Lateral Tibial Plateau Reconstruction Using Tricortical Iliac Crest Autograft as the Weight-Bearing Surface.

https://ota.org/education/ota-online-resources/video-library-procedures-techniques/lateral-tibial-plateau.

Quadriceps muscle quality and quantity following tibial plateau fracture repair.

Purpose: To investigate the qualitative and quantitative changes seen in quadriceps muscles [QM] following tibial plateau fracture and surgery.

Methods: A consecutive series of patients with an isolated tibial plateau fracture presenting to a single academic center were enrolled and prospectively followed. Bilateral knee MRIs were performed preoperatively and 3 and 12 months postoperatively to assess quantity and quality of the quadriceps muscles.

Psychiatric Diagnosis Does Not Influence Management or Resolution of Confirmed Fracture-Related Infection.

Background: The purpose of this study was to determine if the presence of a standing Fifth Edition, psychiatric diagnosis is associated with worse outcomes for patients who develop a confirmed fracture-related infection (FRI).

Materials And Methods: Included patients had open or closed fractures managed with internal fixation and had confirmed FRIs. Baseline demographics, injury information, and outcomes were collected via chart review.

Pneumothorax After Superior Plating of Clavicle Fractures: Are the Concerns Warranted?

Purpose: The primary goal of this study was to determine the anatomic relationship between the clavicle and the apical lung segment. The secondary goal was to determine the incidence of pneumothorax (PTX) in patients who underwent clavicle ORIF to analyze the utility of postoperative chest radiographs.

Methods: Six hundred thirty-one patients with a midshaft clavicle fracture who underwent superior plating at a single institution were identified.

External fixation about the elbow: Indications and long-term outcomes.

Background: Operative management is often required for fractures of the elbow, with treatment goals aiming to restore stability, reduction, and early range of motion. The purpose of this study was to determine risk factors for necessitating the application of an external fixator, and to compare range of motion and functional outcomes between patients who required an elbow external fixator to those who did not.

Hypothesis: We hypothesize that patients who require an external fixator will have worse elbow range of motion and functional outcomes when compared to those who did not.

Thigh compartment syndrome: Outcomes in an urban level 1 trauma center.

Introduction: Thigh compartment syndrome (TCS) is a rare surgical emergency associated with a high risk of morbidity with mortality rates as high as 47 %. There is sparse literature discussing the management as well as outcomes of these injuries. The purpose of this study is to review a consecutive series of patients presenting to a single urban Level 1 trauma center with TCS to identify injury characteristics, clinical presentation, and outcomes associated with this injury.

The effect of traumatic head injuries on the outcome of middle-aged and geriatric orthopedic trauma patients.

Background: The purpose of this study is to characterize the effects of head injuries amongst the middle-aged and geriatric populations on hospital quality measures, costs, and outcomes in an orthopedic trauma setting.

Methods: Patients with head and orthopedic injuries aged >55 treated at an academic medical center from October 2014-April 2021 were reviewed for their Abbreviated Injury Score for Head and Neck (AIS-H), baseline demographics, injury characteristics, hospital quality measures and outcomes. Univariate comparative analyses were conducted across AIS-H groups with additional regression analyses controlling for confounding variables.

Is Postoperative Splinting Advantageous After Upper Extremity Fracture Surgery? Results From the Arm Splint Pain Improvement Research Experiment.

Objectives: The authors report no conflict of interest.To determine if short-term immobilization with a rigid long arm plaster elbow splint after surgery of the arm, elbow, or forearm results in superior outcomes compared with a soft dressing with early motion.

Design: Prospective Randomized Control Trial.

Early Weight-bearing Following Surgical Treatment of Ankle Fractures Without Trans-syndesmotic Fixation Is Safe and Improves Short-term Outcomes.

Objectives: The objective of this study was to ascertain outcome differences after fixation of unstable rotational ankle fractures allowed to weight-bear 2 weeks postoperatively compared with 6 weeks.

Design: Prospective case-control study.

Setting: Academic medical center; Level 1 trauma center.

Total Hip Arthroplasty is the Most Effective Treatment for Atraumatic Subchondral Insufficiency Fractures of the Femoral Head.

Background: Subchondral insufficiency fracture of the femoral head (SIFH) is a relatively newly used diagnosisfollowing an insidious onset of hip pain in individuals without apparent antecedent trauma. The aim of this study was to investigate the outcomes of a consecutive series of patients with SIFH treated at one institution.

Methods: A total of 93 patients aged 23 to 91 years who were treated for SIFH in the outpatient clinics at one academic, urban medical center between August 2012 and August 2019 were identified.

Factors Associated With the Development of a Confirmed Fracture-Related Infection.

Objectives: To identify factors associated with the development of fracture-related infection (FRI) in patients who have undergone operative fixation of their fracture.

Design: Retrospective study.

Setting: Academic medical center.

Posteromedial Surgical Approach for Fixation of Haraguchi Type 2B Posterior Malleolar Fracture.

A case of a 26-year-old man with a displaced medial malleolus fracture with extension into the posteromedial aspect of the posterior malleolus is presented. A CT scan of the ankle is obtained demonstrating a Haraguchi type 2B posterior malleolus fracture with a posteromedial and posterolateral fragment. The posteromedial fragment extends into the posterior colliculus of the medial malleolus and has a subchondral impaction fracture.

Acute Total Hip Replacement for Geriatric Acetabular Fracture: Anterior Intrapelvic Approach + Posterolateral Approach.

This review describes the indications and technique for acute total hip arthroplasty in an incomplete both-column acetabular fracture in a geriatric patient.

Monitored Anesthesia Care and Soft Tissue Infiltration with Local Anesthesia: An Anesthetic Option for High-Risk Patients with Hip Fractures.

This review demonstrates the technique for monitored anesthesia care and soft tissue infiltration with local anesthesia as the only form of anesthesia for short cephalomedullary nailing in medically complex patients. Monitored anesthesia care is defined as providing sedation and analgesia that is titrated to a level that preserves spontaneous breathing and airway reflexes. Soft tissue infiltration refers to soft tissue infiltration with local anesthesia directly into the surgical site and is performed by the surgeon before the start of the procedure.

Effects of Intraoperative Local Pain Cocktail Injections on Early Function and Patient-Reported Outcomes: A Randomized Controlled Trial.

Objective: To determine whether a perioperative pain cocktail injection improves postoperative pain, ambulation distance, and long-term outcomes in patients with hip fracture.

Design: Prospective, single-blinded, randomized controlled trial.

Setting: Academic Medical Center.

One year later: How outcomes of hip fractures treated during the "first wave" of the COVID-19 pandemic were affected.

The purpose of this study was to assess the impact of COVID-19 on long-term outcomes in the geriatric hip fracture population. We hypothesize that COVID + geriatric hip fracture patients had worse outcomes at 1-year follow-up. Between February and June 2020, 224 patients > 55 years old treated for a hip fracture were analyzed for demographics, COVID status on admission, hospital quality measures, 30- and 90-day readmission rates, 1-year functional outcomes (as measured by the EuroQol- 5 Dimension [EQ5D-3L] questionnaire), and inpatient, 30-day, and 1-year mortality rates with time to death.

COVID-19 vaccination improved outcomes in the treatment of geriatric hip fractures between December 2020 and January 2022.

Introduction: Geriatric hip fracture patients are at high risk for perioperative morbidity and mortality from COVID-19. This study analyses the impact of COVID-19 vaccination on geriatric hip fracture outcomes. We hypothesise that having the COVID-19 vaccine improves outcomes for geriatric patients treated for hip fracture.

Improving Cephalad Lag Screw Placement in the Femoral Head During Cephalomedullary Nailing Using a Novel Augmented Reality System.

Objectives: To measure the effect of a novel augmented reality software designed to aid in lag screw placement into the femoral head for cephalomedullary nails.

Design: Retrospective cohort study.

Setting: Single Level I trauma center.

Does mechanism of injury impact the outcome of operative fixation of geriatric proximal humerus fractures.

Background: The purpose of this study is to determine the effects of energy mechanism on outcomes following repair of proximal humerus fractures (PHF) in the middle aged and geriatric population.

Methods: Two hundred sixty-nine patients who presented to our academic medical center between 2006 and 2020, and underwent operative treatment of a proximal humerus fracture were prospectively enrolled in an IRB-approved database. Patients above 55 were divided into high energy (motor vehicle accident, pedestrian struck, or fall > 2 stairs) or low energy mechanisms (fall from standing or < 2 stairs).

Delayed Distraction Bone Block Arthrodesis for a Sanders IV Calcaneus Fracture Nonunion Using Tricortical Iliac Crest Allograft and Reamer/Irrigator/Aspirator Femoral Autograft.

We present the surgical technique for arthrodesis of the subtalar and calcaneocuboid joints of a Sanders type IV calcaneal fracture nonunion via a distraction bone block arthrodesis technique with tricortical iliac crest allograft combined with reamer/irrigator/aspirator autograft from the patient's femur. A lateral extensile approach to the calcaneus was used for the exposure, which allowed the surgeon to follow the stepwise complex surgical plan outlined here. Calcaneal nonunions are difficult to treat, but good outcomes can be achieved if proper technique with bone grafting is used.

Operative Repair of a Schatzker II Tibial Plateau Fracture Using a Combined Anterolateral and Posterolateral Approach Without Fibular Head Osteotomy.

We present the case of a 49-year-old male pedestrian struck by a car while cycling, sustaining a displaced anterolateral tibial plateau fracture and a large coronal plane fracture of the posterolateral plateau involving approximately one-third of the anterior posterior dimension of the articular surface. The posterolateral approach without a fibular osteotomy allows direct access to the posterolateral plateau and avoids complications associated with a fibular head osteotomy. The combined anterolateral and posterolateral approach to the proximal tibia without fibular osteotomy is a viable technique to achieve biomechanically sound fixation for lateral tibial plateau fractures that involve the anterolateral and posterolateral aspects of the tibial plateau.

Repair of a Femoral Head Fracture Dislocation With an Associated Posterior Wall Acetabular Fracture (Pipkin 4) via a Kocher-Langenbeck Approach.

A case of a 27-year-old man with a right-sided largely infra-foveal femoral head fracture dislocation with posterior wall acetabular fracture repaired via a Kocher-Langenbeck approach is presented. This is an atypical approach for fixation of the femoral head and acetabulum used because of the size and displacement of both the posterior wall fracture and the femoral head fracture. Indications for fixation of both the femoral head and the acetabulum include a displaced acetabular fracture with: (1) a fracture of the weight-bearing portion of the femoral head and/or (2) a fracture of the femoral head that engages the anterior or posterior wall.

Partial Articular Fracture of the Distal Radius Treated via Dorsal Approach.

The case of a 60-year-old woman with an impacted, dorsally unstable, displaced intra-articular distal radius fracture with dorsal sheer treated via a dorsal approach. Literature comparing dorsal to volar plating of the distal radius is mixed. Dorsal plating may lead to a greater incidence of implant removal, although radiographic and clinical outcomes seem to be similar.

Flexible Nailing of Pediatric Both Bone Forearm Fracture.

This is the case of a 12-year-old boy presented with a displaced radial and ulnar shaft fracture. Historically, these fractures were managed conservatively with closed reduction and cast immobilization; however, there has been an increasing trend toward operative fixation. Malalignment is an indication for operative fixation of pediatric both bone forearm fractures.