A Simple Method of Measuring the Distance From the Schöttle Point to the Medial Distal Femoral Physis With MRI.

Background: Medial patellofemoral ligament (MPFL) reconstruction is the treatment of choice for recurrent patellar instability in the skeletally immature patient. Avoiding the open physes during anatomic MPFL reconstruction is a challenge in this population.

Purpose: To describe a novel method using magnetic resonance imaging (MRI) to determine the distance from the Schöttle point to the medial distal femoral physis among skeletally immature individuals with patellar instability.

Medial patellofemoral ligament (MPFL) reconstruction technique using an epiphyseal femoral socket with fluoroscopic guidance helps avoid physeal injury in skeletally immature patients.

Purpose: The purpose of this study was to assess the physeal safety associated with the use of an epiphyseal femoral socket for paediatric medial patellofemoral ligament (MPFL) reconstruction.

Methods: Fifty-four knees in 49 skeletally immature patients underwent physeal-sparing MPFL reconstruction performed by 1 surgeon at a tertiary care academic medical centre from 2007 to 2016. A femoral socket distal to the femoral physis was used for graft fixation in all the patients.

Return to Sport and Reoperation Rates in Patients Under the Age of 20 After Primary Anterior Cruciate Ligament Reconstruction: Risk Profile Comparing 3 Patient Groups Predicated Upon Skeletal Age.

Background: With sports specialization and level of competition on the rise, anterior cruciate ligament reconstruction (ACLR) in athletes under the age of 20 has increased significantly in recent years. Reports have demonstrated that the revision ACLR rate is higher and return to sport (RTS) rate is lower in this population.

Purpose: To evaluate the 2-year clinical outcomes of 3 cohorts of primary ACLR in pediatric and adolescent athletes under the age of 20 based on skeletal age with a focus on RTS and the incidence of second surgery.

Complications After Pelvic Arteriography in Patients With Pelvic Ring Disruptions.

Introduction: Pelvic angiography with transcatheter arterial embolization (TAE) is an established intervention for management of pelvic arterial hemorrhage. This study analyzes complication rates after angiography among patients with pelvic trauma treated in the context of a multidisciplinary institutional pelvic fracture protocol.

Methods: Retrospective analysis of prospectively collected data was conducted.

Distal Femoral Valgus and Recurrent Traumatic Patellar Instability: Is an Isolated Varus Producing Distal Femoral Osteotomy a Treatment Option?

Background: Genu valgum, a risk factor for recurrent patellofemoral instability, can be addressed with a varus producing distal femoral osteotomy (DFO). The purpose of this study is to report 3-year clinical and radiographic outcomes on a series of skeletally mature adolescents with traumatic patellofemoral instability and genu valgum who underwent a varus producing DFO.

Methods: Consecutive patients (n=11) who underwent an isolated DFO for recurrent traumatic patellar instability over a 4-year study period (2009 to 2012) were reviewed.

Redefining Optimal Nail to Medullary Canal Diameter Ratio in Stainless Steel Flexible Intramedullary Nailing of Pediatric Femur Fractures.

Purpose: The ideal canal fill for flexible intramedullary fixation of pediatric femoral shaft fractures is considered to be 80% based upon relatively few clinical studies. The purpose of this study is to assess the relationship between the summed nail to intramedullary canal diameter (ND/MCD) ratio and alignment at radiographic union following flexible intramedullary nailing (FIMN) of pediatric femoral shaft fractures.

Methods: An Internal Review Board approved, retrospective review of a consecutive series of patients who sustained a femoral shaft fracture treated by retrograde, stainless steel FIMN was performed at a single level 1 pediatric trauma center from 2005 to 2012.

Biomechanical Analysis of Retrograde Flexible Intramedullary Nail Constructs in a Simulated Pediatric Femur Fracture Model.

Background: Various flexible intramedullary nail (FIMN) constructs for pediatric femur fractures are described; however, no biomechanical study has compared stability of medial-lateral entry versus all-lateral entry retrograde nailing. Our purpose is to compare the rotational and bending stiffness of 2 different FIMN constructs and 2 different materials in a simulated pediatric femur fracture model.

Methods: Eighty adolescent-sized composite femurs were used to simulate transverse (40 femurs) and oblique (40 femurs) mid-diaphyseal fractures.

Flexible Intramedullary Nails for Femur Fractures in Pediatric Patients Heavier Than 100 Pounds.

Background: Flexible intramedullary nailing (FIMN) of femoral shaft fractures in children >100 pounds remains controversial. The purpose of this study is to assess the relationship between patient weight and alignment at radiographic union following Ender's FIMN of pediatric femoral shaft fractures.

Methods: An IRB approved, retrospective review of all patients who sustained a femoral shaft fracture treated by retrograde, stainless-steel Ender's FIMN was performed at a level 1 pediatric trauma center from 2005 to 2012.

Toward a More Robust Prediction of Pulmonary Embolism in Trauma Patients: A Risk Assessment Model Based on 38,000 Patients.

Objectives: Pulmonary embolism (PE) is a rare but sometimes fatal complication of trauma. Risk stratification models identify patients at increased risk of PE; however, they are often complex and difficult to use. This research aims to develop a model, based on a large sample of trauma patients, which can be easily and quickly used at the time of admission to predict PE.

Lack of Acute Hand Care in the Southwest United States.

Objectives: To describe the epidemiology of acute hand injuries and hand infections and to describe the factors associated with the transfer of these patients to a level 1 trauma center. In addition, we sought to understand management before transfer.

Design: Retrospective review of patients with hand trauma or hand infection transferred to our level 1 trauma center from May 2009 to August 2011.

Two Techniques for Retrograde Flexible Intramedullary Fixation of Pediatric Femur Fractures: All-Lateral Entry Versus Medial and Lateral Entry Point.

Background: Multiple techniques for flexible intramedullary nailing (FIMN) of pediatric femur fractures have been described. To our knowledge, no study has compared combined medial-lateral (ML) entry versus all-lateral (AL) entry retrograde nailing. This study compares surgical outcomes, radiographic outcomes, and complication rates between these 2 techniques.

Improved Survival After Pelvic Fracture: 13-Year Experience at a Single Trauma Center Using a Multidisciplinary Institutional Protocol.

Objectives: To analyze pelvic fracture mortality rates before and after initiation of a multidisciplinary pelvic fracture protocol.

Design: Retrospective database analysis.

Setting: Prospective data from our Level-I National Trauma Registry of The American College of Surgeons (NTRACS) database.

Lengthening in Congenital Femoral Deficiency: A Comparison of Circular External Fixation and a Motorized Intramedullary Nail.

Background: Circular external fixation for limb-lengthening is associated with frequent and numerous complications. Intramedullary lengthening devices represent a potential advance in limb-lengthening. The purpose of this study was to compare the outcomes of femoral lengthening in pediatric patients treated by either circular external fixation or a motorized intramedullary nail.