Staged Management for Distal Femur Fractures: Impacts on Reoperation, Stiffness, and Overall Outcomes.

Objectives: To evaluate the outcomes of staged management with external fixation (ex-fix) before definitive fixation of distal femur fractures.

Design: Retrospective cohort.

Setting: Single Level I Trauma Center.

Lower Extremity Amputation in Fracture-Related Infection.

Objectives: To analyze demographics, comorbidities, fracture characteristics, presenting characteristics, microbiology, and treatment course of patients with fracture-related infections (FRIs) to determine risk factors leading to amputation.

Design: Retrospective cohort.

Setting: Single Level I Trauma Center (2013-2020).

Resilience Improves Patient-Reported Outcomes After Orthopaedic Trauma.

Objectives: To analyze the relationship between patient resilience and patient-reported outcomes after orthopaedic trauma.

Design: Retrospective analysis of prospectively collected data.

Setting: Single Level 1 Trauma Center.

Characteristics of Femoral Shaft Fractures That Predict Ipsilateral Femoral Neck Fractures.

Introduction: This study aims to characterize radiographic features and fracture characteristics in femoral shaft fractures with associated femoral neck fractures, with the goal of establishing predictive indicators for the presence of ipsilateral femoral neck fractures (IFNFs).

Methods: A retrospective cohort was collected from the electronic medical record of three level I trauma centers over a 5-year period (2017 to 2022) by current procedural terminology (CPT) codes. Current CPT codes for combined femoral shaft and IFNFs were identified to generate our study group.

Isothermal Microcalorimetry Improves the Time to Diagnosis of Fracture-related Infection Compared With Conventional Tissue Cultures.

Background: A consensus definition recently was formulated for fracture-related infection, which centered on confirmatory criteria including conventional cultures that take time to finalize and have a 10% to 20% false-negative rate. During this time, patients are often on broad-spectrum antibiotics and may remain hospitalized until cultures are finalized to adjust antibiotic regimens.

Questions/purposes: (1) What is the diagnostic accuracy of isothermal microcalorimetry, and how does its accuracy compare with that of conventional cultures? (2) Does isothermal microcalorimetry decrease time to detection (or diagnosis) of fracture-related infection compared with conventional cultures? (3) Does isothermal microcalorimetry have a diagnostic accuracy or time advantage over conventional cultures in patients on chronic suppressive antibiotics?

Methods: Between July 2020 and August 2021, we treated 310 patients with concerns for infection after prior fracture repair surgery.

Understanding postoperative rehabilitation preferences in operatively managed proximal humerus fractures: do trauma and shoulder surgeons differ?

Background: Proximal humerus fractures (PHFs) are common, and their incidence is increasing as the population ages. Despite this, postoperative rehabilitation remains unstandardized and little is known about surgeon preferences. The aim of this study was to assess differences in postoperative rehabilitation preferences and patient education between orthopedic trauma and shoulder surgeons.

Diffuse Recalcitrant Osteomyelitis and Joint Septicemia Because of Bowel Perforation Secondary to Gunshot Injury: A Case Report.

Case: A previously healthy 22-year-old man was brought into the emergency department after sustaining a low-velocity, civilian gunshot wound to the abdomen that perforated the bowel. Over the next 300 days, he would be admitted and discharged multiple times, requiring a total of 48 debridements, 23 different antimicrobials in 81 unique combinations, and had 18 different microbes cultured from various sites in bone, joint, and blood. Multiorganism bacteremia and fungemia culminated in above-knee amputation because of progression of infection, all in a nonimmunocompromised host.

Effect of Obesity on Perioperative Complications, Hospital Costs, and Length of Stay in Patients With Open Ankle Fractures.

Introduction: The objective of this study was to examine the effect of obesity on perioperative complications and the cost of surgical management of open ankle fractures.

Methods: This study examined data from the National Inpatient Sample. The primary outcome variables assessed were occurrence of any complication, complication subtype, length of stay, and total hospital costs.

The expanding use of total elbow arthroplasty for distal humerus fractures: a retrospective database analysis of 56,379 inpatients from 2002-2014.

Objectives: Distal humerus fractures are challenging to treat, with significant morbidity. Precontoured distal humerus locking plates and total elbow arthroplasty implants have become available in the past 15 years, potentially offering the promise of improved outcomes. However, national data regarding the usage of and in-hospital complications associated with these implants is scarce.