Development of a novel murine femur fracture and fixation model.

Background: Animal models have been used for decades to simulate human fractures in the laboratory setting. Fracture models in mice are attractive because they offer a high volume, relatively low-cost method of investigating fracture healing characteristics. We report on the development of a novel murine femur fracture model that is rapid, reproducible and inexpensive.

Infected Hematoma in the Setting of Nonoperatively Treated Proximal Humerus Fracture: A Report of Two Cases.

Case: Two patients presented with infections of their recent proximal humerus fracture sites. These immunocompromised patients were being treated nonoperatively for their proximal humerus fractures; however, both were taken to the operating room for surgical debridement.

Conclusions: These 2 cases demonstrate the need for further investigation into infection of closed fracture sites.

What Patient-related Factors are Associated with an Increased Risk of Surgery in Patients with Stenosing Tenosynovitis? A Prospective Study.

Background: Numerous patient-related risk factors have been identified as contributors to patient progression to operative treatment of stenosing tenosynovitis (STS). Identifying patients most at risk of undergoing surgery after receiving a corticosteroid injection would enable health care providers to identify patients most likely to benefit from nonsurgical treatment.

Questions/purposes: (1) What proportion of prospectively enrolled patients with a new diagnosis of STS did not require further intervention after a first, second, or third injection when offered up to three corticosteroid injections? (2) Which identifiable risk factors present at the initial evaluation in patients with STS are associated with the patient opting for surgical release after a trial of one, two, or three corticosteroid injections?

Methods: One hundred ninety-six patients with a presumed diagnosis of STS were evaluated between March 2014 and June 2015, and 160 patients with 186 affected fingers were prospectively enrolled after a new diagnosis of STS was made during the study period.

Relative Contributions of the Midcarpal and Radiocarpal Joints to Dart-Thrower's Motion at the Wrist.

Purpose: To identify the relative contributions of the radiocarpal (RC) and midcarpal (MC) joints to dart-thrower's motion (DTM) of the wrist.

Methods: Six cadaveric upper extremities were fixed to a custom-designed loading jig allowing for pure moment-rotation analysis in 24 different directions of wrist motion. Each specimen was tested in 3 states: intact, simulated radiocarpal fusion (sRCF) and simulated pancarpal fusion (sPCF).

Fixation Strength in Full and Limited Fixation of Osteoporotic Distal Radius Fractures.

Background: The purpose of this investigation is to determine whether osteoporotic intra-articular distal radius fractures surgically treated by filling all 7 distal screws of a volar plate will have a higher load to failure than those treated by filling only 4 distal screws.

Methods: Ten matched pairs of fresh frozen cadaveric forearms were randomized within each pair to be treated by using either all 7 of the distal holes of a volar plate or only 4 distal screws. The distal radius fixation was performed with unicortical screws going to but not through the dorsal cortex, and the most distal screws were placed within 4 mm of the joint surface.

Three-Dimensional Carpal Kinematics after Carpal Tunnel Release.

Background: Carpal tunnel release (CTR) has been shown to change carpal arch morphology. However, the effect of CTR on the three-dimensional kinematics of the carpal bones has not been demonstrated.

Purpose: This study examined whether release of the transverse carpal ligament (TCL) would alter the three-dimensional kinematics of the carpus, specifically the bony attachments of the TCL.

The effects of partial carpal fusions on wrist range of motion.

Unlabelled: The objective of this investigation was to evaluate the effects of different partial wrist fusions on wrist motion. A total of 20 cadaveric wrists were tested in the intact state and after undergoing either a four-corner fusion or 2- and 3-bone fusion. The moment-rotation behaviour was measured in 24 directions of wrist motion about the forearm axis.

Delayed Erosion of a Pelvic Reconstruction Plate into the Bladder Causing Recurrent Urinary Tract Infections: A Case Report.

Case: A forty-seven-year-old woman presented with recurrent urinary tract infections eleven years after open fixation of a pelvic ring injury. Cystoscopy revealed that the pelvic reconstruction plate had eroded into the bladder, likely the source of the recurrent infections. Following removal of the involved pelvic hardware and repair of the bladder, the patient had no further urinary tract infections.

The effects of distal interlocking screws on torsional stability in three-part intertrochanteric hip fractures.

Objective: Many surgeons currently use long cephomedullary nails for the treatment of intertrochanteric fractures. The optimal indications for deploying distal interlocks are still debatable. This study examined the torsional biomechanical properties of 3-part intertrochanteric femur fractures in a cadaveric bone model using two different distal fixation strategies, an unlocked long cephalomedullary nail versus a dynamically locked nail.

Divergent elbow dislocation and risk of compartment syndrome.

Background: Divergent pediatric elbow dislocations are very rare injuries.

Case: An eight-year-old boy presented to the emergency department with elbow pain after a fall. On examination his elbow was swollen; skin and neurovascular function were intact.

Cobalt toxicity after revision to a metal-on-polyethylene total hip arthroplasty for fracture of ceramic acetabular component.

Cobalt metallosis after revision metal-on-polyethylene total hip arthroplasty for catastrophic failure of ceramic components is uncommon but a potentially devastating complication. Common findings associated with heavy metal toxicity include cardiomyopathy, hypothyroidism, skin rashes, visual disturbances, hearing changes, polycythemia, weakness, fatigue, cognitive deterioration, and neuropathy. We report a case of a 57-year-old woman who presented with complaints of progressively worsening hip pain, fatigue, memory loss, lower extremity sensory loss, persistent tachycardia, and ocular changes 5 years after synovectomy and revision of a failed ceramic-on-ceramic total hip arthroplasty to metal-on-polyethylene components.

Initial management of ankle fractures in the overweight and obese: the providence pinch.

Background: Obese and overweight people have higher rates of ankle injury, particularly operative ankle fractures. The initial management of unstable ankle fractures includes closed reduction and splinting to limit soft tissue injury and articular cartilage damage until definitive operative fixation can be performed. Adequate reduction can be more difficult in the obese patient due to the weight and additional padding provided by the larger soft tissue envelope.

Nerve compression syndromes of the upper extremity: diagnosis, treatment, and rehabilitation.

Nerve compression syndromes of the upper extremity, including carpal tunnel syndrome, cubital tunnel syndrome, posterior interosseous syndrome and radial tunnel syndrome, are common in the general population. Diagnosis is made based on patient complaint and history as well as specific exam and study findings. Treatment options include various operative and nonoperative modalities, both of which include aspects of hand therapy and rehabilitation.

Remote effects of focal hippocampal seizures on the rat neocortex.

Seizures have both local and remote effects on nervous system function. Whereas propagated seizures are known to disrupt cerebral activity, little work has been done on remote network effects of seizures that do not propagate. Human focal temporal lobe seizures demonstrate remote changes including slow waves on electroencephalography (EEG) and decreased cerebral blood flow (CBF) in the neocortex.