Surgical Management of Acute on Chronic Distal Radius Fractures: Correcting Malunion Deformities Through the Secondary Fracture Plane.

It is challenging to restore the clinically acceptable alignment of the distal radius after an acute on chronic fracture or after a secondary fracture occurring after malunion of a primary distal radius fracture. In cases of insignificant primary deformity, restoration to the primary deformity may suffice to obtain a successful clinical result. A borderline acceptable primary radial deformity can be unacceptable after the second injury, resulting in functional disability.

Mitigation of Triceps Avulsion Fracture After Proximal Ulna Plate Fixation.

Objectives: Triceps avulsion fractures have become an increasingly common postoperative complication of olecranon fracture repair with proximal ulna plate (PUP) fixation. The purpose of this study is to create an efficient, reproducible mechanism to mitigate this issue.

Methods: Ten matched pair cadaveric specimens underwent a complete transverse osteotomy to simulate an olecranon fracture, followed by fracture reduction with a PUP.

Effect of Ulnar Head Offset on Distal Radioulnar Joint Stability.

Purpose: A complete ulnar head replacement may be indicated in cases of distal radial ulnar joint (DRUJ) dysfunction to address bony pathology in lieu of using a constrained total DRUJ prosthesis. Complete ulnar head implants are simple, but they may be unstable if soft tissue tension is not adequately restored. We hypothesized that incorporating an increased offset in the complete ulnar head replacement would lead to increased tension on the distal oblique interosseous ligament, increased contact force at the DRUJ, and improved joint stability.

Intraoperative radiographic method of locating the radial head safe zone: the bicipital tuberosity view.

Hypothesis: The proximal radius is asymmetrical, is mostly articular, and rotates through a large arc of motion. Because of these anatomic factors, there is limited space for hardware. This is magnified in the setting of complex fractures.

The Parallelogram Effect: The Association Between Central Band and Positive Ulnar Variance.

Purpose: Ulnar impaction syndrome is a poorly understood degenerative wrist condition characterized by symptoms of pain thought to be caused by increased loads between the ulnar head and the carpals. Radiographic evaluation often reveals an ulnar-positive wrist. We hypothesize that progressive elongation of the central band of the forearm interosseous ligaments changes the longitudinal radial-ulnar relationships, resulting in an ulnar-positive wrist.

The EFCR Approach and the Radial Septum-Understanding the Anatomy and Improving Volar Exposure for Distal Radius Fractures: Imagine What You Could Do With an Extra Inch.

Locked volar plating is the most common surgical procedure to address distal radius fractures. The extended flexor carpi radialis approach continues to be an excellent method for visualizing distal radius fractures and applying a volar plate. A new understanding of the anatomy allows for better visualization and reduction of the many different distal radius fracture patterns surgeons commonly see.

The delicate balance of keeping it all together: Using social capital to manage multiple medications for patients on dialysis.

Objectives: Patients with end-stage kidney disease (ESKD) typically have high medication burdens with numerous medications and specialized instructions. Limited data exist regarding ESKD patient perspectives on medication management. Why can some patients self-manage? Which organizational techniques are used? This project sought to determine experiences and attitudes regarding medication management among hemodialysis patients.

Regional Differential Genetic Response of Human Articular Cartilage to Impact Injury.

Objective: Normal physiological movement creates different weightbearing zones within a human knee: the medial condyle bearing the highest and the trochlea bearing the lowest weight. Adaptation to different physiological loading conditions results in different tissue and cellular properties within a knee. The objective of this study was to use microarray analysis to examine gene expression differences among three anatomical regions of human knee articular cartilage at baseline and following induction of an acute impact injury.

Prevent Collapse and Salvage Failures of the Volar Rim of the Distal Radius.

Background Articular fractures of the distal radius may include a small fragment from the volar margin of the lunate fossa: volar marginal fragments (VMFs); these fragments are prone to loss of fixation and avascular necrosis, and often result in wrist subluxation. We present our experience managing acute and delayed VMFs. The first is treated using a hook plate extension to a volar locking plate and the latter using a volar opening wedge osteotomy to redistribute loads on the remaining articular surface.

Subphysiological compressive loading reduces apoptosis following acute impact injury in a porcine cartilage model.

Background: Acute cartilage injuries induce cell death and are associated with an increased incidence of osteoarthritis development later in life. The objective of this study was to investigate the effect of posttraumatic cyclic compressive loading on chondrocyte viability and apoptosis in porcine articular cartilage plugs.

Hypothesis: Compressive loading of acutely injured cartilage can maintain chondrocyte viability by reducing apoptosis after a traumatic impact injury.