A Percutaneous Threaded Wire as a Clamp Technique for Avoiding Wedge Deformity While Nailing Intertrochanteric Femur Fractures.

Hip fractures are common injuries managed by the orthopaedic surgeon, and within the umbrella of hip fractures, intertrochanteric femur fractures constitute a significant portion of these injuries. Recent trends have shown an increased usage of cephalomedullary nails for these injuries. A known potential complication of this technique is the generation of a wedge deformity creating a varus alignment, especially when the cranial portion of the intertrochanteric fracture exits at or near the starting point of the nail.

Outcomes of Surgical Treatment of Periprosthetic Acetabular Fractures.

Periprosthetic acetabular fractures sustained following acute trauma after total hip arthroplasty are rare and historically have poor outcomes. This article reviews 5 cases and the treatment algorithm used by a single orthopaedic surgeon specializing in acetabular fracture care with a co-surgeon specializing in arthroplasty. Team-based surgical management with arthroplasty- and fracture-trained surgeon(s) is paramount for optimal outcome.

Surgical Gowning Technique: Are We Contaminated Before We Cut?

Objectives: To assess possible breaches of sterility during the initial gowning step.

Design: Observational study. Twenty-seven gowning events were monitored for contamination during a simulated two-person gowning process in which a surgical technician assists a surgeon in the gowning process at the beginning of a surgical procedure.

Arteriovenous Fistula Development After Nonoperative Treatment of a Clavicular Fracture: A Case Report.

Case: We report a case of prominent venous dilation in the supraclavicular area with an underlying arteriovenous fistula following nonoperative management of a fracture in the medial third of the clavicle in an adult. The venous dilation indicated elevated venous pressures, likely caused by hypertrophic callus formation and/or fistula development.

Conclusion: Arteriovenous fistula and prominent venous dilation are possible sequelae of nonoperative treatment of clavicular fractures.

The Relationship of Multiplanar Distal and Uniplanar Proximal Interlocking Screws to Neurovascular Structures with the Depuy Synthes Humeral Nail-EX: An Anatomic Study.

Objective: To determine the proximity of neurovascular structures to multiplanar distal interlocking screws and proximal interlocking devices for an antegrade inserted humeral nail.

Methods: Humeral nails (Depuy Synthes Humeral Nail-EX, Paoli, PA) were inserted into 10 matched cadavers with 3 distal interlocking trajectories: anterior to posterior (A-P), anterolateral to posteromedial, and anteromedial to posterolateral (AM-PL). The distance of the screw path and screw head to the radial, lateral antebrachial cutaneous nerve (LACN), and median nerves and the brachial artery was measured.

Anterolateral Approach to the Pilon.

This video reviews the indications, surgical approach, and case examples of the anterolateral approach to a distal tibial plafond fracture. If this approach is used in a staged fashion, when the soft envelope is ready, it affords excellent visualization for fracture fixation through thick skin flaps. An associated article reviews a cohort of 44 mainly type C3 pilon injuries treated by 2 orthopaedic traumatologist using the anterolateral approach after staged external fixation.

Low Profile Mesh Plating for Patella Fractures: Video of a Novel Surgical Technique.

Patella fractures can be challenging to treat particularly in the presence of inferior pole comminution. In this video we present a novel surgical technique for the treatment of patella fractures using a small fragment low profile mesh plate. Key points are the surgical exposure with direct visualization of the articular reduction, the preparation of the mesh plate to accommodate patellar anatomy and the augmentation of the construct using Krackow sutures to address inferior pole comminution.

Calcium Triglyceride Versus Polymethylmethacrylate Augmentation: A Biomechanical Analysis of Pullout Strength.

Study Design: Biomechanical pullout study using calcium triglyceride (CTG) and polymethylmethacrylate (PMMA) for screw augmentation.

Objective: Compare the biomechanical performance of CTG augmentation versus the gold standard, PMMA, in primary and revision models, using a pedicle screw pullout model.

Background Summary: CTG is a novel form of bone augmentation with several reported biocompatible properties compared with PMMA.