Myocardial Injury in Patients with Hip Fracture: A HIP ATTACK Randomized Trial Substudy.

Background: Myocardial injury after a hip fracture is common and has a poor prognosis. Patients with a hip fracture and myocardial injury may benefit from accelerated surgery to remove the physiological stress associated with the hip fracture. This study aimed to determine if accelerated surgery is superior to standard care in terms of the 90-day risk of death in patients with a hip fracture who presented with an elevated cardiac biomarker/enzyme measurement at hospital arrival.

Use of virtual reality for the management of phantom limb pain: a systematic review.

Purpose: To summarize the research on the effectiveness of virtual reality (VR) therapy for the management of phantom limb pain (PLP).

Methods: Three databases (SCOPUS, Ovid Embase, and Ovid MEDLINE) were searched for studies investigating the use of VR therapy for the treatment of PLP. Original research articles fulfilling the following criteria were included: (i) patients 18 years and older; (ii) all etiologies of amputation; (iii) any level of amputation; (iv) use of immersive VR as a treatment modality for PLP; (v) self-reported objective measures of PLP before and after at least one VR session; (vi) written in English.

Impact of preoperative echocardiography on surgical delays and outcomes among adults with hip fracture.

Aims: Echocardiography is commonly used in hip fracture patients to evaluate perioperative cardiac risk. However, echocardiography that delays surgical repair may be harmful. The objective of this study was to compare surgical wait times, mortality, length of stay (LOS), and healthcare costs for similar hip fracture patients evaluated with and without preoperative echocardiograms.

Delay in Flap Coverage Past 7 Days Increases Complications for Open Tibia Fractures: A Cohort Study of 140 North American Trauma Centers.

Objectives: To measure time to flap coverage after open tibia fractures and assess whether delays are associated with inpatient complications.

Design: Retrospective cohort study.

Setting: One forty level I and II trauma centers in Canada and the United States.

Medical Costs of Delayed Hip Fracture Surgery.

Background: Waiting for hip fracture surgery is associated with complications. The objective of this study was to determine whether waiting for hip fracture surgery is associated with health-care costs.

Methods: We conducted a population-based, propensity-matched cohort study of patients treated between 2009 and 2014 in Ontario, Canada.

Reporting and evaluating wait times for urgent hip fracture surgery in Ontario, Canada.

Background: Although a delay of 24 hours for hip fracture repair is associated with medical complications and costs, it is unknown how long patients wait for surgery for hip fracture. We describe novel methods for measuring exact urgent and emergent surgical wait times (in hours) and the factors that influence them.

Methods: Adults aged 45 years and older who underwent surgery for hip fracture (the most common urgently performed procedure) in Ontario, Canada, between 2009 and 2014 were eligible.

Association Between Wait Time and 30-Day Mortality in Adults Undergoing Hip Fracture Surgery.

Importance: Although wait times for hip fracture surgery have been linked to mortality and are being used as quality-of-care indicators worldwide, controversy exists about the duration of the wait that leads to complications.

Objective: To use population-based wait-time data to identify the optimal time window in which to conduct hip fracture surgery before the risk of complications increases.

Design, Setting, And Participants: Population-based, retrospective cohort study of adults undergoing hip fracture surgery between April 1, 2009, and March 31, 2014, at 72 hospitals in Ontario, Canada.

Timing of femoral shaft fracture fixation following major trauma: A retrospective cohort study of United States trauma centers.

Background: Femoral shaft fractures are common in major trauma. Early definitive fixation, within 24 hours, is feasible in most patients and is associated with improved outcomes. Nonetheless, variability might exist between trauma centers in timeliness of fixation.

Early Weightbearing and Range of Motion Versus Non-Weightbearing and Immobilization After Open Reduction and Internal Fixation of Unstable Ankle Fractures: A Randomized Controlled Trial.

Objectives: The aim of this study was to compare early weightbearing and range of motion (ROM) to nonweightbearing and immobilization in a cast after surgical fixation of unstable ankle fractures.

Design: Multicentre randomized controlled trial.

Setting: Two-level one trauma centers.

Intrathoracic Glenohumeral Dislocation without Fracture of the Humerus: A Case Report and Review of the Literature.

Case: A fifty-three-year-old man presented with an intrathoracic glenohumeral dislocation (ITGHD) and associated hemothorax, rib fracture, massive rotator cuff tear, and axillary nerve palsy following an ice hockey injury. Treatment consisted of closed reduction and staged open rotator cuff repair. Despite a substantial injury, the patient recovered nearly normal use of the arm two years postoperatively.

Forearm compartment syndrome as a result of eosinophilic fasciitis: case report.

Eosinophilic fasciitis is an uncommon scleroderma-like connective tissue disease, usually characterized by symmetrical and painful swelling and induration of the skin and thickened fascia infiltrated with lymphocytes and eosinophils. A middle-aged woman with follicular lymphoma being treated with chemotherapy presented with acute onset atraumatic forearm swelling and severe pain. The history, physical examination, and pressure measurements were consistent with compartment syndrome.

Delayed wound closure increases deep-infection rate associated with lower-grade open fractures: a propensity-matched cohort study.

Background: Primary closure of skin wounds after debridement of open fractures is controversial. The purpose of the present study was to determine whether primary skin closure for grade-IIIA or lower-grade open extremity fractures is associated with a lower deep-infection rate.

Methods: We identified 349 Gustilo-Anderson grade-I, II, or IIIA fractures treated at our level-I academic trauma center from 2003 to 2007.

The osteoporotic acetabular fracture.

Fractures of the acetabulum are some of the most challenging fractures that face orthopedic surgeons. In geriatric patients, these challenges are enhanced by the complexity of fracture patterns, the poor biomechanical characteristics of osteoporotic bone, and the comorbidities present in this population. Nonsurgical management is preferable when the fracture is stable enough to allow mobilization, and healing in a functional position can be expected.

Mortality and complications following stabilization of femoral metastatic lesions: a population-based study of regional variation and outcome.

BACKGROUND: It is considered that patients at risk for spontaneous fracture due to metastatic lesions should undergo surgical stabilization before fracture occurs; however, prophylactic stabilization is associated with surgical morbidity and mortality. We sought to compare pathological fracture fixation versus prophylactic stabilization of diaphyseal femoral lesions for patients with femoral metastases and assess the rate of prophylactic surgery completed in all regions of Ontario. METHODS: Using population data sets, we identified all patients who had undergone femoral stabilization, either for pathological femoral fractures or for prophylactic fixation of femoral metastases before pathological fractures, between 1992 and 1997 in Ontario.

Clinical accuracy of imaging techniques for talar neck malunion.

Objectives: To compare the ability of plain radiographs, computed tomography (CT), and radiostereometric analysis (RSA) to detect changes in talus fracture fragment position and alignment using an in vitro model.

Methods: Eight cadaveric tali were osteotomized at the talar neck. RSA beads were inserted into each talar fragment.

Intraoperative diagnosis of syndesmosis injuries in external rotation ankle fractures.

Objective: This study was designed to compare intraoperative fluoroscopic stress testing, static radiographs, and biomechanical criteria for the diagnosis of distal tibiofibular syndesmotic instability associated with external rotation type ankle fractures.

Design: Prospective, consecutive series.

Setting: Academic level 1 trauma center.

Press-fit versus cemented all-polyethylene patellar component: midterm results.

This study compared the midterm results between press-fit and cemented implantation of a highly congruent, all-polyethylene patellar component. We followed prospectively 172 implants (cemented, n = 133; press-fit, n = 39). Average follow up was 6 years (range, 5-8 years).