Use of Direct Oral Anticoagulants Among Patients With Hip Fracture Is Not an Indication to Delay Surgical Intervention.

Objectives: To compare outcomes in patients on direct oral anticoagulants (DOACs) treated within 48 hours of last preoperative dose with those with surgical delays >48 hours.

Design: Retrospective cohort study.

Setting: Three academic Level 1 trauma centers.

Epidemiology of pelvic and acetabular fractures in the USA from 2007 to 2014.

Unlabelled: Incidence of pelvic and acetabular fracture is increasing in Europe. From 2007 to 2014 in the USA, this study found an age-adjusted incidence of 198 and 40 fractures/100,000/year, respectively, much higher than what has been described before. Incidence remained steady over that period and only a small increase in incidence of pelvic fracture in men was identified.

The direct posterior gluteal muscle splitting approach for posterior access to acetabular fractures: Surgical technique and case series.

We present a minimally invasive direct posterior, gluteal muscle splitting approach (PMS) as an alternative to the traditional Kocher-Langenbeck (KL) approach for posterior access to acetabular fractures. We believe it offers significant advantages and provides improved access while maximizing the range of fracture patterns that can be addressed through a posterior approach. One hundred and eighty-four consecutive patients treated with this approach by the senior author (RMS) between 2001 and 2018 were reviewed.

Tracking the nature and trajectory of social support in Facebook mutual aid groups during the COVID-19 pandemic.

At the onset of the COVID-19 pandemic, thousands of mutual aid groups were established on social media and operated as platforms through which people could offer or request social support. Considering the importance of Facebook mutual aid groups during the early stages of the COVID-19 pandemic in the United Kingdom but also the lack of empirical research regarding the trajectories and types of social support rendered available through the groups, our aims in this paper are threefold; first, to examine the trajectory of social support-related activity during the period between March-December 2020; second, to compare offers and requests of support during the peaks of the first and second waves; third to provide a rich analysis of the types of social support that were offered or requested through the online mutual aid groups. Quantitative findings suggest that online social support activity declined soon after the peak of the first pandemic wave and, at least in Facebook mutual aid groups, did not reach the levels observed during the first wave.

More Than a COVID-19 Response: Sustaining Mutual Aid Groups During and Beyond the Pandemic.

Mutual aid groups have been an indispensable part of the public response to the COVID-19 pandemic. They have provided many forms of support, in particular grocery shopping which has enabled people to self-isolate if required. While community solidarity during emergencies and disasters is common, previous studies have shown that such solidarity behaviors tend to decline over time, even when needs remain high.

Risk Factors for Aseptic Revision of Operatively Treated Ankle Fractures.

Background: Early revision rates within 12 months after ankle fracture open reduction internal fixation (AF-ORIF) are fairly low; however, they remain relevant given the volume of ankle fractures occurring annually. Understanding these rates is complex because reoperation due to technical or mechanical complications is typically reported alongside soft tissue-related problems such as symptomatic hardware, wound dehiscence, or infection. There are limited data identifying risk factors specifically for revision of ankle fracture fixation in the absence of soft tissue complications.

Implementing stakeholder engagement to explore alternative models of consent: An example from the PREP-IT trials.

Introduction: Cluster randomized crossover trials are often faced with a dilemma when selecting an optimal model of consent, as the traditional model of obtaining informed consent from participant's before initiating any trial related activities may not be suitable. We describe our experience of engaging patient advisors to identify an optimal model of consent for the PREP-IT trials. This paper also examines surrogate measures of success for the selected model of consent.

Impact of Age on Consent in a Geriatric Orthopaedic Trauma Patient Population.

Introduction: Persistent misconceptions of frailty and dementia in geriatric patients impact physician-patient communication and leave patients vulnerable to disempowerment. Physicians may inappropriately focus the discussion of treatment options to health care proxies instead of patients. Our study explores the consenting process in a decision-making capable orthogeriatric trauma patient population to determine if there is a relationship between increased patient age and surgical consent by health care proxy.

Factors for Increased Hospital Stay and Utilization of Post -Acute Care Facilities in Geriatric Orthopaedic Fracture Patients.

Background: This study aims to determine the extent of utilization of health care resources in the geriatric fracture population and to identify factors associated with burden on resources.

Methods: This is a retrospective study of 1074 patients ≥65 years admitted to an orthopaedic service for a long bone fracture between July 2014 - June 2015. Outcomes were hospital length of stay (LOS), discharge disposition, and post-acute care facility LOS.

End-stage renal disease increases risk of postoperative complications after lower extremity fracture.

Introduction: End-stage renal disease (ESRD) leads to multiple systemic effects and patients suffer from multiple comorbidities including fractures. While previous studies have examined complications following hip fracture surgery in ESRD patients, there are no studies evaluating other lower extremity fractures. This study aimed to identify postoperative complication risk in patients with ESRD who had lower extremity fractures.

Long-term outcomes after open reduction and internal fixation of bicondylar tibial plateau fractures.

Introduction: To establish normative data, long-term patient-reported functional outcome and health-related quality of life (HrQoL) after operative treatment of bicondylar tibial plateau fractures. Secondly, to identify risk factors associated with functional outcome and HrQoL.

Patients And Methods: We performed a retrospective cohort study at two Level I trauma centers.

Radiostereometric Analysis of Stability and Inducible Micromotion After Locked Lateral Plating of Distal Femur Fractures.

Objectives: To evaluate interfragmentary motion over 1 year after distal femoral fracture fixation using radiostereometric analysis (RSA). The secondary aim was to assess whether RSA data are consistent with diagnoses of nonunion.

Design: Prospective cohort study.

Long-term outcomes after operative treatment for tibial pilon fractures.

Objectives: Aims of the present study were to establish generalizable outcome data on long-term functional outcomes and health-related quality of life (HRQoL) after operative treatment of pilon fractures on a large scale. Second, it was aimed to examine factors associated with these outcomes.

Design: Retrospective cohort study with follow-up by questionnaire.

Is the proximity of external fixator pins to eventual definitive fixation implants related to the risk of deep infection in the staged management of tibial pilon fractures?

Introduction: In the staged management of tibial pilon fractures, overlap between definitive internal fixation and external fixation pin sites has been investigated as a risk factor for infection with equivocal conclusions. Our aim was to determine if overlap or proximity of definitive internal fixation to external fixation pin sites influences the risk of deep infection.

Patients And Methods: We reviewed 280 AO/OTA 43B or 43C type distal tibia fractures in 277 patients at two level-one trauma centers.

Durability of Smoking Cessation for Elective Lower Extremity Orthopaedic Surgery.

Introduction: Smoking tobacco is a risk factor for impaired wound healing, infection, delayed fracture healing, and prolonged hospital stay. Smoking cessation before surgery has shown a 40% relative risk reduction in total perioperative complications. The primary purpose of this study was to evaluate the effectiveness of preoperative smoking cessation on long-term smoking habits in patients undergoing elective lower extremity orthopaedic surgery.

Ideal length of thread forms for screws used in screw fixation of nondisplaced femoral neck fractures.

Background: It is common practice when placing cannulated screws within the femoral head when treating femoral neck fractures to avoid the thread-forms from crossing the fracture line. Despite the widespread use of cannulated screws in internal fixation of femoral neck fractures, there is no study to our knowledge that describes the ideal length of thread-forms.

Purpose: The purpose of this study is to determine the thread length that will maximize purchase within the femoral head while minimizing risk of crossing the fracture line.

Reliability of Proxy-reported Patient-reported Outcomes Measurement Information System Physical Function and Pain Interference Responses for Elderly Patients With Musculoskeletal Injury.

Background: Patient-reported Outcomes Measurement Information System (PROMIS) instruments are useful to evaluate health status, but its use can be challenging for some vulnerable elderly patients, requiring aid from their proxies. Whether the proxies could be accurate informants is unknown. The goal of this study was to compare elderly patients' and their proxies' answers with PROMIS physical function (PF) and pain interference (PI) computer adaptive test for the evaluation of patients' outcomes after musculoskeletal injury.

Patient Perceptions of the Use of Medical Marijuana in the Treatment of Pain After Musculoskeletal Trauma: A Survey of Patients at 2 Trauma Centers in Massachusetts.

Objective: To evaluate musculoskeletal trauma patients' beliefs regarding the usefulness of marijuana as a valid medical treatment for postinjury and postoperative pain and anxiety.

Design: Prospective survey.

Setting: Two academic Level 1 trauma centers.

Magnetic Resonance Imaging of Trauma Patients Treated With Contemporary External Fixation Devices: A Multicenter Case Series.

Objectives: To report the safety and clinical outcomes of placing current magnetic resonance imaging (MRI) components inside and outside the MRI bore during MRIs.

Design: Retrospective case series.

Setting: Four trauma centers (3 Level I and 1 Level II), from January 2005 to January 2015.

Impact of daily noise exposure monitoring on occupational noise exposures in manufacturing workers.

Objective: Despite the use of hearing protection devices (HPDs), noise induced hearing loss (NIHL) remains one of the most prevalent occupational conditions. A new technology allows for daily monitoring of noise exposures under HPDs. We report on an intervention employing the voluntary use of this technology in a worksite setting.

Tracking occupational hearing loss across global industries: a comparative analysis of metrics.

Occupational hearing loss is one of the most prevalent occupational conditions; yet, there is no acknowledged international metric to allow comparisons of risk between different industries and regions. In order to make recommendations for an international standard of occupational hearing loss, members of an international industry group (the International Aluminium Association) submitted details of different hearing loss metrics currently in use by members. We compared the performance of these metrics using an audiometric data set for over 6000 individuals working in 10 locations of one member company.