The Effects of a Stepped-Care Mental Health Program on Trauma Recidivism at a Level 1 Trauma Center.

Objectives: This study aimed to analyze the effects of a stepped-care mental health program (TRRP) on trauma recidivism at a single institution.

Methods: Designs: Retrospective review.

Setting: single Level 1 trauma center.

Adult skateboarding and motorized board injuries: A comparative analysis.

Objectives: Skateboarding and motorized boards are popular as a recreational activity and mode of transportation. Prior studies have investigated injury patterns from these activities in the pediatric population, but there is little data in the adult population. This study aims to investigate and compare the type and severity of injuries associated with skateboarding and motorized boards.

Blood on the drapes: A multispecialty comparison of blood spill estimates.

Introduction: Estimated blood loss (EBL) is an important part of the perioperative process. This project aims to determine the accuracy of perioperative team members to estimate blood volume on drapes and the operating room floor.

Methods: Aliquots of unused human blood were used to create surgical scenarios, and standardized pictures and videos were taken.

Opportunistic CT screening demonstrates increased risk for peri-articular fractures in osteoporotic patients.

Background: Underdiagnosis or undertreatment of osteoporosis consequently impacts individual morbidity and mortality, as well as on healthcare systems and communities as a whole. Dual-energy x-ray absorptiometry (DXA) is the gold standard method for identifying osteoporosis, however, opportunistic CT screening is capable of precisely estimating bone mineral density (BMD) in abdominopelvic imaging with no additional cost, radiation exposure or inconvenience to patients. This study uses opportunistic CT screening to determine the prevalence of osteoporosis and anatomic distribution patterns in patients presenting with lower extremity fractures at our institution.

American Academy of Orthopaedic Surgeons Clinical Practice Guideline Case Report: Prevention of Surgical Site Infection After Major Extremity Trauma.

Major extremity fractures are serious limb injuries often including notable soft-tissue injury with possible injuries to the head, chest, or abdomen. High-energy traumatic fractures carry a high risk of surgical site infections even with use of systemic antibiotics and techniques in risk reduction. The American Academy of Orthopaedic Surgeons released a clinical practice guideline in 2023 based on current literature on the prevention of surgical site infections after major extremity trauma.

Intradepartmental orthopaedic fragility fracture liaison improves osteoporosis follow-up and treatment.

Objective: Over 2 million people in the United States sustain fractures related to osteoporosis annually, but only 20% of these patients receive treatment for their osteoporosis. The purpose of this study was to evaluate the effects of a fragility fracture liaison within the orthopedic department on treatment and follow up for osteoporosis.

Design: Retrospective cohort study SETTING: University Level I Trauma center PARTICIPANTS: 112 patients treated under the aegis of an interdepartmental fracture liaison and 208 patients treated following the introduction of an orthopedic fragility fracture liaison at a single institution.

The Rates of Nonunion and Malunion in Lower Extremity Fractures: Experience in South Carolina over 17 years.

Our purpose was to determine the rates of lower extremity nonunion and malunion over 17 years in South Carolina. Our hypothesis was that malunions and nonunions decreased over time due to improved access to trauma centers and improved orthopaedic surgical training. The South Carolina Department of Budget and Control Hospital Discharge Database was queried between 1998-2014 and yielded a total of 4,994 malunions and 16,454 nonunions.

National Athletic Trainers' Association Position Statement: Immediate Management of Appendicular Joint Dislocations.

Objective: To provide certified athletic trainers (ATs) with recommendations and guidelines for the immediate management of patients with joint dislocations.

Background: One of the primary responsibilities of ATs is to provide immediate injury care for active individuals. Although ATs are confronted with managing patients who have many kinds of injuries, the onsite management of a joint dislocation presents challenges in evaluation and immediate treatment.

Surgical Complications Associated With Atypical Femur Fractures Attributed to Bisphosphonate Use.

Complications of atypical femur fractures (AFFs) are common. AFFs often receive the same treatment as other femoral fractures; however, there appears to be a higher rate of adverse outcomes. Nine patients sustained a total of 13 AFFs, had documented bisphosphonate use before fracture, and had surgery between 2006 and 2012.

Heterotopic Ossification in Trauma.

Better understanding of the biology of heterotopic ossification (HO) formation will lead to treatment and prevention modalities that can be directed specifically at the cellular level. Early identification of HO precursor cells and target genes may provide prognostic value that guides individualized prophylactic treatment. Better understanding of molecular signaling and proteomics variability will allow surgeons to individualize preemptive treatment to suppress inflammation and formation of HO.

The impact of race on the development of severe heterotopic ossification following acetabular fracture surgery.

Objectives: To determine the association between race on severe heterotopic ossification (HO) following acetabular fracture surgery.

Design: Retrospective case control study.

Setting: Level I university trauma centre.

Middle-third clavicle fracture with associated type IV acromioclavicular separation: case report and literature review.

Review of available English literature suggests that combined injuries involving a clavicle shaft fracture and an acromioclavicular (AC) separation are rare. The force dissipation after the occurrence of either a midshaft clavicle fracture or an AC separation typically renders the injuries mutually exclusive. This article presents a review of literature on this combined injury pattern.

Tibiotalocalcaneal fusion using the hindfoot arthrodesis nail: a multicenter study.

Background: Tibiotalocalcaneal arthrodesis is a salvage option for severe ankle and hindfoot deformities, arthritis of the ankle and subtalar joints, avascular necrosis of the talus, failed total ankle arthroplasty, and Charcot arthropathy. This multicenter study reports clinical experience with the hindfoot arthrodesis nail (HAN) in the treatment of patients with severe ankle and foot abnormalities.

Methods: Seven participating clinics from Europe and North America recruited 38 patients who underwent ankle/subtalar arthrodesis using retrograde nailing with the HAN.

Compartment syndrome after low-energy tibia fractures sustained during athletic competition.

Objective: The purpose of this study was to determine whether patients who sustain tibia fractures during athletic competition are at an increased risk of developing acute compartment syndrome (ACS).

Design: Retrospective review.

Setting: University Level I trauma center.

Calcaneal reconstruction with free fibular osteocutaneous flap.

Due to the role of the calcaneus in weight bearing, soft tissue coverage along with proper reduction of the fracture is the treatment following open calcaneal injury. Intra-articular calcaneal fractures present a very difficult management problem, as the lack of soft tissue and the intricate vascularity in this area pose a risk of complications. Coverage with local and free muscle flaps following excision of infected structures is a common approach for the treatment of chronic osteomyelitis.

Randomized prospective clinical trial comparing reamer irrigator aspirator (RIA) to standard reaming (SR) in both minimally injured and multiply injured patients with closed femoral shaft fractures treated with reamed intramedullary nailing (IMN).

Purpose: To investigate whether inflammatory markers are improved among patients with traumatic femur fractures who undergo RIA reamed intramedullary nailing (IMN) prior to fixation when compared to patients treated with standard reamed (SR) IMN.

Methods: A prospective, randomized, single-blind trial was conducted on patients who had a closed femoral shaft fracture amenable to reamed IMN. Patients were randomized to undergo IMN with standard reaming or IMN with the RIA in a 1:1 ratio.

Ankle arthrodesis using anatomically contoured anterior plate.

Background: More than 40 fusion techniques for the ankle joint have been reported. The purpose of this retrospective study was to review our preliminary clinical and radiographic results using an anatomically contoured anterior plate for ankle arthrodesis.

Materials And Methods: Ten ankle arthrodeses with an anatomically contoured anterior plate performed by a single surgeon were reviewed with an average of 14 months followup.

Conventional plate fixation of periarticular fractures.

Over the last few years, locking plates have become increasingly popular for the treatment of a variety of periarticular fractures. Despite the popularity of these new implants, older implants have a long track record of success and are still appropriate for a variety of periarticular fractures. This article reviews some of the current literature on locking plates and compares results for general fracture types to conventional plate fixation.

Precision extruding deposition (PED) fabrication of polycaprolactone (PCL) scaffolds for bone tissue engineering.

Bone tissue engineering is an emerging field providing viable substitutes for bone regeneration. Recent advances have allowed scientists and engineers to develop scaffolds for guided bone growth. However, success requires scaffolds to have specific macroscopic geometries and internal architectures conducive to biological and biophysical functions.