Oral vs Intravenous Antibiotics for Fracture-Related Infections: The POvIV Randomized Clinical Trial.

Importance: Fracture-related infection (FRI) is a serious complication following fracture fixation surgery. Current treatment of FRIs entails debridement and 6 weeks of intravenous (IV) antibiotics. Lab data and retrospective clinical studies support use of oral antibiotics, which are less expensive and may have fewer complications than IV antibiotics.

Refractory Autonomic Instability in Mild Traumatic Brain Injury: A Case Report.

Although the specific relationship between concussion and the autonomic nervous system (ANS) has not been fully elucidated, it is generally understood that the pathologic response after a traumatic brain injury (TBI) is linked with systolic cardiac dysfunction. In this case, we present a patient with multiple concussion injuries over a five-year period who exhibited severe cardiac and autonomic dysfunction, in addition to prolonged impairments in vestibular function, oculomotor function, cognitive function, and headaches. The patient is a 28-year-old male with a past medical history of multiple concussions, with the first concussion occurring due to a skiing accident in January 2015.

Use of the HemaClear™ elastic tourniquet reduces blood loss in operative treatment of humeral shaft fractures.

Background: To determine if the use of a narrower elastic tourniquet compared to a standard pneumatic tourniquet reduces operative blood loss in the operative fixation of humeral shaft fractures.

Methods: This retrospective cohort study was performed at a level I trauma center and included 134 patients, aged 18 to 90 years, with a humeral shaft fracture treated with open reduction internal fixation (ORIF) from January 2007 through June 2018. The primary variable of interest was the application of a HemaClear™ elastic tourniquet versus a standard pneumatic tourniquet during the fixation of a humeral shaft fracture.

A Dorsal Epidural Herniated Disc Fragment Initially Presenting as Guillain-Barré Syndrome.

Guillain-Barré syndrome (GBS) is a rare autoimmune disorder that presents with neurological symptoms that can mimic other conditions. This mimicry can hide other important neurological diagnoses. Here, we present a rare case of thoracic myelopathy secondary to a sequestered dorsal epidural herniated disc fragment that initially presented with the classic findings of GBS.

Risk factors for treatment failure of fracture-related infections.

Objective: Infection after fracture fixation is a potentially devastating outcome, and surgical management is frequently unsuccessful at clearing these infections. The purpose of this study is to determine if factors can be identified that are associated with treatment failure after operative management of a deep surgical site infection.

Methods: We retrospectively reviewed the billing system at a Level I trauma center between March 2006 and December 2015.

Do Fully Threaded Transiliac-Transsacral Screws Improve Mechanical Stability of Vertically Unstable Pelvic Fractures? A Cadaveric Biomechanical Analysis.

Objective: To determine whether fully threaded transiliac-transsacral (TI-TS) fixation is biomechanically superior to partially threaded TI-TS fixation of vertically unstable transforaminal sacral fractures.

Methods: Vertically unstable zone 2 sacral fractures were created in 20 human cadaveric pelves with a unilateral osteotomy and resection of 1 cm of bone through the foramen of the sacrum to represent comminution. Ten specimens received either 2 7.

Association Between Femoral "Spike" Size After Intramedullary Nailing and Subsequent Knee Motion Surgery.

Objectives: To determine the association between displaced femoral shaft bone fragments ("spikes") seen on radiographs after intramedullary nail insertion and the need for future motion surgery.

Design: Retrospective case-control study.

Setting: Academic trauma center.

Posterolateral plating is a safe alternative for the treatment of distal tibial fractures.

Introduction: We assessed the outcome and safety of posterior plating of distal tibial fractures.

Methods: We conducted a retrospective case series at a Level I trauma center. Seventy-four consecutive patients with distal tibial fractures treated with anatomically contoured 3.

Increased morphine requirements are predictive of acute compartment syndrome in adults with tibia fractures.

Purpose: The purpose of this study was to determine if increased milligram morphine equivalent (MME) requirements are a predictor of adult compartment syndrome in patients with tibia fractures.

Methods: A retrospective case-control study at a level-1 trauma center was performed over a five year period. Patients with tibia fractures who had acute compartment syndrome (ACS) requiring fasciotomy (n = 26) were matched with controls (n = 25).

Investigation of Motivational Interviewing and Prevention Consults to Achieve Cardiovascular Targets (IMPACT) trial.

Background: Patients undergoing cardiovascular (CV) procedures often have suboptimal CV risk factor control and may benefit from strategies targeting healthy lifestyle behaviors and education. Implementation of prevention strategies may be particularly effective at this point of heightened motivation.

Methods: A prospective, randomized, pilot study was conducted in 400 patients undergoing a nonurgent CV procedure (cardiac catheterization ± revascularization) to evaluate the impact of different prevention strategies.

A Case of Levofloxacin-Induced Hepatotoxicity.

BACKGROUND Levofloxacin covers a broad spectrum of pathogens and is readily prescribed by clinicians. Hepatotoxicity is a known but unusual complication of levofloxacin use. Here, we present a case of severe transaminitis caused by levofloxacin.