Carotid tortuosity is associated with extracranial carotid artery aneurysms.

Background: Tortuous arteries may be associated with carotid dissection. The intima disruption caused by a carotid dissection is a possible cause of extracranial carotid artery aneurysms (ECAAs). The aim was to investigate if carotid tortuosity is also associated with ECAA in patients without presence or history of a carotid artery dissection.

In-hospital Enrollment Into an Electronic Patient Portal Results in Improved Follow-up After Orthopedic Surgery: Cluster Randomized Controlled Trial.

Background: Electronic patient portal (EPP) use is associated with lower no-show rates and increased patient satisfaction. However, there are disparities in enrollment into these communication platforms.

Objective: We hypothesized that guided inpatient enrollment into an EPP would improve clinical follow-up and EPP use rates for patients who underwent orthopedic surgery compared to the usual practice of providing information in the discharge summary.

The use of patient-reported outcome measures in the literature on traumatic foot fractures: A systematic review.

Introduction: Adequate foot function is paramount in daily activities, yet the incidence of foot fractures shows a rising trend. Patient-reported outcome measures are increasingly used for research; however, the use of a wide variety of available instruments is undesirable. In the current study, an overview is provided of patient-reported outcome measures used in clinical research evaluating outcomes of foot fractures.

In-house versus on-call trauma surgeon coverage: A systematic review and meta-analysis.

Background: A rapid trauma response is essential to provide optimal care for severely injured patients. However, it is currently unclear if the presence of an in-house trauma surgeon affects this response during call and influences outcomes. This study compares in-hospital mortality and process-related outcomes of trauma patients treated by a 24/7 in-house versus an on-call trauma surgeon.

Factors for Increased Hospital Stay and Utilization of Post -Acute Care Facilities in Geriatric Orthopaedic Fracture Patients.

Background: This study aims to determine the extent of utilization of health care resources in the geriatric fracture population and to identify factors associated with burden on resources.

Methods: This is a retrospective study of 1074 patients ≥65 years admitted to an orthopaedic service for a long bone fracture between July 2014 - June 2015. Outcomes were hospital length of stay (LOS), discharge disposition, and post-acute care facility LOS.

Blunt thoracic aortic injury and TEVAR: long-term outcomes and health-related quality of life.

Purpose: Treatment of blunt thoracic aortic injuries (BTAIs) has shifted from the open surgical approach to the use of thoracic endovascular aortic repair (TEVAR), of which early outcomes appear promising but controversy regarding long-term outcomes remains. The goal of this study was to determine the long-term TEVAR outcomes for BTAI, particularly radiographic outcomes, complications and health-related quality of life (HRQoL).

Methods: Retrospectively, all patients with BTAIs presented at a single level 1 trauma center between January 2008 and December 2018 were included.

Association of Patient-reported Outcomes With Clinical Outcomes After Distal Humerus Fracture Treatment.

Unlabelled: In this study, we assessed the patient-reported outcomes of distal humerus fracture treatment using Patient-Reported Outcomes Measurement Information System (PROMIS) or QuickDASH (Disabilities of the Arm, Shoulder, and Hand) scores and the association between patient-reported outcomes and clinical outcomes.

Methods: We performed a retrospective cohort study of 76 adult patients who sustained an acute distal humerus fracture between 2016 and 2018; 53 patients completed at least one patient-reported outcome measure used to assess physical function (PF) during their routine follow-up care (69.7% response rate).

Open Versus Closed Operative Treatment for Tongue-Type Calcaneal Fractures: Case Series and Literature Review.

Because consensus on the optimal surgical treatment of tongue-type calcaneal fractures is lacking, this study aimed to compare outcomes and postoperative complications of open and closed surgical treatment of these fractures. For this cases series, all patients 18 years or older who underwent operative fixation of tongue-type calcaneal fractures at 2 level I trauma centers between 2004 and 2015 were considered eligible for participation. Data on explanatory and outcome variables were collected from medical records based on available follow-up.

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.

Long-term outcomes after operative treatment for tibial pilon fractures.

Objectives: Aims of the present study were to establish generalizable outcome data on long-term functional outcomes and health-related quality of life (HRQoL) after operative treatment of pilon fractures on a large scale. Second, it was aimed to examine factors associated with these outcomes.

Design: Retrospective cohort study with follow-up by questionnaire.

Injury-related variation in patient-reported outcome after musculoskeletal trauma: a systematic review.

Purpose: The purpose of this study was to explore injury-related characteristics that differentiate between patient-reported outcomes (PROs) following traumatic musculoskeletal injury.

Methods: We reviewed English-language articles in PubMed/MEDLINE, Google Scholar, and the Cochrane Database of Systematic Reviews (January 1995 to September 2018). We included studies that compared patient-reported outcomes of musculoskeletal trauma based on injury characteristics, and excluded studies related to development or validation of outcome tools without implementation, measurement, or comparison.

Is the proximity of external fixator pins to eventual definitive fixation implants related to the risk of deep infection in the staged management of tibial pilon fractures?

Introduction: In the staged management of tibial pilon fractures, overlap between definitive internal fixation and external fixation pin sites has been investigated as a risk factor for infection with equivocal conclusions. Our aim was to determine if overlap or proximity of definitive internal fixation to external fixation pin sites influences the risk of deep infection.

Patients And Methods: We reviewed 280 AO/OTA 43B or 43C type distal tibia fractures in 277 patients at two level-one trauma centers.

Cross-Cultural Comparison of Postoperative Discharge Opioid Prescribing After Orthopaedic Trauma Surgery.

Background: The extent of variation in analgesic prescribing following musculoskeletal injury among countries and cultural contexts is poorly understood. Such an understanding can inform both domestic prescribing and future policy. The aim of our survey study was to evaluate how opioid prescribing by orthopaedic residents varies by geographic context.

Redesigning an International Orthopaedic CME Course: The Effects on Participant Engagement over 5 Years.

The time required to observe changes in participant evaluation of continuing medical education (CME) courses in surgical fields is unclear. We investigated the time required to observe changes in participant evaluation of an orthopaedic course after educational redesign using aggregate course-level data obtained from 1359 participants who attended one of 23 AO Davos Courses over a 5-year period between 2007 and 2011. Participants evaluated courses using two previously validated, 5-point Likert scales based on content and faculty performance, and we compared results between groups that underwent educational redesign incorporating serial needs assessment, problem-based learning, and faculty training initiatives (Masters Course), and those that did not (Non-Masters Course).

Blunt cerebrovascular injury: incidence and long-term follow-up.

Purpose: Blunt cerebrovascular injuries (BCVI), which can result in ischemic stroke, are identified in 1-2% of all blunt trauma patients. Computed tomography angiography (CTA) scanning has improved and is the diagnostic modality of choice in BCVI suspected patients. Data about long-term functional outcomes and the incidence of ischemic stroke after BCVI are limited.

Routine incorporation of longer-term patient-reported outcomes into a Dutch trauma registry.

Purpose: Routine collection of post-discharge patient-reported outcomes within trauma registries can be used to benchmark quality of trauma care. This process is dependent on geographic and cultural context, but results are lacking regarding the European experience. We aimed to investigate the feasibility of routine inclusion of longer-term patient-reported health-related quality of life (HRQoL) in a Dutch National Trauma Database (DNTD) and to characterize these outcomes in a prospective cohort study.

Functional outcomes of traumatic midfoot injuries.

Introduction: Midfoot injuries are rare injuries, often the result of high-energy trauma and occurring in the context of multiple trauma. This study aimed to evaluate functional outcomes and health-related quality of life after open reduction and internal fixation for midfoot injuries at a level 1 trauma center treating complex foot injuries.

Methods: Retrospective single level 1 center study with follow-up by questionnaire.

Severely injured patients benefit from in-house attending trauma surgeons.

Introduction: There is continuous drive to optimize healthcare for the most severely injured patients. Although still under debate, a possible measure is to provide 24/7 in-house (IH) coverage by trauma surgeons. The aim of this study was to compare process-related outcomes for severely injured patients before and after transition of attendance policy from an out-of-hospital (OH) on-call attending trauma surgeon to an in-house attending trauma surgeon.

Factors Influencing Functional Outcomes of Subtalar Fusion for Posttraumatic Arthritis After Calcaneal Fracture.

Background: Subtalar arthrodesis is a common salvage operation for posttraumatic subtalar arthritis. This study aimed to identify factors associated with functional outcomes and quality of life after subtalar fusion for posttraumatic subtalar arthritis after calcaneal fracture.

Methods: This is a retrospective study with follow-up by questionnaire in two level 1 trauma centers.

Foot fractures in polytrauma patients: Injury characteristics and timing of diagnosis.

Background: Due to prioritizing care and concomitant injuries, foot fractures in polytrauma patients often receive limited attention initially. However, as foot function is important, treatment and diagnosis of these fractures should be accurate. The aims of this study were to assess the incidence and distribution of foot fractures in polytrauma patients and to examine possible risk factors for delayed diagnosis of foot fractures.

Epidemiology of distal radius fractures in polytrauma patients and the influence of high traumatic energy transfer.

Introduction: For several extremity fractures differences in morphology, incidence rate and functional outcome were found when polytrauma patients were compared to patients with an isolated injury. This is not proven for distal radius fractures (DRF). Therefore, this study aimed to analyse fracture morphology in relation to energy transfer in both poly- and mono-trauma patients with a DRF.

Functional outcomes and quality of life in patients with subtalar arthrodesis for posttraumatic arthritis.

Introduction: Subtalar arthrodesis is a common salvage operation for posttraumatic subtalar arthritis, a condition frequently seen in patients who suffered major trauma. Functional outcomes in trauma patients may be influenced by concomitant injuries and the severity of the initial trauma. The aim of this study was to evaluate quality of life and functional outcomes of subtalar arthrodesis for posttraumatic arthritis in patients with severe or complex foot injuries.

Fractures and dislocations of the hand in polytrauma patients: Incidence, injury pattern and functional outcome.

Introduction: Injuries of the hand can cause significant functional impairment, diminished quality of life and delayed return to work. However, the incidence and functional outcome of hand injuries in polytrauma patients is currently unknown. The aim of this study was to determine the incidence, distribution and functional outcome of fractures and dislocation of the hand in polytrauma patients.

Metastasectomy, intralesional resection, or stabilization only in the treatment of bone metastases from renal cell carcinoma.

Background: The mainstay of treatment for bone metastases from renal cell carcinoma is surgery. We assessed if there was a difference in local recurrence, reoperation, and survival between patients who underwent metastasectomy, intralesional curettage, or stabilization only for renal cell carcinoma metastasis to the appendicular skeleton, and if there was a difference in these outcomes based on margin status.

Methods: This retrospective study included 183 patients; 48% underwent metastasectomy (n = 88, margins: 64 negative; 20 positive; 4 unclear), 30% intralesional curettage (n = 54), and 22% stabilization only (n = 41).