Globally inconsistent: Countries with top health indices erratic developmental hip dysplasia screening protocols.

Purpose: Developmental hip dysplasia is a prevalent pediatric musculoskeletal condition that lacks international standardized screening. We sought to characterize developmental hip dysplasia screening practices in countries with the top global health indices. We also explored diverse definitions in reported epidemiologic rates of this condition.

Radiographic bladder shift is a harbinger of intraoperative blood loss in acetabular surgical fixation.

Purpose: The purpose of this study was to characterize the relationship between a novel radiographic measurement on initial AP pelvis radiograph (termed "bladder shift," BS) to intraoperative blood loss (IBL) during acetabular surgical fixation.

Methods: All adult patients receiving unilateral acetabular fixation (Level 1 academic trauma; 2008-18) were reviewed. AP pelvis radiographs were reviewed for visible bladder outlines and then measured to determine the percentage deformation toward the midline.

Acetabular fracture pattern is altered by pre-injury sacroiliac joint autofusion.

Purpose: Acetabular fracture shape is determined by the direction of force applied. We perceive an anecdotally observed connection between pre-existing autofused sacroiliac joints (aSIJ) and high anterior column (HAC) injuries. The purpose of this study was to compare variations in acetabular fracture patterns sustained in patients with and without pre-injury sacroiliac (SI) joint autofusion.

Methods of Quantifying Intraoperative Blood Loss in Orthopaedic Trauma Surgery: A Systematic Review.

Objectives: To collect and present the recently published methods of quantifying blood loss (BL) in orthopaedic trauma.

Data Sources: A systematic review of English-language literature in PubMed, Cochrane Library, and Scopus databases was conducted according to the PRISMA guidelines on articles describing the methods of determining BL in orthopaedic trauma published since 2010.

Study Selection: English, full-text, peer-reviewed articles documenting intraoperative BL in an adult patient population undergoing orthopaedic trauma surgery were eligible for inclusion.

Methamphetamines and Acetabular Reoperation Rates: Poor Outcomes From the Front Lines.

Objectives: To compare acetabular fracture reoperation rates within 1 year of surgery in methamphetamine ("meth") abusers and abstainers.

Design: Retrospective database analysis.

Setting: Level 1 academic trauma facility, 2008-2018.

Adolescents with spondylolysis have lower SRS-22 scores than controls and peers with pre-operative idiopathic scoliosis.

Purpose: The Scoliosis Research Society Outcomes Questionnaire (SRS-22) is a health-related quality-of-life (HRQL) tool for scoliosis patients. Since no equivalent questionnaire exists for spondylolysis patients, we characterized patient-reported scores in pediatric spondylolysis patients using the SRS-22, and compared these scores to previously published values for age-matched controls and patients with pre-operative adolescent idiopathic scoliosis (AIS).

Methods: A single-institution cross-sectional observational study was performed using SRS-22 data from spondylolysis patients aged 12-18 years.

Physical Examination Is Predictive of Cauda Equina Syndrome: MRI to Rule Out Diagnosis Is Unnecessary.

Study Design: Cross-sectional cohort study.

Objectives: Cauda equina syndrome (CES) is a neurologic emergency, and delay in diagnosis can result in irreversible impairment. Our purpose was to determine the value of physical examination in diagnosis of CES in patients complaining of bladder and/or bowel complications in the emergency department.

A Systematic Review of the Utility of Postoperative Imaging in the Management of Pediatric Supracondylar Humerus Fractures.

Background: Recently published studies call into question the clinical utility of postoperative radiographs in the management of pediatric supracondylar humerus (SCH) fractures. This topic has been addressed as part of the American Academy of Orthopaedic Surgeons Appropriate Use Criteria, although recommendations regarding serial radiographs were not included as part of the discussion. The purpose of this systematic review is to summarize the recent literature regarding the utility of postoperative radiographs as part of the management of SCH fractures.

Postoperative management factors affect urinary retention following posterior spinal fusion for adolescent idiopathic scoliosis.

Study Design: Retrospective cohort study.

Objectives: This study investigates postoperative urinary retention (POUR) following posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) and the effects of postoperative analgesia and mobility on retention. High opioid use and decreased postoperative mobility are proposed risk factors for retention in adults.

Utility of Follow-up Radiographs After Pin Removal in Supracondylar Humerus Fractures: A Retrospective Cohort Study.

Introduction: Displaced supracondylar humerus fractures (SCFs) are common pediatric injuries, typically treated by closed reduction and percutaneous pinning (CRPP). Radiographs are obtained at pin removal and subsequently to evaluate fracture healing. We evaluated the utility of radiographs obtained after pin removal in pediatric SCF management.

Developmental Dysplasia of the Hip.

Pediatricians are often the first to identify developmental dysplasia of the hip (DDH) and direct subsequent appropriate treatment. The general treatment principle of DDH is to obtain and maintain a concentric reduction of the femoral head in the acetabulum. Achieving this goal can range from less-invasive bracing treatments to more-invasive surgical treatment depending on the age and complexity of the dysplasia.

Life Expectancy and Metastatic Spine Scoring Systems: An Academic Institutional Experience.

Study Design: A retrospective data collection study with application of metastatic spine scoring systems.

Objectives: To apply the Tomita and revised Tokuhashi scoring systems to a surgical cohort at a single academic institution and analyze spine-related surgical morbidity and mortality rates.

Summary Of Background Data: Surgical management of metastatic spine patients requires tools that can accurately predict patient survival, as well as knowledge of morbidity and mortality rates.

A scoring system to predict postoperative medical complications in high-risk patients undergoing elective thoracic and lumbar arthrodesis.

Background Context: Various surgical factors affect the incidence of postoperative medical complications following elective spinal arthrodesis. Because of the inter-relatedness of these factors, it is difficult for clinicians to accurately risk-stratify individual patients.

Purpose: Our goal was to develop a scoring system that predicts the rate of major medical complications in patients with significant preoperative medical comorbidities, as a function of the four perioperative parameters that are most closely associated with the invasiveness of the surgical intervention.

Preoperative epidural spinal injections increase the risk of surgical wound complications but do not affect overall complication risk or patient-perceived outcomes.

OBJECT A lack of information exists on the relationship between preoperative epidural spinal injections and outcomes after spine surgery. There is concern that injections might cause local changes, increasing the infection risk and surgical difficulty. Therefore, the authors explored the relationship between preoperative spinal injections and postoperative outcome.

Association between advanced degenerative changes of the atlanto-dens joint and presence of dens fracture.

Background: Dens fractures in elderly patients are often related to issues associated with aging. We examined the association between degenerative changes of the atlanto-dens joint and the risk of dens fracture.

Methods: We conducted a retrospective study of trauma patients, fifty-five years of age or older, who had undergone a computed tomography scan of the cervical spine as part of their admission to a single level-I trauma center.

Postoperative prevertebral soft tissue swelling does not affect the development of chronic dysphagia following anterior cervical spine surgery.

Study Design: Prospective cohort study.

Objective: To characterize the relation between postoperative soft tissue swelling and the development of chronic dysphagia after anterior cervical spine surgery. Chronic dysphagia was defined as dysphagia that persists more than 1 year.

Traditional threshold for retropharyngeal soft-tissue swelling is poorly sensitive for the detection of cervical spine injury on computed tomography in adult trauma patients.

Study Design: Retrospective cohort study.

Objective: To examine the diagnostic value of prevertebral soft-tissue swelling in the setting of cervical spine trauma.

Summary Of Background Data: In adult patients with trauma, an increase in the thickness of the retropharyngeal soft tissues is commonly used as a potential indicator of occult injury, but no studies have examined this parameter using computed tomography (CT) as a screening modality.

Incidence of second cervical vertebral fractures far surpassed the rate predicted by the changing age distribution and growth among elderly persons in the United States (2005-2008).

Study Design: Nationwide epidemiological cohort study.

Objective: To characterize the incidence of second cervical vertebral (C2) fractures by age and geographical region among the elderly Medicare population and to elucidate if the rate changed in the years 2005 to 2008.

Summary Of Background Data: Recent publications hypothesized that the rate of cervical vertebral fractures may be increasing.