Subsidence in Nonexpandable, Single-Plane Expandable, and Dual-Plane Expandable TLIFs A Propensity-Matched Cohort Study.

Background: Transforaminal lumbar interbody fusion (TLIF) has become a common tool to achieve interbody fusion in lumbar spine surgery while avoiding the time, expense, and morbidity associated with an anterior approach. Nonexpandable (NE) devices have excellent fusion results but are limited to implant size by spinal anatomy; conversely, expandable implants have been associated with increased intraoperative subsidence. Dual-plane expandable (DPE) devices are theorized to have reduced subsidence risk, but DPE cages have not been directly compared to NE and single plane expandable (SPE) implants in vivo.

Comparative Studies in the Shoulder Literature Lack Statistical Robustness: A Fragility Analysis.

Purpose: Evidenced-based decision-making is rooted in comparative clinical studies; however, a small number of outcome event reversals have the potential to change study significance. The purpose of this study was to determine the utility of applying fragility analysis to comparative studies in the published orthopaedic shoulder literature.

Methods: Comparative clinical shoulder research studies reporting 1:1 dichotomous categorical data were analyzed in 6 leading orthopaedic journals between 2006 and 2016.

Role of Robotics in Adult Spinal Deformity.

Robotic-assisted adult deformity surgery has played a rapidly expanding role since its introduction. As robotic spine technologies improve, the potential to limit complications and morbidity is vast. The improvements in instrumentation accuracy combined with the ability to maintain that accuracy in multiple positions allow creative surgical approaches and techniques that can limit operative time, blood loss, and improve outcomes.

Severe aortic stenosis is associated with perioperative mortality in proximal femur fracture patients.

Objectives: Evaluate the correlation between aortic stenosis and perioperative mortality in patients following surgical fixation of proximal femur fractures.

Design: Retrospectively reviewed case series.

Setting: Two Academic, Level 1 Trauma Centers.

The Prognostic Value of Laboratory Markers and Ambulatory Function at Presentation for Post-Treatment Morbidity and Mortality Following Epidural Abscess.

Study Design: Retrospective cohort study.

Objective: To develop a comprehensive understanding of the prognostic value of laboratory markers on morbidity and mortality following epidural abscess.

Summary Of Background Data: Spinal epidural abscess is a serious medical condition with high rates of morbidity.

Implant Removal Matrix for the upper Extremity Orthopedic Surgeon.

Orthopedic implant removal is a commonly performed procedure. While implant removal can be associated with improved symptoms, risks of the surgery are notable. Stripped screws, broken and retained hardware, and morbidity associated with soft tissue compromise during difficult removal are all common.

Does Surgical Approach Influence the Risk of Postoperative Infection After Surgical Treatment of Tibial Pilon Fractures?

Objectives: To determine whether a particular surgical approach or combination of approaches is a risk factor for infection.

Design: Retrospective review.

Setting: Two Level-1 trauma centers.

Statistical Significance in Trauma Research: Too Unstable to Trust?

Objectives: To evaluate the stability of statistical findings in the fracture care literature based on minor changes in event rates and to determine the utility of applying both the Fragility Index (FI) and Fragility Quotient (FQ) to comparative orthopaedic trauma trials.

Methods: All fracture care studies from 1991 to 2013 in the Journal of Bone and Joint Surgery and the Journal of Orthopaedic Trauma were screened. The FI was determined by altering the number of reported outcome events, a single event at time, until a reversal of statistical significance was determined.

Syndesmotic Fixation Utilizing a Novel Screw: A Retrospective Case Series Reporting Early Clinical and Radiographic Outcomes.

Syndesmotic disruption occurs in 20% of ankle fractures and requires anatomical reduction and stabilization to maximize outcomes. Although screw breakage is often asymptomatic, the breakage location can be unpredictable and result in painful bony erosion. The purpose of this investigation is to report early clinical and radiographic outcomes of patients who underwent syndesmotic fixation using a novel metal screw designed with a controlled break point.

Predicting survival in older patients treated for cervical spine fractures: development of a clinical survival score.

Background Context: Emerging literature has identified the importance of pretreatment health and functional status as influential in the prognostication of survival. A comprehensive, accessible, predictive model for survival following cervical spine fracture has yet to be developed.

Purpose: To develop an accessible and intuitive predictive model for survival in individuals aged 50 and older treated for cervical spine fractures.

Garden 1 and 2 Femoral Neck Fractures Collapse More Than Expected After Closed Reduction and Percutaneous Pinning.

Objectives: To report on the final displacement after in situ percutaneous pinning for Garden type 1 and 2 fractures in height, femoral neck fracture collapse, and loss of offset.

Design: Retrospectively reviewed case series.

Setting: Three Academic Medical Centers.

Statistical Fragility and the Role of P Values in the Sports Medicine Literature.

Introduction: Comparative trials evaluating categorical outcomes have important implications on surgical decision making. The purpose of this study was to examine the statistical stability of sports medicine research.

Methods: Comparative clinical sports medicine research studies involving anterior cruciate ligament, meniscus, and knee instability were reviewed in two journals between 2006 and 2016.

A Compatibility Guide for the Orthopaedic Surgeon Planning to Perform Hardware Removal Surgery.

Background: Removal of previously placed orthopaedic implants is a commonly performed procedure worldwide. Given the diversity of orthopaedic implant manufacturers, surgeons may be uncertain whether they have the appropriate screwdriver on site. The purpose of this study was to assess the compatibility of screw head and size configurations from various orthopaedic manufacturers with two commonly used universal screw removal sets.

Outcomes after plating of olecranon fractures: A multicenter evaluation.

Introduction: The aim of this study was to report the physical and functional outcomes after open reduction internal fixation of the olecranon in a large series of patients with region specific plating across multiple centres.

Patients/methods: Between January 2007 and January 2014, 182 consecutive patients with a displaced olecranon fracture treated with open reduction internal fixation were included in this study. Retrospective review across four trauma centres collected elbow range of motion, DASH scores, hardware complications, and hardware removal.