objectives: To compare patient-reported outcomes (PROs), range of motion (ROM), and complication rates for proximal humerus fractures managed nonoperatively or with open reduction internal fixation (ORIF).

Design: Retrospective cohort.

Setting: Academic level 1 trauma center.

Superior Outcomes With Reverse Shoulder Arthroplasty versus Nonoperative Management for Proximal Humerus Fractures: A Matched Cohort Analysis.

Objective: To evaluate early outcomes (within 1 year) for geriatric proximal humerus fractures managed nonoperatively or with reverse shoulder arthroplasty (RSA).

Design: Retrospective cohort.

Setting: Academic level 1 trauma center, level 2 trauma/geriatric fracture center.

Femoral Neck Fractures in Young and Middle-Aged Adults: Pearls and Pitfalls.

The management of femoral neck fracture in young and middle-aged adults remains challenging. Although the influence of timing on the outcome is controversial, surgical management within 12 hours is recommended. Reduction quality is the most important modifiable factor that is correlated with outcomes.

Risk factors for loss of reduction following locked plate fixation of proximal humerus fractures in older adults.

Purpose: To identify characteristics associated with loss of reduction following open reduction and locked plate fixation (ORIF) of proximal humerus fractures in older adults and determine if loss of reduction affects patient reported outcomes (PROs), range of motion (ROM), and complication rates during the first postoperative year.

Methods: Patients >55 years old who underwent proximal humerus ORIF were reviewed. Patient and fracture characteristics were recorded.

Outcomes for type C proximal humerus fractures in the adult population: comparison of nonoperative treatment, locked plate fixation, and reverse shoulder arthroplasty.

Background: This study compares patient-reported outcomes and range of motion (ROM) between adults with an AO Foundation/Orthopaedic Trauma Association type C proximal humerus fracture managed nonoperatively, with open reduction and internal fixation (ORIF), and with reverse shoulder arthroplasty (RSA).

Methods: This is a retrospective cohort study of patients >60 years of age treated with nonoperative management, ORIF, or RSA for AO Foundation/Orthopaedic Trauma Association type 11C proximal humerus fractures from 2015 to 2018. Visual analog scale pain scores, Patient-Reported Outcomes Measurement Information System (PROMIS) scores, ROM values, and complication and reoperation rates were compared using analysis of variance for continuous variables and chi square analysis for categorical variables.

Contemporary Issues in the Acquisition of Orthopaedic Surgical Skills During Residency: Competency-Based Medical Education and Simulation.

➤: Orthopaedic education should produce surgeons who are competent to function independently and can obtain and maintain board certification.

➤: Contemporary orthopaedic training programs exist within a fixed 5-year time frame, which may not be a perfect match for each trainee.

➤: Most modern orthopaedic residencies have not yet fully adopted objective, proficiency-based, surgical skill training methods despite nearly 2 decades of evidence supporting the use of this methodology.

Rethinking strategies for blood transfusion in hip fracture patients.

Objectives: Most patients can tolerate a hemoglobin (Hgb) > 8 g per deciliter. In some cases, however, transfusion will delay physical therapy and hospital discharge. This study aims to review Hgb and transfusion data for a large volume of recent hip fracture patients in order to identify new opportunities for decreasing the length of hospital stay.

Increasing the Educational Value of the Orthopaedic Subinternship: The Design and Implementation of a Fourth-Year Medical Student Curriculum.

Introduction: Most orthopaedic subinternships function as month-long interviews. These rotations remain relatively unstructured and lack standardization, and their overall educational value has been called into question. The goals of this educational initiative were to create a structured subinternship curriculum for orthopaedic applicants and to shift the focus of the subinternship from a month-long interview to an organized educational experience.

Preoperative measurement of the thickness of the center of the humeral head predicts screw cutout after locked plating of proximal humeral fractures.

Hypothesis And Background: Preoperative computed tomography (CT) scans can be used to measure the thickness of the center of the humeral head to identify patients at a higher risk of screw cutout after open reduction-internal fixation.

Methods: At an academic medical center, we performed a retrospective review of all patients aged ≥ 18 years who had sustained a proximal humeral fracture that was treated with open reduction-internal fixation between January 1, 2005, and December 31, 2014, and who underwent preoperative shoulder CT. Ninety-four patients were included.

Immediate Improvement in Physical Function After Symptomatic Syndesmotic Screw Removal.

Objective: To investigate the immediate impact of removing symptomatic syndesmotic screws on PROMIS outcomes and ankle range of motion (ROM) in patients who had previously undergone ankle fracture open reduction and internal fixation (ORIF) and syndesmotic fixation and later experienced functional limitations.

Design: Prospective cohort study.

Setting: Level 1-trauma center.

The Current Status of Medical School Clerkship Grades in Residency Applicants.

Background: Two criteria that have been investigated for evaluating orthopedic surgery residency candidates are achieving an "honors" grade during a surgery clerkship and the total number of honors grades received in all clerkships. Unfortunately, the rate of honors grades given and the criteria for earning an honors grade differ between medical schools, making comparison of applicants from different medical schools difficult.

Objective: We measured the rate of honors grades in clerkships at different medical schools in the United States to examine the utility of clerkship grades in evaluating orthopedic surgery residency applicants.

Simultaneous Bilateral Extensor Mechanism Disruptions: More Than Double the Trouble?

Simultaneous bilateral extensor mechanism disruption (BEMD) is a rare condition, for which the relationship between comorbid conditions, complications, and clinical outcomes has not been well defined. We hypothesized that patients with BEMD would have more comorbidities, more repair failures, and worse clinical outcomes compared with patients with unilateral extensor mechanism disruption (UEMD). We performed a retrospective review of all adult patients seen at our institution for either a quadriceps or patellar tendon rupture between 2012 and 2017.

Orthopedic Surgery and the Geriatric Patient.

As more patients live longer, it is probable that an increasing number of geriatric patients will require surgery. An organized, systematic, coordinated, multidisciplinary approach to the perioperative management of these patients will result in fewer complications, improved outcomes, and reduced cost of care. Details are herein provided on the preoperative diagnostic evaluation and assessment as well as perioperative care provided to optimize outcomes.

Surgical management of U/H type sacral fractures: outcomes following iliosacral and lumbopelvic fixation.

Background: U and H-type sacral fractures are under diagnosed injuries resulting from significant axial loading that are often associated with neurological deficits. No studies to date have compared two common methods of surgical fixation, iliosacral screw fixation (ISF) and lumbopelvic fixation (LPF).

Methods: Patients with sacral fractures from 2009-2015 at one level 1 trauma center were identified by current procedural terminology (CPT) code and imaging reviewed for U/H type sacral fractures.

Radiographic Risk Factors For Interprosthetic Femur Fractures.

Purpose: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are among the most common orthopaedic procedures performed in the United States annually. As the number of patients undergoing these procedures increases so too does the incidence of periprosthetic femur fractures. A number of these periprosthetic fractures occur between two ipsilateral implants, so-called interprosthetic fractures.

Radiographic Review of Helical Blade Versus Lag Screw Fixation for Cephalomedullary Nailing of Low-Energy Peritrochanteric Femur Fractures: There is a Difference in Cutout.

Objectives: To compare the rate of cutout of helical blades and lag screws in low-energy peritrochanteric femur fractures treated with a cephalomedullary nail (CMN).

Design: Retrospective review.

Setting: Academic medical center.

Detection of Femoral Neck Fractures in Pediatric Patients With Femoral Shaft Fractures.

Background: Ipsilateral femoral neck fractures occur in 1% to 9% of adult trauma patients with femoral shaft fractures making dedicated imaging important. This is not as clear in children. Our purpose is to establish the incidence of ipsilateral femoral neck fractures in children with femoral shaft fractures and to provide recommendations regarding diagnostic imaging protocols.

The impact of residual angulation on patient reported functional outcome scores after non-operative treatment for humeral shaft fractures.

Purpose: To determine if residual angular deformity following non-operative treatment of humeral diaphyseal fractures correlates with patient reported outcomes.

Methods: Skeletally mature patients treated by one of three orthopaedic trauma surgeons at a level 1 trauma centre with humeral shaft fractures treated without surgery were retrospectively identified over a 7 year period. After inclusion and exclusion criteria, 42 patients were eligible for the study.

Risk factors for failure of a single surgical debridement in adults with acute septic arthritis.

Background: Acute septic arthritis in a native joint may require more than one surgical debridement to eradicate the infection. Our objectives were to determine the prevalence of failure of a single surgical debridement for acute septic arthritis, to identify risk factors for failure of a single debridement, and to develop a prognostic probability algorithm to predict failure of a single surgical debridement for acute septic arthritis in adults.

Methods: We collected initial laboratory and medical comorbidity data of 128 adults (132 native joints) with acute septic arthritis who underwent at least one surgical debridement at our institution between 2000 and 2011.

Factors predicting patient-reported functional outcome scores after humeral shaft fractures.

Purpose: The aim of this study was to determine patient variables that are independent predictors of validated functional outcome scores after humeral diaphyseal fractures.

Methods: Adult patients with humeral shaft fractures were retrospectively recruited from a level 1 trauma centre over an 8-year period. Basic demographic information was obtained along with Disabilities of the Arm, Shoulder and Hand (DASH), Simple Shoulder Test (SST) and Short Form 12 (SF-12) physical component summary (PCS) and mental component summary (MCS).