How difficult is titanium plate and screw implant removal? A retrospective case series.

Introduction: Titanium implants are commonly used for surgical fixation in orthopedic trauma, and have many benefits compared to stainless steel implants. Despite these benefits, some orthopedic surgeons remain hesitant to use titanium implants due to concerns of difficulty with future implant removal, given concerns with cold-welding and screw strippage. The objective of this study was to assess difficulties associated with titanium plate and screw implant removal.

Industry Payments to Foot and Ankle-Trained Orthopedic Surgeons: An Analysis of the Open Payments Database From 2014 to 2019.

Introduction The authors examined if the transparency in industry payments to foot and ankle-trained orthopedic surgeons resulted in the following changes to the (1) median general payments to surgeons, (2) trend in median payments to surgeons across all subcategory payments, and (3) trend in median payments to surgeons in 11 regions of the United States. Methods A retrospective review of the Centers for Medicare and Medicaid Services (CMS) and Open Payments Database (OPD) was performed to identify all industry payments made by drug and medical device companies to orthopedic surgeons (N = 3,835) between January 1, 2014, and December 31, 2019. Descriptive statistics were calculated, and trend analyses in annual payments, number of payments to surgeons per year, payment subtypes, and regional distributions were analyzed.

Industry Payments to Orthopedic Surgeons Among All Subspecialties: An Analysis of the Open Payments Database From 2014 to 2019.

Introduction Since the passage of the Physician Payments Sunshine Act in 2010, the Centers for Medicare and Medicaid Services (CMS) started the National Physician Payment Transparency Program and Open Payments Database (OPD), which allowed for public access to financial disclosures between physicians and industry. Although orthopedic surgeons receive the highest average payments when compared to other specialties, there has been limited data evaluating these payments among the different orthopedic subspecialties. The purpose of this study was to analyze all industry payments made across all subspecialties among orthopedic surgeons.

Management of Grade 1 Open Distal Radius Fractures: A Survey of Practicing Surgeons.

Introduction Standard of care management for open fractures historically mandates emergent systemic antibiotic administration, followed by urgent irrigation and debridement in the operating room, regardless of injury severity. However, significant controversy exists regarding the specific implementation and importance of these commonly accepted guidelines. We aimed to define differences in the management of grade 1 open distal radius fractures.

Immediate Weight-bearing Through Walker or Crutches After Surgical Fixation of Clavicle Fractures in Patients With Lower Extremity Fractures: A Retrospective Cohort Study.

Objectives: To assess the safety of immediate upper extremity weight-bearing as tolerated (WBAT) rehabilitation protocol after clavicle fracture open reduction internal fixation (ORIF).

Design: Retrospective cohort study.

Setting: Three Level 1 trauma centers.

Use of a Continuous Intracompartmental Pressure Monitoring Device During Fasciotomy.

A 52-year-old man presented with a bicondylar tibial plateau fracture and acute compartment syndrome. Continuous compartment pressure monitoring was used while the patient was treated with fasciotomies and application of an external fixator. The intraoperative pressure reading in the anterior compartment decreased from 105 mm Hg to 50 mm Hg after skin and subcutaneous tissue incision.

Cannabidiol as a treatment for arthritis and joint pain: an exploratory cross-sectional study.

Introduction: An estimated 54 million Americans currently suffer from debilitating arthritis. Patients who have exhausted conservative measures can be subject to chronic pain and resort to symptomatic management with anti-inflammatories, acetaminophen, and opioids. Cannabidiol (CBD) is a non-psychoactive cannabinoid that has shown promise in preclinical studies to reduce inflammation and pain associated with arthritis.

Annular Pulley Rupture of the Toes: Expanding the Differential Diagnosis for Forefoot Pain with Novel MR Findings: A Case Report.

Case: Herein is presented a case of rupture of the A2/A3 annular pulleys of the left second toe in a 33-year-old male patient after a snowboarding injury. The injury was detected on magnetic resonance imaging (MRI) 7 weeks after the initial trauma. The patient was treated conservatively, including toe splinting, with the patient returning to his asymptomatic preinjury baseline after 6 months.

Peroneus Longus and Peroneus Brevis: A Review on Pathology and Updated Treatments.

»: Peroneus longus (PL) and peroneus brevis (PB) pathologies involve a variety of etiologies and degrees of dysfunction, which complicates their diagnoses.

»: Patient presentation includes a spectrum of disease; however, despite advanced imaging, a misunderstanding of the pathology and diagnostic algorithms has contributed to continued misdiagnoses.

»: This article summarizes the anatomy and the pathophysiology of the PL and the PB; it also provides updated treatment options and their associated outcomes in order to illuminate an often-misunderstood topic.

Increased Regular Season Soft Tissue Injury Rates in National Football League (NFL) Players May Be Associated With the Canceled 2020 NFL Preseason Due to COVID-19.

Introduction The purpose of this study is to evaluate the rates of regular season soft tissue injuries in National Football League (NFL) players during the 2020 season, which had a canceled preseason due to the COVID-19 pandemic. Methods This study retrospectively reviewed the injury rates of the 2020-2021 NFL regular season in comparison to the 2018-2019 NFL regular season using publicly available injury data. The focus of our analysis was comparing the following soft tissue injuries: hamstring, groin, calf, quadriceps, thigh, knee - anterior cruciate ligament (ACL), pectoral, and Achilles.

The Association of Immediate-Use Steam Sterilization with the Incidence of Orthopaedic Surgical Site Infections: A Propensity Score-Matched Cohort Study.

Background: Immediate-use steam sterilization (IUSS), formerly termed "flash" sterilization, has been historically used to sterilize surgical instruments in emergency situations. Strict guidelines deter its use, as IUSS has been theorized to increase the risk of surgical site infections (SSIs), leading to increased health-care costs and poor patient outcomes. We sought to examine the association between the use of IUSS and the rate of orthopaedic SSIs.

Case Study: Trans-styloid, Trans-scaphoid, Trans-triquetral, and Perilunate Dislocation.

Introduction: Perilunate dislocations are rare high-energy injuries, and the diagnosis is not infrequently missed at initial presentation. The combination of fractures resulting in a trans-styloid, trans-scaphoid, and trans-triquetral perilunate fracture dislocation is extremely rare. Early recognition and diagnosis of these injuries is prudent to restore patient function and prevent morbidity.

Orthopaedic Trauma Surgeons' Financial Relationships With Industry: An Analysis of the Sunshine Act Reporting of Physician Open Payments From 2014 to 2019.

Introduction: Orthopaedic trauma surgeons have an intricate relationship with the medical device industry. In the past decade, legislation has created transparency of monetary exchanges between physicians and industry. In 2013, the Physician Payments Sunshine Act was passed and ultimately led to the creation of the Open Payments Database.

Industry Payments to Adult Reconstruction-Trained Orthopedic Surgeons: An Analysis of the Open Payments Database From 2014 to 2019.

Background: In recent time, there has been an increased push toward transparency in industry funding toward physicians. The Physician Payments Sunshine Act called for the creation of the Open Payments Database managed by the Centers for Medicare & Medicaid Services. To our knowledge, there have been no studies evaluating the trends in payments among adult reconstruction fellowship-trained orthopedic surgeons.

Patient Satisfaction After Lower Extremity Total Joint Arthroplasty: An Analysis of Medical Comorbidities and Patient Demographics.

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey has received increased attention to determine which demographics may influence patient satisfaction after Total Hip and Knee Arthroplasty. The purpose of this study was to evaluate the various effects that patient-specific factors, medical comorbidities, and demographics had on patient satisfaction. Two thousand and ninety-two patients underwent lower extremity total joint arthroplasty at our institution between 2014 and 2018.

Review of Industry Payments to General Orthopaedic Surgeons Reported by the Open Payments Database: 2014 to 2019.

Introduction: The Physician Payments Sunshine Act was placed into law in 2010 in an effort to create transparency between physicians and industry. Along with many other specialties, orthopaedic surgeons have long worked intimately with medical industry companies. This study aimed to evaluate trends in industry payments to general orthopaedic surgeons from 2014 to 2019.

The Influence of the Sunshine Act on Industry Payments to United States Orthopaedic Sports Medicine Surgeons.

Purpose: The purpose of the present study is to investigate trends in overall payments to orthopaedic sports medicine surgeons reported by the Open Payments Database (OPD) over the 6 full years of available data (2014-2019).

Methods: A retrospective review of industry payments to United States sports medicine trained orthopaedic surgeons from 2014 to 2019 was performed using the Centers for Medicare and Medicaid Services OPD. Total payments and subtype payments were analyzed for yearly trends.

The Effect of Operating Room Size on Orthopaedic Surgical Site Infection Rates.

Objective: With many preventable causes of surgical site infections (SSIs) identified, the effect of operating room (OR) size on SSI rates has not been assessed. This study investigated the effect of OR size on incidence of SSIs for orthopaedic procedures.

Background: SSIs remain a common complication within the perioperative realm.

Return-to-Driving Recommendations After Lower-Extremity Orthopaedic Procedures.

Following lower-extremity orthopaedic surgery, recommendations for safe return to driving include at least 6 to 12 weeks for a right ankle fracture, 2 days to 2 weeks for a right ankle arthroscopy, 6 to 9 weeks for a total ankle arthroplasty, 6 to 7 weeks for a right Achilles tendon rupture repair, 1 to 4 weeks for a right total knee arthroplasty, 2 weeks for a left total knee arthroplasty, 3 to 6 weeks for a right anterior cruciate ligament repair, and 1 to 4 weeks for a total hip arthroplasty. Important individual factors such as extent of injury, laterality of injury, current driving habits, type of vehicle transmission (manual or automatic), and medical comorbidities must be taken into consideration. State laws vary widely and often use vague language to describe the legal responsibilities that orthopaedic surgeons have when providing return-to-driving recommendations.

Risk factors for complications and in-hospital mortality: An analysis of 19,834 open pelvic ring fractures.

Background: Open pelvic fractures are rare injuries, associated with high patient morbidity and mortality. Few studies have investigated the impact of patient demographics, comorbidities, and injury related factors on complication and mortality rates. The purpose of this study was to: (1) identify the overall incidence of complications and mortality after open pelvic fractures, (2) compare patient factors between those who did and did not develop complications, (3) identify perioperative independent risk factors for complications and mortality.

Short-Term Outcomes of Primary Total Ankle Arthroplasty in Octogenarians: A National Database Analysis.

Background: Total ankle arthroplasty (TAA) is an increasingly popular option for end-stage ankle arthritis. Americans over the age of 80 years grew to 16.7 million in 2010, but there are scarce data assessing the outcomes of octogenarians undergoing TAA.