Intraoperative Cardiac Arrest in Orthopaedic Surgery: A Case Series of 42 Patients.

Introduction: Intraoperative cardiac arrest (IOCA) is a rare event during orthopaedic surgery. Although infrequent, it has a notable effect, with mortality as high as 35%. Little is known about the outcomes of IOCA in orthopaedic surgery, and this study aims to fill that knowledge gap to improve patient counseling and treatment decisions.

Marijuana Use and Complication Risk Following Tibia Shaft Fracture Fixation.

Objectives: The aim of this study was to investigate the relationship between preoperative marijuana use and complications following tibia shaft fracture fixation.

Methods: Design: Retrospective cohort study.

Setting: Two academic Level I trauma centers.

Refined Techniques in Tibial Nailing.

Intramedullary nail fixation of unstable tibial diaphyseal fractures is commonly used with excellent clinical results. Indications for nailing have rapidly expanded over recent years, allowing for more difficult fractures to be addressed with "extreme nailing." Despite its widespread use, evolution of newer nailing systems and varying techniques for insertion bring new difficulties with tibial fracture reduction, and malalignment occurs with relative frequency.

Pathoanatomy of the anterior column-posterior hemitransverse acetabular fracture.

Purpose: To define the pathoanatomy of the anterior column-posterior hemitransverse (ACPHT) subtype of acetabulum fractures and assess the morphologic variation therein.

Methods: Retrospective cohort study including 50 patients age greater than 60 with an ACPHT acetabular fracture managed operatively over an 11-year period at an ACS Level 1 Trauma center. Cross-sectional CT images were reviewed for anterior column/wall comminution, anterior column fracture exit point, completeness of the anterior column and posterior column fractures, articular impaction and quadrilateral surface continuity with the posterior column.

Recovery after neurologic injury in operative acetabular and pelvic fractures: Defining the natural history of foot drop.

Introduction: Dorsiflexion weakness, or footdrop, is a well-described sequela of high-energy acetabular and pelvic trauma, but little data exists describing the factors related to neurologic recovery and the timeline therein. An improved understanding of these factors would facilitate prognostication, patient education, and treatment decision-making. The aim of this study was to compare neurologic recovery between acetabular and pelvic fractures, delineate factors associated with recovery, and determine the expected timeline of recovery.

Research Fellowships for Unmatched Orthopaedic Applicants: What Can They Expect?

Introduction: Unmatched orthopaedic surgery applicants often pursue research fellowships to strengthen their residency applications. The aims of this study were to (1) report the trend of the number of orthopaedic research fellowships offered online between 2019 and 2024, (2) describe the characteristics of research fellowships available to unmatched applicants, and (3) assess the quality of support received by unmatched applicants who complete research fellowships.

Methods: An online orthopaedic forum was retrospectively reviewed to identify job postings for medical student research fellowships in the 2019 to 2020 and 2024 to 2025 academic years.

Iatrogenic Sciatic Nerve Injury in Posterior Acetabular Surgery: Surgeon More Predictive Than Position.

Objectives: To identify factors that contribute to iatrogenic sciatic nerve palsy during acetabular surgery through a Kocher-Langenbeck approach and to evaluate if variation among individual surgeons exists.

Design: Retrospective cohort.

Setting: Level I trauma center.

Management of Femoral and Tibial Shaft Fractures in Patients With Chronic Spinal Cord Injury.

Objectives: To compare outcomes and complications between nonoperative and operative management of femur and tibia fractures in patients with paraplegia or quadriplegia from chronic spinal cord injury (SCI).

Design: Retrospective cohort study.

Setting: Three Level-1 Trauma centers.

Femoral Head Fractures: Evaluation, Management, and Outcomes.

Fractures of the femoral head typically occur after high-energy trauma. Radiographs and cross-sectional imaging are used to appropriately classify and identify associated injuries or morphologic characteristics that may influence management. Identification of the radiographic and clinical hallmarks of an irreducible variant is critical to optimizing the patient's outcome.

The Effect of Extracorporeal Membrane Oxygenation in Patients With Multiple Orthopaedic Injuries.

Introduction: Extracorporeal membrane oxygenation (ECMO) plays a vital role in providing life support for patients with reversible cardiac or respiratory failure. Given the high rate of complications and difficulties associated with caring for ECMO patients, the goal of this study was to compare outcomes of orthopaedic surgery in polytrauma patients who received ECMO with similar patients who have not. This will help elucidate the timing and type of fixation that should be considered in patients on ECMO.

Evaluating ChatGPT's Ability to Answer Common Patient Questions Regarding Hip Fracture.

Introduction: ChatGPT is an artificial intelligence chatbot software programmed for conversational applications using reinforcement learning techniques. With its growing popularity and overall versatility, it is likely that ChatGPT's applications will expand into health care especially because it relates to patients researching their injuries. The purpose of this study was to investigate ChatGPT's ability to accurately answer frequently asked questions regarding hip fractures.

Lumbopelvic fixation in the treatment of spinopelvic dissociation: union, complications, and neurologic outcomes of a multicenter case series.

Purpose: To review outcomes of spinopelvic dissociation treated with open lumbopelvic fixation.

Methods: We reviewed all cases of spinopelvic dissociation treated at three Level-I trauma centers with open lumbopelvic fixation, including those with adjunctive percutaneous fixation. We collected demographic data, associated injuries, pre- and postoperative neurologic status, pre- and postoperative kyphosis, and Roy-Camille classification.

Percutaneous Posterior Pelvic Fixation of Spinopelvic Dissociation: A Multicenter Series of Displaced Patterns.

Objective: To characterize the success and complications of percutaneous posterior pelvic fixation in the treatment of displaced spinopelvic dissociation patterns.

Design: Retrospective cohort study.

Setting: Three Level I trauma centers.

Comparative Analysis of Supplemental Medial Buttress Plate Fixation for High-Energy Displaced Femoral Neck Fractures in Young Adults.

Objectives: To evaluate whether augmenting traditional fixation with a femoral neck buttress plate (FNBP) improves clinical outcomes in young adults with high-energy displaced femoral neck fractures.

Design: Multicenter retrospective matched cohort comparative clinical study.

Setting: Twenty-seven North American Level 1 trauma centers.

Non-osseous considerations in diagnostic imaging for pelvic and acetabular trauma.

High-quality imaging is crucial for orthopedic traumatologists in the evaluation and management of pelvic and acetabular fractures. Computed tomography (CT) plays an essential role in the diagnosis and treatment of patients with these complex injuries. A thoughtful evaluation of associated soft tissues can reveal additional details about the patient and their injury that may impact treatment.

Neurologic injury after spinopelvic dissociation: Incidence, outcome, and predictors.

Background: Traumatic spinopelvic dissociation is a rare injury pattern resulting in discontinuity between the spine and bony pelvis. This injury is associated with a known risk of neurologic compromise which can impact the clinical outcome of these patients. We sought to determine incidence and characteristics of neurologic injury, outcomes following treatment, and predictive factors for neurologic recovery.

Comparing Calcaneus Fracture Radiographic Outcomes and Complications after Percutaneous Pin versus Screw Fixation.

Calcaneus fracture fixation is associated with high rates of morbidity and disability from wound complications, infection, subtalar arthritis, and malunion. Percutaneous fixation with Kirshner wires (K-wires) or screws may be implemented when soft tissue injury precludes an open approach. Although screws are thought to provide greater stability, limited data exists directly comparing fixation success of these implants.

Hands-free Femoral Traction Using the Bookwalter Retractor System During Anterior Approaches to the Acetabulum.

Displaced acetabular fractures with medial and cranial displacement of the femoral head commonly require an anterior approach for reduction and stabilization. Restoration of the femoral head to its native position under the reduced acetabular dome is a primary goal of surgery. We present a surgical technique for applying traction to the proximal femur using the Bookwalter retractor system during the repair of acetabular fractures when using an anterior approach.

Sacral Insufficiency Fractures.

»: Primary osteoporosis is the most common cause of sacral insufficiency fractures (SIFs). Therefore, a multidisciplinary team approach is necessary for treatment of the fracture and the underlying biologic pathology, as well as prevention of future fragility fractures.

»: The presentation of SIFs typically includes lower back or buttock pain after a ground-level fall or without an identified trauma.

Treatment Failure in Femoral Neck Fractures in Adults Less Than 50 Years of Age: Analysis of 492 Patients Repaired at 26 North American Trauma Centers.

Objectives: To assess the operative results of femoral neck fractures (FNFs) in young adults in a large multicenter series, specifically focusing on risk factors for treatment failure.

Design: Large multicenter retrospective cohort series.

Setting: Twenty-six North American Level 1 trauma centers.

Preoperative and Intraoperative Considerations Using Intramedullary Nails for the Treatment of Tibial Shaft Fractures Below Total Knee Arthroplasty.

Periprosthetic tibial shaft fractures below total knee arthroplasty (TKA) are relatively rare, with an incidence of approximately 1%. However, as the rates of arthroplasty increase, orthopaedic surgeons are likely to see a corresponding increase in these types of fractures. Native tibial shaft fractures are routinely treated with either nails or plates, and the success of intramedullary nailing of tibial shaft fractures has been well described in the literature.

Statistical Literacy in the Orthopaedic Trauma Population.

Objective: To evaluate the baseline level and demographic predictors of statistical literacy in orthopaedic patients who sustained traumatic injuries.

Design: Prospective observational.

Setting: Level 1 trauma center.

Extra-articular Unstable Iliac Fractures: Associated Injuries, Fixation Strategies, and Outcomes.

Objective: To characterize the associated injuries, fixation constructs, and outcomes of extra-articular unstable iliac fractures.

Design: Retrospective cohort study.

Setting: Level I trauma center.

Clamp Assisted Reduction of the Transverse Acetabular Fracture With Anterior Column Screw Fixation and Posterior Plating: A Technical Trick and Case Series.

Displaced transverse acetabular fractures are unstable injuries that frequently require repair. Although multiple approaches, techniques, and fixation constructs have been described to treat this pattern, achieving an anatomical reduction and applying fixation to maintain this until union remains the goal of treatment. We present a surgical technique for transverse or transverse/posterior wall acetabular fractures repaired using a clamp-assisted reduction through the sciatic notch, followed by anterior column screw fixation and subsequent posterior column plating through a Kocher-Langenbeck exposure.