Risk Factors for Lower Extremity Minor Amputation Conversion to Major Amputation.

Background: Minor lower extremity amputations (LEAs) have become an important part of the limb salvage approach but are not as benign as previously thought. This study investigates the difference in outcome between toe/ray versus midfoot amputations and the risk factors for major amputation conversion associated with each procedure.

Methods: We performed retrospective chart review of foot amputation patients at a single tertiary care medical center with a primary end point of conversion to major amputation and secondary end points of 1-year wound healing and mortality rate.

An investigational time course study of titanium plasma spray on osseointegration of PEEK and titanium implants: an in vivo ovine model.

Background Context: Methods to improve osseointegration of orthopedic spinal implants remains a clinical challenge. Materials composed of poly-ether-ether-ketone (PEEK) and titanium are commonly used in orthopedic applications due to their inherent properties of biocompatibility. Titanium has a clinical reputation for durability and osseous affinity, and PEEK offers advantages of a modulus that approximates osseous structures and is radiolucent.

Predictive Factors for Mortality Following Major Lower Extremity Amputation.

Background: Despite advances in techniques and care, major amputation bears a high risk for mortality. Previously identified factors associated with increased risk of mortality include amputation level, renal function, and pre-operative white cell count.

Methods: A single center retrospective chart review was conducted identifying patients who had undergone a major amputation.

Patients value their own pain over braking safety when deciding when to return to driving: a discrete choice experiment on lower extremity injuries.

Objective: To quantify patient preferences towards time to return to driving relative to compromised reaction time and potential complication risks.

Design: Cross-sectional discrete choice experiment.

Setting: Academic trauma center.

The Caged Knickerbocker: A Novel Modification to Targeted False Lumen Management in Complex Aortic Dissection.

Introduction: Targeted false lumen management has been described for complex presentations of aortic dissection. The "Knickerbocker" technique is often referenced and includes dilating a focal portion of an oversized endograft in the true lumen to purposefully rupture the false lumen septum, but at the expense of increased risk for visceral propagation and malperfusion. This case series describes a novel modification of the Knickerbocker technique by caging the distal end of the endograft prior to focal dilation.

Hip Fracture With Elevated Troponin: Harbinger of Mortality or Need for Accelerated Surgery?

Objective: To determine the association of elevated troponin levels with time to surgery and the risk of mortality and other key clinical outcomes among elderly patients with hip fracture who had measured troponin levels at hospital admission.

Design: Retrospective cohort study.

Setting: Single academic trauma center.

Open Proximal Endarterectomy with Retrograde Access and Stenting: A Novel Technique for Lower Extremity Revascularization.

Background: Treatment of chronic limb threatening ischemia (CLTI) poses a significant clinical challenge despite recent medical advancements. Chronic total occlusion (CTO) lesions make endovascular approaches to CLTI particularly challenging. Open proximal exposure with retrograde access and stenting (OPERAS) aims to solve this challenge through retrograde subintimal crossing of a CTO with direct visualization of proximal re-entry into the true lumen.