Survival and Recovery From Postmyocardial Infarction Apical Wall Rupture With a Complex Course.

Ventricular wall rupture is associated with poor outcomes subsequent to an acute myocardial infarction. We describe a case of postmyocardial infarction apical wall rupture following percutaneous coronary intervention. Our case emphasizes the importance of swift evaluation, diagnosis, and management to enhance survival in individuals confronting this critical condition.

Total Thickness Bilateral Rupture of the Rectus Abdominis: A Case Report and Literature Review.

Rupture of the rectus abdominis is a rare condition. We describe the case of a young male trainee paratrooper who presented with sudden onset severe lower abdominal pain that occurred during military training. Magnetic resonance imaging revealed full-thickness bilateral rupture of the rectus abdominis.

Management of Open Fractures of the Extremities and Pediatrics.

The modern management of open fractures was established after the foundational work of Gustilo and Anderson, but we continue to strive to determine the optimal treatment of open fractures to diminish the risk of infection. The ideal timing of antibiotics, presentation to the operating room, and timing of procedures such as flap coverage continue to be investigated with incremental changes recommended over the years. This article aims to provide the most recent review of the literature regarding the timing and management of both upper and lower extremity open fractures, pediatric open fractures, current topics of controversy, and the data supporting current treatment recommendations.

Failure after operative repair is higher for ballistic femoral neck fractures than for closed, blunt-injury fractures: a multicenter retrospective cohort study.

Introduction: The purpose of this study was to describe the outcomes after operative repair of ballistic femoral neck fractures. To better highlight the devastating nature of these injuries, we compared a cohort of ballistic femoral neck fractures to a cohort of young, closed, blunt-injury femoral neck fractures treated with open reduction and internal fixation (ORIF).

Methods: Retrospective chart review identified all patients presenting with ballistic femoral neck fractures treated at three academic trauma centers between January 2016 and December 2021, as well as patients aged ≤50 with closed, blunt-injury femoral neck fractures who received ORIF.

Reducing Complications in Pilon Fracture Surgery: Surgical Time Matters.

Objective: To correlate patient-specific and surgeon-specific factors with outcomes after operative management of distal intra-articular tibia fractures.

Design: Retrospective cohort study.

Setting: 3 Level 1 tertiary academic trauma centers.

Sinus Tarsi Versus Extended Lateral Approach for Displaced Intra-Articular Calcaneal Fractures: A Single Surgeon's Experience.

Background: The aim of the study is to investigate the differences between the extensile lateral (EL) and sinus tarsi (ST) approaches for the treatment of displaced intra-articular calcaneus fractures as treated by a single surgeon.

Methods: A retrospective cohort study performed at a Level 1 trauma center. One hundred twenty-nine consecutive intra-articular calcaneus fractures from 2011 to 2018 that were surgically treated by a single surgeon.

Distal Radius Fracture Management: Surgeon Factors Markedly Influence Decision Making.

Introduction: It is our hypothesis that physician-specific variables affect the management of distal radius (DR) fractures in addition to patient-specific factors.

Methods: A prospective cohort study was conducted evaluating treatment differences between Certificate of Additional Qualification hand surgeons (CAQh) and board-certified orthopaedic surgeons who treat patients at level 1 or level 2 trauma centers (non-CAQh). After institutional review board approval, 30 DR fractures were selected and classified (15 AO/OTA type A and B and 15 AO/OTA type C) to create a standardized patient data set.

Surgeon-specific factors have a larger impact on decision-making for the management of proximal humerus fractures than patient-specific factors: a prospective cohort study.

Background: There is significant variability both in how proximal humerus fractures (PHFs) are treated and the ensuing patient outcomes. The purpose of this study was to investigate which surgeon- and patient-specific factors contribute to decision-making in the treatment of adult PHFs. We hypothesized that orthopedic sub-specialty training creates inherent bias and plays an important role in management algorithms for PHFs.

Cannabinoids for Pain Modulation in Orthopedic Surgery.

Cannabinoid compounds are being increasingly used as an analgesic adjuvant in the orthopedic population, but little data exist to either support or oppose this practice pattern. A review of all contemporary (2000-2020) studies on the use of cannabinoids in orthopedics is presented. Physicians and patients are optimistic that cannabinoids can decrease pain scores and perhaps opioid use; however, their application in orthopedics is not well characterized.

Chemoprophylaxis for venous thromboembolism in pelvic and/or acetabular fractures: A systematic review.

Background: It is unclear which pharmacological agents, and at what dosage and timing, are most effective for venous thromboembolism (VTE) prophylaxis in patients with pelvic/acetabular fractures.

Methods: We searched the Cochrane Database of Systematic Reviews, Embase, Web of Science, EBSCO, and PubMed on October 3, 2020, for English-language studies of VTE prophylaxis in patients with pelvic/acetabular fractures. We applied no date limits.

A New Algorithm for Classifying Acetabular Fracture Patterns on Three-dimensional Computed Tomography Reconstructions Markedly Improves Residents' Ability to Correctly Classify Fractures.

Introduction: CT and three-dimensional (3D) CT reconstructions have been shown to improve the understanding of acetabular fractures. With the increased availability of 3D pelvic CT reconstructions, our goal for this study was to develop an algorithm to aid residents in the classification of acetabular fractures. We hypothesized that the use of a stepwise algorithm will markedly enhance the trainees' ability to correctly identify acetabular fracture patterns.

Outcomes of periprosthetic distal femur fractures following total knee arthroplasty: Intramedullary nailing versus plating.

Background: Periprosthetic distal femur fractures (PPDFFs) present a challenge in terms of optimizing fixation in patients with poor bone quality and limited bone stock. The main treatment options include laterally based plating and intramedullary nailing. We hypothesized that treatment of PPDFFs with intramedullary nails would result in improved union rate, fewer complications, and an equivalent rate of malalignment compared to plating.

Knowledge and Opinion on Cannabinoids Among Orthopaedic Traumatologists.

Introduction: Cannabinoids are an increasingly popular therapy among orthopaedic patients for musculoskeletal conditions. A paucity of evidence to support their use in orthopaedics exists, likely because of the incongruence of federal and state legalization and the stigma surrounding cannabis. The purpose of this study is to elucidate sentiments and knowledge base of the orthopaedic trauma community with regard to cannabinoid-containing compounds.

Morbid obesity and short-term complications following acetabular fracture surgery: A comparative cohort study.

Introduction: Obesity is an epidemic facing the United States affecting nearly 40% of the population (93.3 million adults). The objective of this study was to compare early perioperative complications in patients with a normal BMI to patients who are pre-obese, obese, and morbidly obese.

Complication Rates after Lateral Plate Fixation of Periprosthetic Distal Femur Fractures: A Multicenter Study.

Objective: Periprosthetic fractures of the distal femur can be challenging injuries to treat; nonunion rates of up to 22% have been reported. The purpose of this study was to determine the rate of complications and nonunion in a multicenter series, and to identify patient or surgical factors that were associated with nonunion.

Design: Retrospective comparative study SETTING: Three Level 1 trauma centers PATIENTS: Fifty-five patients with a periprosthetic distal femur fracture proximal to a total knee arthroplasty.

Venous Thromboembolism Prophylaxis After Pelvic and Acetabular Fractures: A Survey of Orthopaedic Surgeons' Current Practices.

Introduction: The goal of this study was to identify the current practices and rationale of orthopaedic surgeons regarding venous thromboembolism (VTE) prophylaxis for pelvic and acetabular (P&A) fractures.

Methods: A 25-item web-based questionnaire was made available to all Orthopaedic Trauma Association (OTA) members on the OTA website. Analysis of data was performed after the three-month study period.

Increasing Fellow Recruitment: How Can Fellowship Program Websites Be Optimized?

Background: The purpose of this study was to determine the importance of factors considered by orthopaedic trauma fellowship applicants when evaluating programs. We hypothesized that applicants will prioritize consistent factors when applying to programs. In addition, we assessed how the applicants use the Internet to research potential fellowships.

Clinical Results of Acetabular Fracture Fixation Using a Focal Kocher-Langenbeck Approach Without a Specialty Traction Table.

Objectives: To report the clinical result of a series of patients who underwent acetabular fracture fixation using a Kocher-Langenbeck approach without a specialty traction table.

Design: Retrospective case series.

Setting: Level 1 trauma center.

Impact of Surrounding Canal Size on Time to Union After Intramedullary Nailing of Femur Fractures: Are 10-mm Nails All We Need?

Objective: To determine whether intramedullary nail (IMN) size and its relation to the canal diameter [nail-canal (NC) diameter] impacts the union rate or time to union in the treatment of femoral shaft fractures.

Design: Retrospective review.

Setting: Two Level 1 and 1 Level 2 trauma centers.

Process improvement for follow-up radiology report recommendations of lung nodules.

Unlabelled: In the modern healthcare system, there are still wide gaps of communication of imaging results to physician and patient stakeholders and tracking of whether follow-up has occurred. Patients are also unaware of the significance of findings in radiology reports. With the increase in use of cross-sectional imaging such as CT, patients are not only being diagnosed with primary urgent findings but also with incidental findings such as lung nodules; however, they are not being told of their imaging findings nor what actions to take to mitigate their risks.

Three-Dimensional-Printed Uterine Model for Surgical Planning of a Cesarean Delivery Complicated by Multiple Myomas.

Background: Uterine myomas encountered at cesarean delivery increase the complexity and risk of the procedure. Preoperative planning of such deliveries may help optimize patient outcomes. The application of three-dimensional printing technology is rapidly expanding in many surgical specialties.