Lost in the Shuffle: Low Health Literacy in Geriatric Fracture Patients and Families Regarding Post-Acute Care-A Prospective Study.

Introduction: This study aims to evaluate health literacy (HL) in geriatric orthopaedic trauma patients and their families as it relates to their post-acute care (PAC) in skilled nursing facilities (SNFs) and inpatient rehabilitation facilities (IRFs).

Methods: This nonrandomized controlled clinical trial included patients aged 65 years and older treated for acute fracture at a Level 1 trauma center and discharged to either IRF or SNF. First 106 patients enrolled served as the control group and received standard discharge instructions.

Outcomes After Acute Versus Staged Fixation of Complete Articular Tibial Plafond Fractures.

Objective: To determine the outcomes after acute versus staged fixation of complete articular tibial plafond fractures.

Design: Retrospective cohort study.

Setting: Single Level 1 Trauma center.

A Prospective Randomized Controlled Trial Comparing Enoxaparin & Rivaroxaban for Venous Thromboembolism Prophylaxis in Orthopaedic Trauma.

Objectives: To determine whether there is a difference in orthopaedic trauma patient medication satisfaction and adherence using an oral versus subcutaneous injectable anticoagulant for venous thromboembolism chemoprophylaxis.

Design: Randomized controlled trial.

Setting: Single academic Level 1 trauma center.

Twenty-Year Trends in Upper-Extremity Infections at a Single Urban Institution.

Purpose: Empiric antibiotic therapy for hand and upper-extremity infections aims to cover the most common causative organisms, which may change over time. The purpose of this study was to investigate the changes in the bacterial profile of upper-extremity infections over 2 decades at our institution.

Methods: We performed a retrospective chart review of patients with upper-extremity infections treated at a single level 1 trauma center between 2001 and 2019.

Physician wellness in orthopaedic surgery : a multinational survey study.

Aims: Physician burnout and its consequences have been recognized as increasingly prevalent and important issues for both organizations and individuals involved in healthcare delivery. The purpose of this study was to describe and compare the patterns of self-reported wellness in orthopaedic surgeons and trainees from multiple nations with varying health systems.

Methods: A cross-sectional survey of 774 orthopaedic surgeons and trainees in five countries (Australia, Canada, New Zealand, UK, and USA) was conducted in 2019.

Symptoms and Clinical Outcomes of Coronavirus Disease 2019 in the Outpatient Setting.

Because most cases of coronavirus disease 2019 (COVID-19) are not severe, understanding the epidemiology of mild cases has important clinical implications. We aimed to describe the symptom profile and associated outcomes in a virtual outpatient COVID-19 clinic. We conducted a prospective cohort study from March through June 2020.

Cervical length change as a predictor of preterm birth in symptomatic patients.

Background: Distinguishing between true and false preterm labor remains a challenge. The shortening in cervical length throughout a gestation has been theorized to be a possible predictor of spontaneous preterm birth. Although there are some studies evaluating cervical length shortening as a predictor of spontaneous preterm birth, it is not known whether the shortening in cervical length from an asymptomatic to symptomatic state, when a patient presents with preterm labor symptoms, is predictive of spontaneous preterm birth.

Patient Perception of Pain Control (Not Opiate Amount) Affects Hospital Consumer Assessment of Healthcare Providers and Systems and Press Ganey Satisfaction Scores After Orthopaedic Trauma.

Introduction: Opiate abuse is a public health issue linked to prescribing. Prescribing increased partly in response to adopting pain as the fifth vital sign. Assessing pain control on patient satisfaction surveys, including government-mandated Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and optional private surveys (Press Ganey) administered on hospital discharge, may contribute.

Routine Postoperative Complete Blood Counts Are Not Necessary After Most Primary Total Hip and Knee Arthroplasties.

Background: Routine postoperative complete blood count tests are commonplace after total joint arthroplasty. The goal of this study was to identify if these result in any clinically meaningful action and if it would be safe to forego this testing in a population without known risk factors for transfusion.

Methods: A retrospective review of 1060 patients undergoing a total knee or total hip arthroplasty at a single institution was performed.

"Unstable" Pediatric Femoral Shaft Fractures Treated With Flexible Elastic Nails Have Few Complications.

Objectives: To determine our complication rate in pediatric femoral shaft fractures treated with flexible elastic nailing and to determine fracture characteristics that may predict complications.

Design: Retrospective cohort study.

Setting: One Level 1 and One Level 2 academic trauma centers.

Quality of Reduction of Displaced Intra-articular Calcaneal Fractures Using a Sinus Tarsi Versus Extensile Lateral Approach.

Objective: To evaluate the difference in the quality of fracture reduction between the sinus tarsi approach (STA) and extensile lateral approach (ELA) using postoperative Computed Tomography (CT) scans in displaced intra-articular calcaneal fractures (DIACFs).

Design: Retrospective.

Setting: Level 1 and level 2 academic centers.

ORIF of Distal Humerus Fractures with Modern Pre-contoured Implants is Still Associated with a High Rate of Complications.

Background: The purpose of this study was to identify complications after operative treatment of distal humerus fractures with anatomic, pre-contoured, locking distal humeral plates. We hypothesized that these fractures have high complication rates despite the use of these modern implants.

Materials And Methods: Between 2010 and 2018, 43 adult patients with a distal humerus fracture underwent open reduction and internal fixation (ORIF) at a Level I trauma center.

Defining the younger patient: age as a predictive factor for outcomes in shoulder arthroplasty.

Background: The purpose of this study was to define an age cutoff at which clinical outcomes and revision rates differ for patients undergoing primary anatomic total shoulder arthroplasty (TSA) and patients undergoing primary reverse shoulder arthroplasty (RSA).

Methods: This retrospective cohort study included 1250 primary shoulder arthroplasties (1131 patients) with minimum 2-year clinical follow-up (mean, 50 months [range, 24-146 months]). TSA (n = 518; mean age, 68.

Does the etiology of a failed hemiarthroplasty affect outcomes when revised to a reverse shoulder arthroplasty?

Background: The purposes of this study were to evaluate patient outcomes after revision of hemiarthroplasty to reverse shoulder arthroplasty (RSA) based on initial pathology, to determine the re-revision rate, and to identify characteristics that may predict subsequent re-revision.

Methods: A total of 207 shoulder hemiarthroplasty, bipolar prosthesis, and humeral resurfacing cases revised to RSA between January 2004 and January 2017 were reviewed. Outcome measures included shoulder motion and American Shoulder and Elbow Surgeons and Simple Shoulder Test (SST) scores.

Evaluating the impact of a standardized induction protocol to reduce adverse perinatal outcomes: a prospective cohort study.

Objective: Our objective was to evaluate the impact of a standardized induction protocol on reducing maternal and neonatal morbidity in women undergoing an induction with an unfavorable cervix.

Study Design: We performed a prospective cohort study of women undergoing an induction from May 2013 to June 2015. Women who were ≥18 years, ≥37 weeks with intact membranes and an unfavorable cervix (Bishop score of ≤6 and cervical dilation ≤2 cm) with no prior cesarean were included.

Persistent cardiac dysfunction on echocardiography in African American women with severe preeclampsia.

Background: Cardiovascular disease (CVD) and preeclampsia both disproportionally affect African American women. Evidence continues to grow linking a history of preeclampsia to future CVD. Therefore, we sought to determine whether abnormalities in cardiac function, as determined by echocardiography, could be identified at the time of preeclampsia diagnosis in African American women, and if they persist into the early postpartum period.

Early to midterm results of "low-friction" articulating antibiotic spacers for septic total knee arthroplasty.

Background: Infection of total knee arthroplasty is a complex problem often resulting in multiple surgeries for the patient. We examined the early to midterm results of a retained cemented "low-friction" metal-on-polyethylene articulating antibiotic spacer in total knee arthroplasty.

Methods: We retrospectively reviewed patients with a total knee cemented articulating antibiotic spacer performed for joint sepsis.

Is there a relationship between preoperative diagnosis and clinical outcomes in reverse shoulder arthroplasty? An experience in 699 shoulders.

Background: The influence of diagnosis on outcomes after reverse shoulder arthroplasty (RSA) is not completely understood. The purpose of this study was to compare clinical outcomes of different pathologies.

Methods: A total of 699 RSAs were performed for the following diagnoses: (1) rotator cuff tear arthropathy (RCA), (2) massive cuff tear (MCT) with osteoarthritis (OA), (3) MCT without OA, (4) OA, (5) acute proximal humeral fracture, (6) malunion, (7) nonunion, and (8) inflammatory arthropathy.

Using the Probability of Cesarean from a Validated Cesarean Prediction Calculator to Predict Labor Length and Morbidity.

Objective: To determine if increasing predicted risk of cesarean was associated with longer labor length and increased morbidity among women undergoing induction with an unfavorable cervix.

Study Design: Using a publically available database, we evaluated whether a previously validated prediction model for cesarean delivery after induction was associated with labor length, maternal morbidity (third-/fourth-degree lacerations, endometritis, blood transfusion, wound infection, venous thromboembolism, hysterectomy, intensive care unit admission, and death), and neonatal morbidity (blood transfusion, encephalopathy, intraventricular hemorrhage, severe respiratory distress syndrome, necrotizing enterocolitis, and sepsis). Full-term (≥37 weeks) singleton gestations with intact membranes and an unfavorable cervix (Bishop score ≤6 and dilation ≤2 cm) undergoing induction of labor were included.

Noninvasive blood tests for fetal development predict gestational age and preterm delivery.

Noninvasive blood tests that provide information about fetal development and gestational age could potentially improve prenatal care. Ultrasound, the current gold standard, is not always affordable in low-resource settings and does not predict spontaneous preterm birth, a leading cause of infant death. In a pilot study of 31 healthy pregnant women, we found that measurement of nine cell-free RNA (cfRNA) transcripts in maternal blood predicted gestational age with comparable accuracy to ultrasound but at substantially lower cost.

Quantitative fetal fibronectin and cervical length in symptomatic women: results from a prospective blinded cohort study.

Our objectives were to determine whether quantitative fetal fibronectin (fFN) and cervical length (CL) screening can be used alone or in combination as prognostic tests to identify symptomatic women at the highest or lowest risk for spontaneous preterm birth (sPTB). A prospective, blinded cohort study of women presenting with a singleton gestation to our triage unit between 22-33w6d with preterm labor symptoms was performed. Women with ruptured membranes, moderate/severe bleeding, and dilation >2 cm were excluded.