Rate of skin and nerve complications as a result of cutaneous traction with modern foam boots.

Introduction: Cutaneous traction is used to temporize lower extremity fractures and relies on friction between the skin and surrounding material to apply a longitudinal force. This circumferential compressive force can lead to pressure sores, skin sloughing, or compressive neuropathies. These complications have been reported in up to 11% of patients when the cutaneous traction relies on adhesive tapes, plaster, and rubber bandages being in immediate contact with the skin.

Radiographic Thigh Muscle Measurements Are a Reliable Predictor of Psoas Area and Sarcopenia.

Background: Sarcopenia is associated with falls, fractures, postoperative complications such as periprosthetic joint infections and dislocations, and early mortality. Although cross-sectional imaging is currently used to diagnose sarcopenia, inexpensive and widely available screening tests are needed. The goal of this study was to investigate whether measurements of thigh muscles made on radiographs can predict psoas muscle area and the presence of sarcopenia as determined on computed tomography (CT) scans.

Gender equity in hiring: examining the effectiveness of a personality-based algorithm.

Introduction: Gender biases in hiring decisions remain an issue in the workplace. Also, current gender balancing techniques are scientifically poorly supported and lead to undesirable results, sometimes even contributing to activating stereotypes. While hiring algorithms could bring a solution, they are still often regarded as tools amplifying human prejudices.

Early postoperative step count and walking time have greater impact on lower limb fracture outcomes than load-bearing metrics.

Introduction: Weight-bearing protocols for rehabilitation of lower extremity fractures are the gold standard despite not being data-driven. Additionally, current protocols are focused on the amount of weight placed on the limb, negating other patient rehabilitation behaviors that may contribute to outcomes. Wearable sensors can provide insight into multiple aspects of patient behavior through longitudinal monitoring.

Changes in frontal plane kinematics over 12-months in individuals with the Percutaneous Osseointegrated Prosthesis (POP).

Background: A bone-anchored prosthesis (BAP) eliminates the need for a conventional socket by attaching a prosthesis directly to the user's skeleton. Currently, limited research addresses changes in gait mechanics post BAP implantation.

Objective: Examine changes in frontal plane movement patterns after BAP implantation.

The First FDA Approved Early Feasibility Study of a Novel Percutaneous Bone Anchored Prosthesis for Transfemoral Amputees: A Prospective 1-year Follow-up Cohort Study.

Objective: Evaluate the safety and efficacy of a novel press-fit bone-anchored prosthesis in an FDA approved study.

Design: Single-center, prospective 1-year follow-up cohort study of a percutaneous bone anchored prosthesis.

Setting: Veterans Health Administration Hospital.

Use of computer tomography imaging for analyzing bone remodeling around a percutaneous osseointegrated implant.

Osseointegration (OI) is being used for the direct skeletal attachment of prosthetic limbs using an intramedullary stem that extends percutaneously from the subject's residual limb. For this technology to be successful, bone ingrowth and remodeling around the implant must occur. Physicians need an effective way to assess bone remodeling to make informed treatment and rehabilitation decisions.

Fewer Hip Dislocations With Anterior Total Hip Arthroplasty for Displaced Femoral Neck Fracture.

The primary goal of this study was to compare dislocation rates with an anterior approach vs a posterior approach for patients who underwent total hip arthroplasty (THA) for displaced femoral neck fracture. A retrospective review was conducted of patients who underwent THA for acute femoral neck fracture at the authors' level I trauma center. All patients had at least 1 year of follow-up.

Effect of Statewide Social Distancing and Stay-At-Home Directives on Orthopaedic Trauma at a Southwestern Level 1 Trauma Center During the COVID-19 Pandemic.

Objectives: To compare orthopaedic trauma volume and mechanism of injury before and during statewide social distancing and stay-at-home directives.

Design: Retrospective.

Setting: Level 1 trauma center.

It's All About the Timing: When Do I Take This Injury to the Operating Room?

Over time, what was considered urgent or emergent in orthopaedic trauma has been revisited, and as awareness of factors associated with outcomes has increased, priorities have changed. There are multiple procedures performed urgently in the belief that early intervention allowed for better outcomes for the injury and the patient. Classic examples of conditions for which urgent intervention has been implemented include open fractures, femoral neck fractures in the young adult, talus fractures, and compartment syndrome.

Validated Radiographic Scoring System for Lateral Compression Type 1 Pelvis Fractures.

Objectives: To develop a radiographic fracture scoring system for lateral compression type 1 (LC-1) pelvic fractures based on OTA/AO survey data and to preliminarily evaluate this system within an LC-1 pelvis fracture cohort.

Design: Survey study with validation patient cohort.

Setting: Two Level 1 academic trauma centers.

Surgery for Unilateral Sacral Fractures: Are the Indications Clear?

Objectives: To evaluate unilateral sacral fractures and compare those treated operatively versus nonoperatively to determine indications for surgery.

Design: Prospective, multicenter, observational study.

Setting: Sixteen trauma centers.

Does Operative Intervention Provide Early Pain Relief for Patients With Unilateral Sacral Fractures and Minimal or No Displacement?

Objectives: To compare pain after operative versus nonoperative pelvic ring injuries with unilateral sacral fractures.

Design: Prospective, multicenter, observational.

Setting: Sixteen trauma centers.

Analysis of the Stomal Microbiota of a Percutaneous Osseointegrated Prosthesis: A Longitudinal Prospective Cohort Study.

Percutaneous osseointegrated (OI) prostheses (POPs) are used to skeletally attach artificial limbs in amputees. While any permanent percutaneous interface is at risk of becoming infected by the resident microbiota colonizing the stoma, most of these patients remain infection-free. Avoidance of infection likely depends upon a mechanically and/or biologically stable skin-to-implant interface.

Development of a step counting algorithm using the ambulatory tibia load analysis system for tibia fracture patients.

Unlabelled: : Ambulation can be used to monitor the healing of lower extremity fractures. However, the ambulatory behavior of tibia fracture patients remains unknown due to an inability to continuously quantify ambulation outside of the clinic. The goal of this study was to design and validate an algorithm to assess ambulation in tibia fracture patients using the ambulatory tibial load analysis system during recovery, outside of the clinic.

Center of pressure in a walking boot shifts posteriorly in patients following lower leg fracture.

Background: Studies have shown that the ambulatory behavior and amount of weight bearing performed by lower leg fracture patients, increases over time. It is likely that gait features, such as center of pressure (CoP), also change over time.

Research Question: The purpose of this study was to characterize changes in CoP exhibited by lower leg fracture patients wearing a walking boot during the recovery period.

Short Versus Long Cephalomedullary Nails for Fixation of Stable Versus Unstable Intertrochanteric Femur Fractures at a Level 1 Trauma Center.

The purpose of this study was to compare failure and complication rates associated with short cephalomedullary nail vs long cephalomedullary nail fixation for stable vs unstable intertrochanteric femur fractures. This study included 201 adult patients with nonpathologic intertrochanteric femur fractures without subtrochanteric extension (OTA 31-A1.1-3, 31-A2.

A Comparison of the Open Semi-extended Parapatellar Versus Standard Entry Tibial Nailing Techniques and Knee Pain: A Randomized Controlled Trial.

Objective: To determine if an open, semi-extended, parapatellar tibial nailing technique (SEK) imparts any undue knee symptoms/pain compared with the traditional infrapatellar tibial nailing technique (FK).

Design: Randomized controlled trial.

Setting: Level 1 trauma center.

Periprosthetic Fractures About the Hip and Knee: Contemporary Techniques for Internal Fixation and Revision.

The number of periprosthetic fractures is expected to increase given the growing number of elderly individuals who are living longer and advances in technology that allow for total hip and knee arthroplasty in younger patients. Evolving technologies in combination with a better understanding of required total hip and knee reconstruction has allowed for continued improvements in applied fixation strategies and patient outcomes. Current fixation and revision options have led to reliable, reproducible management of periprosthetic fractures about the hip and knee, including proximal femur and supracondylar femur fractures, which are common, and fractures about an acetabular component and between proximal and distal hip and knee prostheses, which are rare.

Ankle Fractures in Elderly Patients with Osteopenia and Neuropathy.

Ankle fractures are increasingly common in elderly patients given the number of aging individuals who remain active. The already difficult aspects of ankle fixation are amplified by the compromised soft-tissue envelope and bone quality present in elderly patients with an ankle fracture. In addition, elderly patients with an ankle fracture often have compromised neuroprotective mechanisms and are physically unable to follow postoperative protected weight-bearing protocols during ambulation.

External validation of the clinical indications of computed tomography (CT) of the head in patients with low-energy geriatric hip fractures.

Introduction: On evaluation of the clinical indications of computed tomography (CT) scan of head in the patients with low-energy geriatric hip fractures, Maniar et al. identified physical evidence of head injury, new onset confusion, and Glasgow Coma Scale (GCS)<15 as predictive risk factors for acute findings on CT scan. The goal of the present study was to validate these three criteria as predictive risk factors for a larger population in a wider geographical distribution.

Bone penetrance of locally administered vancomycin powder in a rat femur fracture model.

Introduction: Locally delivered, crystalline vancomycin has been suggested as a potential prophylactic measure against the development of deep and superficial surgical site infection. Clinical expectations regarding the duration and peak of drug concentration in local tissues following administration are unknown. Our goal was to develop concentration vs time curves for locally administered vancomycin powder in a high-energy, open femur fracture rat model in local tissues and to compare that data to two well performed similar, systemic administration studies.

Serial Radiographs Do Not Change the Clinical Course of Nonoperative Stable OTA/AO 44-B1 Ankle Fractures.

Objective: To assess radiographic markers of ankle stability in stable OTA/AO 44-B1 ankle fractures.

Design: Retrospective review.

Setting: Academic Level-I trauma hospital.

Inflammatory cytokine response is greater in acute tibial plafond fractures than acute tibial plateau fractures.

The purpose of the study was to compare the inflammatory cytokine and matrix metalloproteinase (MMP) concentrations in synovial fluid after acute plafond fracture with acute tibial plateau fracture. Between December 2011 and August 2014, we prospectively enrolled patients with acute tibial plateau and plafond fractures. Synovial fluid aspirations were obtained from injured and uninjured joints.