Incidence of venous thromboembolism in fracture below the knee with and without chemical thromboprophylaxis: a systematic review and meta-analysis.

Introduction: Low rates of venous thromboembolism (VTE) have been found in patients with isolated orthopaedic trauma below the knee. Many surgeons routinely provide chemical thromboprophylaxis in these injuries, however. This is not without inherent risks, and this remains a controversial topic in perioperative care in orthopaedic trauma.

Primary arthrodesis versus open reduction internal fixation for acute Lisfranc injuries: a systematic review and meta-analysis.

Introduction: The presence of a Lisfranc injury alone is considered a surgical indication in most patients. Indications for primary arthrodesis (PA) versus open reduction internal fixation (ORIF), however, is a topic of debate among surgeons. Conflicting data exists as to which treatment modality leads to improved patient-reported outcome measures (PROMs), reoperations, and complications.

Flexible fixation versus open reduction internal fixation and primary arthrodesis for ligamentous Lisfranc injuries: A systematic review and meta-analysis.

Introduction: Flexible fixation (FF) has allowed treatment of isolated ligamentous Lisfranc injuries while preserving joint motion. We hypothesize that patient-reported outcome measures (PROMs), complications, and return-to-activity rates will be similar between patients undergoing FF versus those undergoing open reduction internal fixation (ORIF) or primary arthrodesis (PA).

Methods: Databases included PubMed, OVID Medline, Embase, SCOPUS, Cochrane Central Register of Clinical Trials, and clinicaltrials.

Plate, short nail, or long nail? Revision rates and complications of three different treatments for peritrochanteric femur fractures.

Background: We sought to investigate the relationship between peritrochanteric femur fracture (OTA 31A fractures) fixation and rates of peri-implant fracture, rates of transfusion, and the rates of increased dependence after secondary surgery for fracture for short cephalomedullary nails (SCMN), long cephalomedullary nails (LCMN), and plate and screw devices (PSD).

Methods: Multi center retrospective study involving data collected from 151 Level I-IV trauma centers using ICD9/10 and CPT codes for identification. 13,197 patients with peritrochanteric femur fractures between 2016 and 2021 were included in analysis.

Intramedullary nail fixation versus open reduction and internal fixation for treatment of adult diaphyseal forearm fractures: a systematic review and meta-analysis.

Background: Diaphyseal radius and ulna fractures require surgical fixation in adults. Open reduction and internal fixation (ORIF) have been considered the gold standard of treatment. The recent development of an interlocking intramedullary nail (IMN) has provided an alternative treatment method for these fractures.

Sling and forget it? A systematic review of operative versus nonoperative outcomes for scapula fractures.

Background: The majority of scapula fractures have historically been treated nonoperatively. The current literature describing patient outcomes following scapula fractures is limited. Our objective was to determine differences in outcomes between operatively and nonoperatively treated scapular fractures.

Complications of Hip Hemiarthroplasty.

Hip hemiarthroplasty is a commonly performed orthopedic surgery, used to treat proximal femur fractures in the elderly population. Although hip hemiarthroplasty is frequently successful in addressing these injuries, complications can occur. Commonly seen complications include dislocation, periprosthetic fracture, acetabular erosion, and leg-length inequality.

Platelet-Rich Plasma and Stem Cell Injections in the Treatment of Arthritis of the Knee.

Platelet-rich plasma (PRP) and stem cell (SC) injections have become increasingly common in the treatment of knee arthritis. This systematic review was performed to answer the following questions: (1) What effects does intraarticular PRP injection have in the setting of knee arthritis? (2) What effects does intra-articular SC injection have in the setting of knee arthritis? (3) What adverse events have been reported in the literature from PRP injections for knee arthritis? (4) What adverse events have been reported in the literature from SC injections for knee arthritis? [. 2021;44(6):376-383.

Surgical Treatment for Avulsion Fractures of the Anterolateral Ligament Associated with Periarticular Fractures of the Knee.

The existence and anatomy of the anterolateral ligament (ALL) of the knee are a somewhat controversial topic in orthopaedic surgery. The fixation of the avulsion fracture of the ALL (Segond fracture), associated with periarticular knee fractures, is rarely given much consideration while the major fracture fragments are reconstructed. This study aims to confirm the existence of ALL and evaluate the clinical outcomes of surgical management for avulsion fractures, involving its insertion, when associated with periarticular knee fractures.

Do Early Weight-Bearing and Range of Motion Affect Outcomes in Operatively Treated Ankle Fractures: A Systematic Review and Meta-Analysis.

Objectives: This systematic review was performed to answer the following questions: (1) Does early weight-bearing (WB) after ankle fracture (AF) open reduction internal fixation (ORIF) affect outcomes? (2) Does early WB after AF ORIF cause an increase in complications? (3) Does early ankle motion after AF ORIF affect outcomes? and (4) Does early ankle motion after AF ORIF cause an increase in complications?

Data Sources: Articles from 1970 to 2020 were found using the PubMed database.

Study Selection: Level I studies of adult patients with operatively treated ankle fractures were selected. A total of 1130 cases across 20 studies fit the participant criteria.

Biomechanics of the Injured Fibula Following Plate Fixation of a Concomitant Tibia Fracture To Fix or Not to Fix?

Background: The mechanical role of supplemental fibula fixation in both bone lower leg fractures is not well defined. The benefit of fibula plate fixation in this context is controversial. The purpose of this study was to ascertain the mechanical contributions of the fibula under three conditions (intact, fractured, or plated fibula) following standard tibia locked plating.

Effect of a Dynamic Fixation Construct on Syndesmosis Reduction: A Cadaveric Study.

Objectives: To explore what effect a dynamic fixation construct would have on the final reduction of the syndesmosis.

Methods: Syndesmotic ligaments were sectioned in 10 cadaveric specimens. The syndesmosis was intentionally malreduced with a clamp, and the distance from the anterior edge of the fibula to the anterior incisura of the tibia was measured to quantify the sagittal syndesmotic displacement (SSD).

Sternoclavicular Joint Dislocation: A Systematic Review and Meta-analysis.

Objectives: This meta-analysis was performed to answer the following questions: (1) What is the expected outcome of sternoclavicular (SC) dislocations left untreated? (2) What are the indications for closed reduction of SC dislocations? (3) What are the indications for open reduction of SC dislocations? and (4) Does the evidence support the need for a cardiothoracic surgeon to be available for the open reduction of a SC dislocation?

Data Sources: Articles were obtained from the database EBSCOhost and supplemented by hand searching of bibliographies of included references. A search using the following terms: SC joint AND (dislocation OR injuries OR vascular injury OR cardiovascular surgeon) of the English-language literature from 1970 to 2018 on the topic of SC joint dislocations was performed.

Study Selection: Studies were included if they contained clinical data on one or more of our study objectives.

Efficacy of Arthroscopic Teaching Methods: A Prospective Randomized Controlled Study.

Arthroscopic education research recently has been focused on the use of skills labs to facilitate resident education and objective measure development to gauge technical skill. This study evaluates the effectiveness of three different teaching methods. Medical students were randomized into three groups.

Open and contaminated pediatric pelvic ring injury case report: Fixation without metal.

Introduction: Pelvic fractures are relatively uncommon in children, accounting for 0.3-7.5% of all pediatric injuries (Gänsslen et al.

The incidence of deep vein thrombosis and pulmonary embolism after fracture of the tibia: An analysis of the National Trauma Databank.

Controversy exists regarding the routine use of chemical prophylaxis in isolated lower extremity fractures. The incidence of VTE in specific fracture locations in the lower extremity is largely unknown, and represents key information necessary to determine the need for prophylaxis. A large cross-sectional study using the National Trauma Databank was performed evaluating for the incidence and risk factors of VTE in isolated tibia fractures.

Examination Under Anesthesia for Posterior Wall Acetabular Fracture A Survey of the OTA Membership.

Objectives: The purpose of this survey was to learn more about the indications, criteria, and methods surgeons use for performing examination under anesthesia (EUA) for "intermediate" sized posterior wall acetabular fractures (those involving 20% to 40% of the posterior wall) and to find what criteria are used to determine hip instability.

Methods: An 18 question survey was posted on the Ortho- paedic Trauma Association's website and was used to gather anonymous data from orthopaedic surgeons regarding their approach to the intermediate sized posterior wall fracture.

Results: Considerable variability existed among re- sponses to many of the questions asked.

Fractures Due to Gunshot Wounds: Do Retained Bullet Fragments Affect Union?

Background: Many types of projectiles, including modern hollow point bullets, fragment into smaller pieces upon impact, particularly when striking bone. This study was performed to examine the effect on time to union with retained bullet material near a fracture site in cases of gunshot injury.

Methods: All gunshot injuries operatively treated with internal fixation at a Level 1 Trauma Center between March 2008 and August 2011 were retrospectively reviewed.

Muscle Viability Revisited: Are We Removing Normal Muscle? A Critical Evaluation of Dogmatic Debridement.

Purpose: Determination of muscle viability during debridement is a subjective process with significant consequences. Evaluating muscle color, consistency, contractility, and capacity to bleed (the 4 Cs) was established by a study performed half a century ago. This work reinvestigates the utility of the 4 Cs using current histopathologic techniques.

Medial malleolus screws: out in one view and out.

Cartilage damage or mechanical blocking from screw penetration into intra-articular cartilage can reduce the chances of successful outcomes during medial malleolus fixation. There have been diverging opinions among surgeons concerning the reliability of radiographic assessment of fracture fixation and malleolus screw positioning. Therefore, this radiographic study examines the location of medial malleolus lag screws relative to the ankle mortise articular surface.

Intramedullary nailing of subtrochanteric fractures--does malreduction matter?

Introduction: Subtrochanteric femur fractures remain challenging injuries to treat. Historically, varus malreduction has been linked to the development of nonunion; however, there is a paucity of literature evaluating the impact of sagittal plane malreduction. The purpose of this study was to evaluate the influence of coronal and sagittal plane malreductions on time to union of subtrochanteric femur fractures treated with an intramedullary device.

Minimally displaced clavicle fracture after high-energy injury: are they likely to displace?

Background: Nondisplaced or minimally displaced clavicle fractures are often considered to be benign injuries. These fractures in the trauma patient population, however, may deserve closer follow-up than their low-energy counterparts. We sought to determine the initial assessment performed on these patients and the rate of subsequent fracture displacement in patients sustaining high-energy trauma when a supine chest radiograph on initial trauma survey revealed a well-aligned clavicle fracture.

Caesarean section rates following pelvic fracture: a systematic review.

Background: Following pelvic fracture in females of childbearing age, the question of whether or not natural pregnancy and childbirth can occur is often asked by both patients and clinicians. The following is a systematic review of the literature examining caesarean section rate in patients with prior pelvic fracture.

Methods: An extensive search of the English-language literature was performed to include all articles describing pregnancy outcomes in women with prior pelvic fracture.