Robotic-assistance is associated with better joint outcomes compared to conventional techniques in surgically routine total hip arthroplasty: a propensity-matched large database study of 3948 patients.

Introduction: The outcomes of total hip arthroplasty (THA) are highly dependent upon the restoration of native hip biomechanics and optimal component positioning. Robotic technologies for THA have rapidly improved the accuracy of component positioning and maintaining the planned center of rotation. While robotic-assisted THA (RA-THA) has primarily been employed in surgically intricate cases, its potential benefits in scenarios of diminished surgical complexity remain less explored.

Use of metered dose inhalers for bronchodilator responsiveness testing: laboratory practices in Australia and opportunities for carbon footprint reduction.

Background: Metered dose inhalers (MDIs) are important devices for delivering inhaled medications; however, they have an outsized carbon footprint due to their propellant gas. Many short-acting beta-agonist inhalers contain HFA-134a which has a global warming potential >1000 fold higher than carbon dioxide. We aimed to determine the practices around MDI use and disposal within Australia's major lung function testing laboratories and identify the actions that most influence the carbon footprint of bronchodilator responsiveness (BDR) testing.

Outcomes of Total Hip Arthroplasty in Seronegative Spondyloarthropathies: A Propensity-Matched Cohort Analysis.

Background: Total hip arthroplasty (THA) is a common surgical intervention for patients who have seronegative spondyloarthropathies (SpA). However, there is a paucity of literature addressing the outcomes of THA specifically in SpA patients. This study aimed to investigate both the short-term and long-term systemic and orthopaedic outcomes of THA in SpA patients as a whole, as well as within the individual subtypes of SpA.

Improving Patient Recall Following Operative Orthopaedic Trauma.

Background: Orthopaedic trauma patients may experience poor recall regarding their injury and treatment, impairing postoperative outcomes. We sought to evaluate the impact of a standardized postoperative educational protocol on patient recall, adherence to the treatment plan, and satisfaction.

Methods: Two hundred and twenty adult, English-speaking patients with surgically treated lower-extremity fractures were prospectively included.

Fracture related infection and sepsis in orthopedic trauma: A review.

Trauma is a leading cause of death in the United States for people under 45. Amongst trauma-related injuries, orthopedic injuries represent a significant component of trauma-related morbidity. In addition to the potential morbidity and mortality secondary to the specific traumatic injury or injuries sustained, sepsis is a significant cause of morbidity and mortality in trauma patients as well, and infection related to orthopedic trauma can be especially devastating.

Immediate plate fixation of open tibial plafond fractures does not elevate risk of infection.

Objective: To determine if immediate plate fixation of open tibial plafond fractures has a negative effect on soft tissue complications and increases the risk of deep infection.

Design: This was a single-institution retrospective cohort study performed at level-1 trauma center. All patients with open OTA/AO 43C plafond fractures treated over 20-year period with follow-up until fracture union or development of deep infection.

Local administration of vancomycin powder in orthopaedic fracture surgery: current practice and trends.

Objectives: Surgical site infections in orthopaedic trauma are a significant problem with meaningful patient and health care system-level consequences. Direct application of antibiotics to the surgical field has many potential benefits in reducing surgical site infections. However, to date, the data regarding the local administration of antibiotics have been mixed.

Interprosthetic Femur Fractures: A Review Article.

➢: The prevalence of interprosthetic femur fractures (IFFs) is rising with the aging population and increased prevalence of total joint arthroplasty.

➢: IFFs have high rates of complications and high associated morbidity and mortality.

➢: The main treatment methods available for IFFs include plate fixation, intramedullary nailing, combined plate fixation and intramedullary nailing, and revision arthroplasty including partial and total femur replacement.

Pulmonary function testing during SARS-CoV-2: An ANZSRS/TSANZ position statement.

The Thoracic Society of Australia and New Zealand (TSANZ) and the Australian and New Zealand Society of Respiratory Science (ANZSRS) commissioned a joint position paper on pulmonary function testing during coronavirus disease 2019 (COVID-19) in July 2021. A working group was formed via an expression of interest to members of both organizations and commenced work in September 2021. A rapid review of the literature was undertaken, with a 'best evidence synthesis' approach taken to answer the research questions formed.

Comparable Outcomes Between Native and Periprosthetic Fractures of the Distal Femur.

Despite the rising prevalence of arthroplasty and aging population, limited data exist regarding differences in periprosthetic fracture clinical outcomes compared with native counterparts. This study compares differences in hospital treatment, morbidity, and mortality associated with periprosthetic distal femur fractures at an urban level 1 trauma center. We retrospectively reviewed all adult AO/OTA type 33 fractures (526) that presented to our institution between 2009 and 2018.

Traumatic Dislocation of the Proximal Tibiofibular Joint: A Systematic Review and 10-year Experience From a Level 1 Trauma Center.

Introduction: Traumatic proximal tibiofibular joint dislocations occur infrequently and are typically the result of high-energy trauma. These injuries can be a marker of limb injury severity because patients often sustain vascular injury and are at high risk of amputation. The purpose of this study was to present a systematic review of traumatic proximal tibiofibular joint dislocations and compare rates of associated injuries with a retrospective series of patients at a level 1 trauma center.

Weight-bearing status may influence rates of radiographic healing following reamed, intramedullary fixation of diaphyseal femur fractures.

Objective: To investigate the effect of weight-bearing status on radiographic healing of diaphyseal femur fractures.

Design: Retrospective 1:1 matched cohort study.

Setting: Single-level 1 trauma center.

Missed diagnosis or misdiagnosis: how often do hospitalised patients with a diagnosis of chronic obstructive pulmonary disease have spirometry that supports the diagnosis?

Background: Chronic obstructive pulmonary disease (COPD) is one of the most common clinical diagnoses among hospital inpatients. Diagnosis requires the demonstration of post-bronchodilator airflow obstruction. However, it is uncertain how often spirometry results are available at the time a diagnostic label of COPD is applied.

Suture Fixation of a Pediatric Pelvic Ring Injury: A Case Report.

Case: A 2-year-old male child presented as a polytrauma after having been run over by a motor vehicle. His orthopaedic injuries included a pelvic ring injury, a displaced subtrochanteric femur fracture, and a clavicle fracture. His pelvic ring injury ultimately required open reduction with suture fixation after failure of closed management.

Case series of two successful pelvic ring reconstructions using a pedicled anterolateral thigh flap.

Open pelvic ring fractures can have devastating functional consequences including prolonged disability, chronic pain, infection, and even death. These injuries are uncommon but often involve soft tissue defects. Without early and appropriate coverage, patients are likely to sustain infection, which can be fatal.

Diaphragm dysfunction: a comprehensive review from diagnosis to management.

Although the diaphragm represents a critical component of the respiratory pump, the clinical presentations of diaphragm dysfunction are often non-specific and can be mistaken for other more common causes of dyspnoea. While acute bilateral diaphragm dysfunction typically presents dramatically, progressive diaphragm dysfunction associated with neuromuscular disorders and unilateral hemidiaphragm dysfunction may be identified incidentally or by recognising subtle associated symptoms. Diaphragm dysfunction should be considered in individuals with unexplained dyspnoea, restrictive respiratory function tests or abnormal diaphragm position on plain chest imaging.

Technique for Open Reduction and Internal Fixation of Lateral Process Talus Fractures.

Lateral process fractures of the talus may occur either in isolation or in combination with a talar neck or body fracture. Screw fixation has been well described as a means of stabilization; however, many patients have multifragmentary fragments, unable to be controlled by isolated screw fixation alone. Plate fixation of the lateral process has been yet to be described in detail with presence of a clinical series.

Palliative Management of Nonoperative Femoral Neck Fractures With Continuous Peripheral Indwelling Catheters: Case-Control Series.

Introduction: This case-control study evaluates the success of indwelling pain catheters in nonoperatively treated femoral neck fractures (FNFs) for end-of-life pain management.

Methods: Patients older than 65 years with nonoperatively treated FNFs were retrospectively identified at a level 1 trauma center between March 2012 and September 2015. Twenty-three received indwelling continuous peripheral pain catheters (experimental) and 10 received traditional pain control modalities (control).

Significance of Lateral Process Fractures Associated With Talar Neck and Body Fractures.

Objectives: To determine whether fracture of the lateral process (LP) elevates the risk of development of radiographic subtalar arthrosis in patients with talar body and neck fractures.

Design: Retrospective review.

Setting: Level 1 academic trauma center.

A Rare Cause of Pyogenic Flexor Tenosynovitis: Nocardia nova.

Infection complicates approximately 5% of open trigger digit releases. Both superficial and deep infections may occur. We present a unique case of a cactus farmer who underwent an uneventful thumb trigger finger release and subsequently developed pyogenic flexor tenosynovitis and acute carpal tunnel syndrome resulting from Nocardia nova infection.

Incidence of Vacuum Phenomenon Related Intra-articular or Subfascial Gas Found on Computer-Assisted Tomography (CT) Scans of Closed Lower Extremity Fractures.

Objectives: To determine the incidence of vacuum phenomenon related intra-articular or subfascial gas found on computer-assisted tomography (CT) scans of closed lower extremity fractures.

Design: Retrospective Review.

Setting: Level I Trauma Center.

Interprosthetic Fractures of the Femur.

As the rate of hip and knee arthroplasty procedures increases, so will the rate of interprosthetic fractures. Several factors, including bone quality, bone quantity, and stability of the prosthetic components, play a role in determining the appropriate operative treatment. Patients with stable components should undergo reduction and internal fixation, while patients with loose components should undergo either revision arthroplasty, with or without additional fixation, or conversion to total femur replacement.