Robotic Placement of 3 Trans-Sacral TransiIliac Screws Through a Single Corridor for U-Type Sacrum Fracture: A Case Report.

Case: We present a case of robot-assisted placement of 3 trans-sacral transiliac screws through a single corridor for an unstable U-type sacral fracture in a 95-year-old woman. She had persistent pain and inability to mobilize with physical therapy. At 3-month follow-up, the patient had evidence of interval healing and stable hardware and was able to return to her prior functional baseline.

Peripheral Nerve Blocks for Hip Fractures.

The incidence of hip fractures has continued to increase as life expectancy increases. Hip fracture is one of the leading causes of increased morbidity and mortality in the geriatric population. Early surgical treatment (<48 h) is often recommended to reduce morbidity/mortality.

Postoperative pain score does not correlate with injury severity in isolated tibial plateau fractures.

Purpose: Appropriate management of acute postoperative pain is critical for patient care and practice management. The purpose of this study was to determine whether postoperative pain score correlates with injury severity in tibial plateau fractures.

Methods: A retrospective review of prospectively collected data was completed at a single academic level one trauma center.

Dysphagia is associated with increased mortality risk after hip fracture surgery.

Purpose: This study aims to explore the prevalence of dysphagia, as well as mortality associated with dysphagia in the elderly population receiving surgical treatment for a hip fracture.

Methods: A retrospective cohort study was completed at an academic level 1 tertiary care center. Patients older than or equal to 65 admitted with a hip fracture diagnosis from January 2015 to December 2020 (n = 617) were included.

Traumatic brain injury is common and undertreated in the orthopaedic trauma population.

Introduction: Traumatic brain injuries (TBIs) can be difficult to diagnose and are often marginalized when compared to more obvious physical injuries. Despite this, recognition and early treatment can lead to improved outcomes. Even mild TBIs have the potential to cause significant long-term consequences for patients, which may affect their physical recovery from orthopaedic injuries.

Identifying Reasons for Nonmedical Delays in Fixation of Femur, Pelvis, and Acetabular Fractures at a Level 1 Trauma Center.

Objective: To identify reasons for nonmedical delays in femur, pelvis, and acetabular fracture fixation at an institution with a dedicated orthopaedic trauma room (DOTR) and an early appropriate care practice model.

Design: Retrospective review of a prospective registry.

Setting: Urban Level 1 trauma center.

Outcomes Following Hemiarthroplasty for Femoral Neck Fracture in Patients Who Have Hemiparesis.

Background: Hemiparesis increases the risk of femoral neck fracture (FNF) in the elderly, which frequently necessitates hemiarthroplasty. There are limited reports on the outcomes of hemiarthroplasty in patients who have hemiparesis. The purpose of this study was to evaluate hemiparesis as a potential risk factor for medical and surgical complications following hemiarthroplasty.

Risk factors for screw breach and iatrogenic nerve injury in percutaneous posterior pelvic ring fixation.

Background: Percutaneous screw fixation of the posterior pelvic ring is technically demanding and can result in cortical breach. The purpose of this study was to examine risk factors for screw breach and iatrogenic nerve injury.

Methods: A retrospective review at a single level-one trauma center identified 245 patients treated with 249 screws for pelvic ring injuries with postoperative computed tomography (CT) scans.

Three-Dimensional Computed Tomography Reconstructions Do Not Improve the Interobserver Reliability of the AO/Orthopaedic Trauma Association and Young and Burgess Pelvic Fracture Classifications.

Purpose: To evaluate the value of three-dimensional (3D) computed tomography (CT) scans on the interobserver and intraobserver reliability of AO/Orthopaedic Trauma Association (OTA) and Young and Burgess (YB) classifications for pelvic ring injuries.

Methods: Seven reviewers (four fellowship-trained orthopaedic trauma surgeons and three fellows) independently classified 36 pelvic ring injuries using radiographs and axial two-dimensional (2D) CT scan images and then repeated this process 2 months later with the addition of 3D CT images. Interobserver and intraobserver reliability was assessed.

Rami Comminution Is Associated With Displacement of Minimally Displaced Lateral Compression Type 1 Injuries on Lateral Stress Radiographs.

Objectives: To determine whether displacement on lateral stress radiographs (LSRs) in patients with minimally displaced lateral compression type 1 pelvic ring injuries is associated with any demographic and/or injury characteristics.

Design: Retrospective comparative cohort.

Setting: Urban level 1 trauma center.

Defining Sacral Dysmorphism: What Size Corridor Precludes Transsacral Screw Placement.

Objective: To determine what size S1-transsacral (TS) corridor is amenable to TS screw placement, as this is commonly used to identify sacral dysmorphism, and to determine if gender, ethnicity, or screw breach is associated with narrow corridors.

Design: Retrospective review.

Setting: Urban level-1 trauma center.

Lateral Stress Radiographs of Lateral Compression Type 1 Pelvic Injuries, With the Injured Side Down or Up, Reliably Measure Occult Instability.

Objectives: To evaluate the interobserver reliability of measured displacement and occult instability of minimally displaced lateral compression type 1 (LC1) fractures on lateral stress radiographs (LSRs) and to compare differences in displacement between LSR with the injured side down (ID) and up (IU).

Design: Retrospective review.

Setting: Urban Level 1 trauma center.

Native tibia valga: a potential source of varus malreduction during intramedullary tibial nail fixation of tibial shaft fractures.

Purpose: To determine the effect of native tibia valga on intramedullary nail (IMN) fixation of tibial shaft fractures.

Methods: Retrospective comparative cohort analysis of 110 consecutive patients with tibial shaft fractures undergoing IMN fixation at an urban level one trauma centre was performed. Medical records and radiographs were reviewed for demographics, tibia centre of rotation of angulation (CORA), nail starting point, incidence of varus malreduction, and nail/canal proportional fit.

Nonoperative Management of Minimally Displaced Lateral Compression Type 1 Pelvic Ring Injuries With and Without Occult Instability.

Objectives: To determine the association of pelvic fracture displacement on lateral stress radiographs (LSRs) with the hospital course of patients with minimally displaced lateral compression type 1 (LC1) pelvic injuries.

Design: Retrospective review.

Setting: Level 1 trauma center.

Using Reformatted Axial Computed Tomography Images in Isolation Will Miss Narrow S1 Transsacral Screw Corridors.

Objective: To evaluate S1 transsacral (TS) corridors on reformatted and nonreformatted computed tomography (CT) images to determine which most reliably identifies narrow corridors.

Design: Retrospective cohort.

Setting: Level 1 trauma center.

Percutaneous Reduction of Intra-Articular Posterior Wall Acetabular Rim Fragment: Surgical Technique and Case Series With an Average Follow-Up of 2 Years.

Small posterior wall rim fractures are typically stable; however, if incarcerated in the joint, they must be removed. It is possible to reduce the morbidity associated with open approaches by addressing these incarcerated fragments in a percutaneous manner. This allows the restoration of joint congruity and removal of the osteochondral fragment from the joint space.

Anatomical Considerations in Percutaneous Fixation of the Pelvis and Acetabulum.

Reduction and fixation techniques of the pelvis and acetabulum continue to evolve. There has been increased use of percutaneous and minimally invasive techniques in the past several decades. Although offering many advantages to traditional open techniques, percutaneous techniques still place nearby structures at risk, making a thorough understanding of the applied surgical anatomy essential.

Treatment of intertrochanteric nonunion after sliding hip screw fixation with a short cephalomedullary nail.

Intertrochanteric femur fracture nonunions are a rare complication that can be difficult to treat with limited evidence regarding treatment options. Revision fixation is typically reserved for well-aligned nonunions with sufficient femoral head bone stock. The most common implant used for revision fixation is a sliding hip screw implant.

Urinary Bladder Matrix Grafting: A Simple and Effective Alternative to Flap Coverage for Wounds in High-Risk Orthopaedic Trauma Patients.

Complex traumatic and/or infected wounds and their sequelae are a significant burden for high-volume trauma centers. Local or free flap coverage options are well described; however, they may be high risk in poor hosts with multiple comorbidities and active infections. In addition, flap coverage can result in delays in wound coverage depending on specialist availability.

Need for syndesmotic fixation and assessment of reduction during ankle fracture fixation, with and without contralateral fluoroscopic images, has poor interobserver reliability.

Purpose: To determine the interobserver reliability of syndesmosis assessment using intraoperative ankle mortise fluoroscopic images, with and without contralateral images.

Methods: A survey of 19 operative ankle fracture cases was administered to 17 orthopedic surgeons. Respondents were presented with fluoroscopic mortise and stress images of the ankle after fracture fixation and asked if they would fix the syndesmosis.

From Dr. Miller E. Preston (1879-1928) to the Department of Orthopaedics at Denver Health Medical Center in Denver, CO.

Dr. Miller Edwin Preston was a surgeon with a deep interest in trauma and orthopaedics who practiced in Denver in the early 1900s. Dr.

The utilization of intraoperative contralateral ankle images for syndesmotic reduction.

Purpose: To evaluate the variability in ankle syndesmotic morphology on contralateral ankle fluoroscopic images and the reductions obtained utilizing these images.

Methods: A retrospective cohort study was performed at a level one trauma center including 46 adult patients undergoing operative fixation of malleolar ankle fractures that also had anteroposterior (AP) and lateral fluoroscopic images of the uninjured contralateral ankle intraoperatively. Contralateral and post-fixation fluoroscopic images were used to measure the tibiofibular clear space (TFCS) as a proportion of the superior clear space (SCS) on mortise images and the posterior tibiofibular distance (PTFD) as a proportion of the lateral superior clear space (LSCS) on lateral images.