Outcomes of SARS-CoV-2 infection among patients with orthopaedic fracture surgery in the National COVID Cohort Collaborative (N3C).

Background: The objective of this study was to investigate the outcomes of COVID-19-positive patients undergoing orthopaedic fracture surgery using data from a national database of U.S. adults with a COVID-19 test for SARS-CoV-2.

Intravenous tranexamic acid decreases intraoperative transfusion requirements and does not increase incidence of symptomatic venous thromboembolic events in musculoskeletal sarcoma surgery.

Background And Objectives: Tranexamic acid (TXA) is poorly studied in patients with bone and musculoskeletal sarcoma due to perceived increased risk of venous thromboembolism (VTE). This study aims to assess the safety and efficacy of intravenous (IV) TXA for patients undergoing surgical resection of primary bone or soft-tissue sarcoma.

Methods: A retrospective, single center review of adult patients with pelvic or extremity sarcoma who underwent surgical resections between January 2005 and March 2020 was performed.

Giant Cell Tumor of the Distal Radius: A Review.

Giant cell tumor of the distal radius presents a significant challenge in management due to high risk of recurrence and potential loss of function. Shared decision-making guides management, particularly for more advanced lesions. Intralesional curettage can optimize wrist function but at the cost of a higher recurrence risk.

Diagnosis and Management of Traumatic Hemipelvectomy.

Traumatic hemipelvectomy (THP) is a catastrophic injury associated with high-energy trauma and high mortality. THP has been defined as a complete dislocation of the hemipelvis, often with disruption through the symphysis pubis and sacroiliac joint with concurrent traumatic rupture of the iliac vessels. Despite recent advances in prehospital resuscitative techniques, the true incidence of THP is difficult to ascertain because many patients die before hospital arrival.

Is it necessary to fuse to the pelvis when correcting scoliosis in cerebral palsy?

Background: Neuromuscular scoliosis is commonly associated with a large pelvic obliquity. Scoliosis in children with cerebral palsy is most commonly managed with posterior spinal instrumentation and fusion. While consensus is reached regarding the proximal starting point of fusion, controversy exists as to whether the distal level of spinal fusion should include the pelvis to correct the pelvic obliquity.

Prevalence and Risk Factors of Postoperative Falls Following Foot and Ankle Surgery.

Background: No study has examined the incidence of risk factors for postoperative falls following foot and ankle surgery. We investigated the incidence and risk factors for postoperative falls in foot and ankle surgery using inpatient and outpatient population.

Methods: A single fellowship-trained foot and ankle surgeon instituted collection of a postoperative fall questionnaire at 2 and 6 weeks postoperatively.

Webril-only Soft Spica Cast for Pediatric Femoral Fractures: A Preliminary Study.

We report using a spica cast created with cotton padding and Ace wrap without a rigid component for femur fracture in infants. Outcomes and complications of this soft spica cast were retrospectively compared with other treatments. There were 43 children younger than 6 months (43 diaphyseal fractures) included in the study.

COVID-19 and Acute Cervical Spinal Cord Injury-Case Report of 2 Patients: Do We Need to Rethink Our Standard Treatment Strategy?

Study Design: This was a case series.

Objective: The authors sought to examine the high-risk population of COVID-positive patients with acute cervical spinal cord injury (SCI) in a large level 1 trauma and tertiary referral center.

Summary Of Background Data: There are limited studies regarding the surgical management of patients with acute SCI in the setting of the recent coronavirus pandemic.

Non-Necrotizing Bullous Cellulitis and Bacteremia: A Rare Presentation of the Shewanella Algae Infection.

A 58-year-old male with severe psoriasis on Risankizumab presented with painful, left leg swelling with erythema and blisters concerning for necrotizing fasciitis. Intraoperative findings showed non-necrotizing bullous cellulitis. The blood and tissue cultures grew  algae.

Distal clavicle autograft for anterior-inferior glenoid augmentation: A comparative cadaveric anatomic study.

Introduction: The aim of this study was to anatomically compare distal clavicle and coracoid autografts and their potential to augment anterior-inferior glenoid bone loss.

Methods: Ten millimeters of distal clavicle and 20 mm of coracoid were harvested bilaterally from 32 cadavers. Length, weight, and height were measured and surface area and density were calculated.

Applications of the transfibular approach to the hindfoot: A systematic review and description of a preferred technique.

Background: The indications and technique for the transfibular approach to the tibiotalar joint have evolved since its initial popularization in 1942. The purpose of this systematic review is to assess the indications, techniques, and postoperative outcomes among procedures performed with the transfibular approach.

Methods: A comprehensive search of PubMed, Medline, and Embase databases from 1942 to 2018 was performed in accordance with PRISMA guidelines.

Descriptive Epidemiology of Injuries in Professional Ultimate Frisbee Athletes.

Context: Injuries in professional ultimate Frisbee (ultimate) athletes have never been described.

Objective: To determine injury rates, profiles, and associated factors using the first injury-surveillance program for professional ultimate.

Design: Descriptive epidemiology study.

Predictive Accuracy of the ACS-NSQIP Surgical Risk Calculator for Pathologic Humerus Fracture Fixation.

Pathologic fractures are associated with poor outcomes. This article investigated the prevalence of underestimation of risk by the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Surgical Risk Calculator (SRC) in patients with pathologic humerus fractures. Two hundred seven (207) patients were identified and analyzed using the ACS-NSQIP SRC.

Reamed Versus Unreamed Intertrochanteric Femur Fractures, Is It Time?

Objectives: This study compares the intraoperative and postoperative outcomes of the traditional technique of femoral canal reaming to placement of an unreamed 10-mm nail.

Design: Retrospective cohort study.

Setting: Academic Level I Trauma Center, Southeastern US.

Extraskeletal Myxoid Chondrosarcoma of the Midfoot Presenting as Charcot Arthropathy: A Case Report.

Case: Extraskeletal myxoid chondrosarcoma (EMC) is a rare soft tissue malignancy that very seldomly presents in the foot or ankle and as a result is not commonly in the differential of patients presenting with foot pain. We cite a case of EMC presenting in the atypical location of the midfoot. Because of its location and similarities, this tumor was initially misdiagnosed and mistreated by multiple medical providers as midfoot Charcot arthropathy.

Accurate Prediction of Antegrade and Retrograde Femoral Intramedullary Implant Length From Patient-Reported Height.

Objective: To determine whether patient height correlates with implant length selection of antegrade or retrograde femoral intramedullary implants.

Design: Case-control Study.

Setting: A single level 1 trauma center.

Postoperative Lyme Arthritis in the Orthopaedic Patient.

Context: Lyme disease is the most common tick-borne illness in North America and Europe, and Lyme arthritis is a frequent late-stage manifestation in the United States. However, Lyme arthritis has rarely been reported as a postoperative complication.

Evidence Acquisition: The PubMed database was queried through June 2018, and restricted to the English language, in search of relevant articles.

Early Clinical and Economic Outcomes of Prophylactic and Acute Pathologic Fracture Treatment.

Introduction: Pathologic fractures often contribute to adverse events in metastatic bone disease, and prophylactic fixation offers to mitigate their effects. This study aims to analyze patient selection, complications, and in-hospital costs that are associated with prophylactic fixation compared with traditional acute fixation after completed fracture.

Materials And Methods: The Nationwide Inpatient Sample database was queried from 2002 to 2014 for patients with major extremity pathologic fractures.

RISK FACTORS FOR EARLY HOSPITAL READMISSION FOLLOWING TOTAL KNEE ARTHROPLASTY.

Objective: To identify independent risk factors, complications and early hospital readmission following total knee arthroplasty.

Methods: Using the ACS-NSQIP database, we identified patients who underwent primary TKA from 2012-2015. The primary outcome was early hospital readmission.

Outcomes of Staged Treatment for Complex Distal Radius Fractures.

Introduction Distal radius fractures are common, but the results and complications of treatment with early external fixation and staged open reduction internal fixation have not been previously reported. Materials and methods Patients who received staged distal radius fracture treatment from 1/1/2008 to 12/31/2015 at the University of Alabama at Birmingham were identified. Patient, injury, and treatment characteristics, as well as complications, were collected from the medical record.

Myositis Ossificans in Sport: A Review.

Myositis ossificans is a benign, solitary, frequently self-limiting, ossifying soft-tissue mass encountered often in the active sporting population. Typically occurring within skeletal muscle - most often the brachialis, quadriceps and adductor muscle groups - lesions may arise with or without a traumatic history. The exact pathophysiology of these ossifying lesions is still poorly understood.

Early life lead exposure causes gender-specific changes in the DNA methylation profile of DNA extracted from dried blood spots.

Aims: In this paper, we tested the hypothesis that early life lead (Pb) exposure associated DNA methylation (5 mC) changes are dependent on the sex of the child and can serve as biomarkers for Pb exposure.

Methods: In this pilot study, we measured the 5mC profiles of DNA extracted from dried blood spots (DBS) in a cohort of 43 children (25 males and 18 females; ages from 3 months to 5 years) from Detroit. Result & Discussion: We found that the effect of Pb-exposure on the 5-mC profiles can be separated into three subtypes: affected methylation loci which are conserved irrespective of the sex of the child (conserved); affected methylation loci unique to males (male-specific); and affected methylation loci unique to females (female-specific).

A retained secretory signal peptide mediates high density lipoprotein (HDL) assembly and function of haptoglobin-related protein.

Haptoglobin-related protein (Hpr) is a component of a minor subspecies of high density lipoproteins (HDL) that function in innate immunity. Here we show that assembly of Hpr into HDL is mediated by its retained N-terminal signal peptide, an unusual feature for a secreted protein and the major difference between Hpr and the soluble acute phase protein haptoglobin (Hp). The 18-amino acid signal peptide is necessary for binding to HDL and interacts directly with the hydrocarbon region of lipids.