Neurovascular Complications Following Clavicle Fracture Fixation: Timing, Mechanisms, and Clinical Implications.

This review addresses the neurovascular complications associated with the surgical treatment of clavicle fractures through open reduction and internal fixation (ORIF). Despite being a generally safe procedure, it can lead to severe complications including brachial plexopathy, pseudoaneurysm, arteriovenous fistulas (AVF), deep vein thrombosis (DVTs), and thoracic outlet syndrome (TOS). One significant observation, not often highlighted in previous literature, is that neurovascular complications are more common in cases involving delayed fixation, nonunion, or malunion, compared to those treated acutely.

Analysis of intestinal ostomy content on TikTok: The role of social media in countering fear and stigma.

Background: Ostomates suffer from multiple comorbidities and social stigma, which can be especially debilitating in young patients. TikTok has become a popular platform for this population to establish a community and gain resources. This study aims to characterize intestinal ostomy videos on TikTok.

Evaluation of Patient Expectations and Outcomes after Distal Radius Fractures.

Background: Patient expectations influence patient-reported outcomes after musculoskeletal injuries. The goal of this study is to determine how pretreatment expectations correlate with outcomes in patients with distal radius fractures.

Methods: Seventy-five patients with an isolated distal radius fracture were prospectively enrolled into nonoperative and operative cohorts.

Understanding Variations in the Management of Displaced Distal Radius Fractures With Satisfactory Reduction.

Background: The American Academy of Orthopaedic Surgeons has set forth Clinical Practice Guidelines (CPGs) to help guide management of closed, displaced distal radius fractures (DRFs). There still exists variation in practice regarding operative vs nonoperative decision-making. This study aims to identify which factors influence the decision to treat DRFs not indicated for surgery by the CPGs after initial closed reduction.

The "Bag of Bones" Treatment of Comminuted Intra-articular Distal Humerus Fractures in the Elderly.

Background: Extensively comminuted intra-articular distal humerus fractures in the elderly present a challenging therapeutic dilemma. The purpose of this study was to investigate the results of nonoperative treatment of these fractures in a select subset of patients.

Methods: Patients treated with nonoperative management for a comminuted intra-articular distal humerus fracture between 2007 and 2018 were reviewed.

Revisiting the Importance of the Pre-Operative Assessment - A Case Report.

Introduction: The available literature underscores the importance of optimizing surgical outcomes through a pre-operative checklist, which includes a review of the medical records and recent test results, changes in medical history, and a physical examination of the cardiovascular system, pulmonary system, and airway.

Case Report: We report a case of a 47-year-old man who decompensated during an outpatient wrist procedure and needed to remain intubated requiring transfer to a hospital. On follow-up with the patient, laboratory work revealed a positive HIV test and CD4 count of 11 cells/mm3, along with a pneumonia consistent with pneumocystis pneumonia, which was unbeknownst to the surgical team before the procedure.

Management of Isolated Ulnar Shaft Fractures.

» Most isolated ulnar shaft fractures are stable and heal without complication regardless of treatment protocol.» Casting above the elbow may create unwanted stiffness without enhancing union rates.» Defining unstable fractures and determining which injuries would benefit from operative management remain a challenge.

Distal Intersection Syndrome Between Second and Third Dorsal Compartments of the Wrist.

Distal intersection syndrome (DIS) is a rare form of tenosynovitis affecting the second and third dorsal extensor compartments of the wrist, which is rarer and more distal than the classically described intersection syndrome between the first and second compartments. In this report, we present three cases of DIS, their inciting activities, and ensuing treatment courses. Diagnosis of DIS was confirmed via MRI in all cases.

Antiracism Training for Nutrition Professionals in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC): a Promising Strategy to Improve Attitudes, Awareness, and Actions.

Introduction: Women, Infants and Children (WIC) nutrition professionals serve as frontline providers for Black families who disproportionately experience poor perinatal outcomes. With racism driving inequities, we developed an antiracism training tailored to WIC. This report describes the training framework, design, components, and evaluation.

Reduction Techniques in Volar Locking Plate Fixation of Distal Radius Fractures.

Distal radius fractures are the most common upper extremity fracture and volar locking plate fixation has become a common modality for operative management of these injuries over the last 2 decades. However, despite the widespread use of volar locking plates, there remains no comprehensive guide detailing the available reduction techniques using these systems. This review aims to consolidate the reduction techniques from the literature along with the authors' experiences into a blueprint for distal radius fracture reduction when using a volar plate.

Postoperative Rhabdomyolysis in the Bilateral Shoulder Areas After Cardiac Surgery.

Rhabdomyolysis (RML) is a disease that results from the death of muscle fibers and the release of intracellular contents into the bloodstream as a result of traumatic or non-traumatic muscle injury. Postoperative RML is a rare complication that may result from improper patient positioning, extended surgery time, or unique patient risk factors. We describe a case of a 43-year-old obese male who presented with postoperative bilateral shoulder RML after undergoing cardiothoracic surgery for aortic valve disease.

Novel Method for Reduction of Distal Radius Fractures.

Distal radius fractures are one of the most common fractures seen in orthopaedics. These fractures may be treated surgically or conservatively depending on patient-related and radiographic factors. Displaced fractures should be reduced in the acute setting to better align the fracture fragments and a splint applied to hold the fracture in this position.

Platelet-Rich Product Supplementation in Rotator Cuff Repair Reduces Retear Rates and Improves Clinical Outcomes: A Meta-analysis of Randomized Controlled Trials.

Purpose: The purpose of this study was to conduct a comprehensive systematic review and meta-analysis to investigate the clinical and imaging outcomes of all 4 types of platelet-rich therapies (pure platelet-rich plasma [P-PRP], leukocyte and platelet-rich plasma, pure platelet-rich fibrin, and leukocyte and platelet-rich fibrin) in rotator cuff repairs.

Methods: A systematic literature search was performed to identify rotator cuff tears comparing any of the 4 types of platelet-rich products (PRP) to a control in rotator cuff repair. Data extracted from the studies included retear rates diagnosed with imaging studies, as well as outcome scores such as Constant, American Shoulder and Elbow Surgeons (ASES), University of California Los Angeles (UCLA), Simple Shoulder Test (SST), and visual analog scale (VAS).

Volar Cortical Integrity in Non-Operatively Treated Adult Distal Radius Fractures.

We sought to independently validate published data that volar cortical integrity (VCI) is an independent predictor of maintenance of closed reduction in a series of non-surgically treated distal radius fractures, while simultaneously investigating previously reported predictors of instability. Our null hypothesis was that volar cortical integrity would not affect maintenance of reduction. Four hundred thirty-three adult distal radius fractures were screened from our Orthopedic database with 112 meeting inclusion criteria.

A Novel Method of Patient Positioning Using Shoulder Arthroscopy Equipment for Elbow Arthroscopy.

Indications for elbow arthroscopy are expanding; however, it is uncommon compared with shoulder arthroscopy. Elbow arthroscopy can be complicated by positioning, including the need to obtain specific arm holders required by most operating rooms. Surgery can be performed in the supine, prone, or lateral position.

Biomechanical Comparison of a First- and a Second-Generation All-Soft Suture Glenoid Anchor.

Background: All-soft tissue suture anchors provide advantages of decreased removal of bone and decreased glenoid volume occupied compared with traditional tap or screw-in suture anchors. Previous published data have led to biomechanical concerns with the use of first-generation all-soft suture anchors.

Purpose/hypothesis: The purpose of this study was to evaluate the load to 2-mm displacement and ultimate load to failure of a second-generation all-soft suture anchor, compared with a first-generation anchor and a traditional PEEK (polyether ether ketone) anchor.

Complications Associated with Intra-Articular and Extra-Articular Corticosteroid Injections.

Side effects of corticosteroids can occur in association with both intra-articular and extra-articular injections. Less-severe reactions include skin reactions and flare responses. Although rare, worrisome complications such as infections, tendon ruptures, and osteonecrosis can occur.

Acute Shoulder Injuries in Adults.

Acute shoulder injuries in adults are often initially managed by family physicians. Common acute shoulder injuries include acromioclavicular joint injuries, clavicle fractures, glenohumeral dislocations, proximal humerus fractures, and rotator cuff tears. Acromioclavicular joint injuries and clavicle fractures mostly occur in young adults as the result of a sports injury or direct trauma.

Acute multiple flexor tendon injury and carpal tunnel syndrome after open distal radius fracture.

Although the rupture of extensor tendons after distal radius fractures is well described, acute flexor tendon ruptures are much less common. We report a case of acute rupture of the flexor pollicis longus and flexor carpi radialis tendons with acute carpal tunnel syndrome after a Gustilo-Anderson type II open distal radius fracture. We reviewed the literature to identify risk factors for tendon rupture and the development of carpal tunnel syndrome.

Surgical treatment of symptomatic superior labrum anterior-posterior tears in patients older than 40 years: a systematic review.

Background: Successful arthroscopic repair of symptomatic superior labral tears in young athletes has been well documented. Superior labral repair in patients older than 40 years is controversial, with concerns for residual postoperative pain, stiffness, and higher rates of revision surgery.

Purpose: To analyze the published data on the surgical treatment of superior labral injuries in patients aged ≥40 years, including those with concomitant injuries to the rotator cuff.

Radial head arthroplasty.

Radial head arthroplasty remains an encouraging treatment option for comminuted radial head fractures in an unstable elbow or forearm. This article discusses the surgical considerations related to radial head arthroplasty, including anatomy, indications, and surgical technique. Radial head arthroplasty outcomes literature and a review of current implant options are also discussed.

Correlation of radiographic muscle cross-sectional area with glenohumeral deformity in children with brachial plexus birth palsy.

Background: Muscle imbalance about the shoulder in children with persistent brachial plexus birth palsy is thought to contribute to glenohumeral joint deformity. We quantified cross-sectional areas of the internal and external rotator muscles in the shoulder by magnetic resonance imaging in patients with chronic brachial plexopathy and the correlation between these muscle cross-sectional area ratios and glenohumeral deformity. The purposes of this investigation were to evaluate differences in the ratios between affected and unaffected shoulders in the same individual and to assess whether an increased internal to external rotator muscle cross-sectional area correlated with greater glenohumeral deformity.

Long-term follow-up of basal joint resection arthroplasty of the thumb with transfer of the abductor pollicis brevis origin to the flexor carpi radialis tendon.

Purpose: To investigate the long-term functional and clinical outcomes of a tendon transfer during basal joint interposition arthroplasty for osteoarthritis of the basal joint of the thumb, in which the origin of the abductor pollicis brevis (APB) and opponens pollicis is transferred to the flexor carpi radialis tendon, in order to increase the abduction moment arm of the thumb and provide dynamic stabilization of the base of the first metacarpal.

Methods: We observed 22 patients, who received basal joint interposition arthroplasty with APB and opponens pollicis tendon transfer, over an average of 9 years (range, 3-20 years). Subjective outcome measures included patient satisfaction scores, visual analog scale scores for pain, and Disabilities of the Arm, Shoulder and Hand (DASH) scores.

Radial nerve palsy in the newborn: a report of four cases and literature review.

Background: Radial nerve palsy in the neonate is a rare clinical entity but must be distinguished from the more common brachial plexus birth palsy which occurs during the perinatal period. Although longer term upper-limb function following brachial plexus birth palsy is highly variable depending on the extent of neurological involvement, sparse reports of neonates with radial nerve palsy have nearly universal spontaneous recovery with normal upper-limb function.

Methods: We report 4 cases of patients born with findings consistent with radial nerve palsy.