Pediatric all-terrain vehicle (ATV) injuries: An epidemic of cost and grief.

Objective: Evaluate cost of care of all-terrain vehicle (ATV) related injuries sustained by riders 16 years and younger in Pennsylvania.

Methods: Population-based retrospective cohort design reviewing costs of care of 78 patients (≤16 years), admitted (01/01/2007-12/31/2009) to our institution for injuries sustained during an ATV accident.

Results: Cost of care varied from $322 to $310,435.

Reducing mortality in hip fracture patients using a perioperative approach and "Patient- Centered Medical Home" model: a prospective cohort study.

Background: Hip fracture patients experience high morbidity and mortality rates in the first post-operative year after discharge. We compared mortality, utilization, costs, pain and function between two prospective cohorts of hip fracture patients, both managed with identical perioperative protocols and one group subsequently managed via a "Patient-Centered Medical Home" (PCMH) primary care management model.

Methods: We analyzed 6 and 12-month outcomes from two matched cohorts of patients who were surgically treated for hip fracture from January 1, 2010 to June 30, 2011 at two hospitals (n = 194).

Hemodynamically unstable pelvic fracture management by advanced trauma life support guidelines results in high mortality.

The purpose of this study was to examine the acute outcomes and mortality rates of an Advanced Trauma Life Support guideline approach for managing hemodynamically unstable pelvic ring injuries. We retrospectively reviewed the acute outcomes of 48 consecutive patients with hemodynamically unstable pelvic fractures. Patients underwent treatment via the advanced trauma life support protocol, with primary angiography based on trauma surgeon preference.

Treatment of interprosthetic fractures of the femur.

Background: The treatment of interprosthetic femoral fractures is challenging because of several factors. Poor bone stock, advanced age, potential prosthetic instability, and limited fracture fixation options both proximally and distally can complicate standard femur fracture treatment procedures. The purpose of this report was to describe our experience treating interprosthetic femoral fractures, providing an emphasis on treatment principles and specific intraoperative management.

Delayed flap reconstruction with vacuum-assisted closure management of the open IIIB tibial fracture.

Objective: Vacuum-assisted closure (VAC) therapy has been shown to be effective at reducing bacterial counts in wounds until definitive bony coverage. However, there is continued debate over timing and type of definitive wound coverage even with VAC therapy application.

Methods: From 2004 to 2009, 32 patients with Gustilo type IIIB open tibia fractures were initially treated with VAC therapy were included.

Severe postpartum disruption of the pelvic ring: report of two cases and review of the literature.

Pelvic dislocations are rare during labor, and the treatment is controversial. We report two cases of young women who sustained postpartum disruption of the pelvic ring: one case is an 8.8 cm wide separation of the pubic symphysis with sacroiliac joint disruption underwent surgical stabilization and the second case with 4.