A novel technique for the fixation of inter-trochantieric hip fractures: A telescoping lag screw.

One-hundred and three patients with intertrochanteric hip fractures as classified by the OTA 2007 system underwent fixation using the telescoping AOS Galileo lag screw system and ES Nail (a long IM nail). Thirty-one patients (76%) were female and ten (24%) were male, with an average age of 75.70 ± 11.

Complete blood count before and after total hip or knee arthroplasty.

Purpose: To validate our transfusion protocol based on pre- and post-operative complete blood count (CBC) data in patients undergoing primary total hip or knee arthroplasty (THA or TKA).

Methods: Records of 113 men and 205 women aged 32 to 94 (mean, 70) years who underwent primary uncemented THA (n=123) or cemented TKA (n=195) for osteoarthritis by 2 senior surgeons were reviewed. A post-surgical drain was used in 29 THA patients and 74 TKA patients, based on the surgeon's preference.

Recurrent patellar tendon rupture in a patient after intramedullary nailing of the tibia: reconstruction using an Achilles tendon allograft.

Various complications after intramedullary (IM) nailing of the tibia have been reported, the most common of which are anterior knee pain and symptoms similar to patella tendonitis. Complete rupture of the patellar tendon after IM nailing of the tibia has been reported on 2 occasions, in conjunction with predisposing patient factors, such as systemic disease or a proud tibial nail. Patellar tendon ruptures are disabling injuries that can be technically difficult to repair because of the poor quality of remaining tendon tissue, quadriceps muscle atrophy and/or contracture, and scar-tissue formation.

Biomechanical comparison of long, short, and extended-short nail construct for femoral intertrochanteric fractures.

Objectives: Short and long cephalomedullary (CM) nails are commonly used construct for fixation of intertrochanteric (IT) fractures. Each of these constructs has its advantages and its shortcomings. The extended-short (ES) CM nail offers a hybrid between long and short nail design that aims to combine their respective benefits.

The extended-short nail system, a novel concept in the management of proximal femur fractures.

In light of recent health care reform and the aging US Medicare population, it is becoming increasingly important for orthopedic surgeons to use effective and efficient strategies for hip fracture surgery. The Extended-Short Nail System (ES nail) is a US Food and Drug Administration-approved titanium nail which is locked at the same location as the locking hole of a short intramedullary (IM) nail. The ES nail takes advantage of an "extended-short" hybrid design combining the mechanical characteristics of a long IM nail with the surgical ease of use offered with a short IM nail.

Nontraumatic, spontaneous dislocation of polyethylene tibial insert 1 year after TKA.

The authors report a case of nontraumatic, spontaneous dislocation of a polyethylene insert detected 1 year after total knee arthroplasty. The patient demonstrated initial improvement and returned to work 4 months postoperatively. At 6 months postoperatively, the patient developed pain and a clunking sensation with motion; however, he denied any traumatic precipitating events.

Extensor mechanism repair failure with use of bidirectional barbed suture in total knee arthroplasty.

Total knee arthroplasty (TKA) continues to advance as innovative devices become available. #2 PDO Quill SRS (Angiotech, Reading, Pa) bidirectional barbed suture was used for 161 primary TKAs at our facility. We report on 3 separate cases of extensor mechanism repair failure after primary TKA in which a barbed suture was used for extensor mechanism closure.

Bilateral femoral neck stress fractures in a fire academy student.

Unilateral femoral neck stress fractures are well documented in active patients; however, the risk of a subsequent contralateral stress fracture remains unknown in patients who continue to be active. This article describes a 24-year-old male fire academy student who sustained a left femoral neck stress fracture, followed approximately 11 months later by a right femoral neck stress fracture, both of which went on to completely displace. A review of the index radiographs of each hip from outside institutions revealed femoral neck stress fractures that went undiagnosed until they displaced.

Sequential compression device may cause peroneal nerve palsy.

This article presents 2 cases of foot drop after joint replacement surgery that presented after sequential compression device application. In both cases, intact peroneal nerve function was documented by the surgeon in the recovery room prior to sequential compression device application. We believe that excessive pressure over the superficial aspect of the peroneal nerve in conjunction with decreased pain stimulus from analgesia may have contributed to these complications.

Impact of MRI on treatment plan and fracture classification of tibial plateau fractures.

Objective: To evaluate the interobserver agreement for both treatment plan and fracture classification of tibial plateau fractures using plain radiographs, computed tomography (CT) scan, and magnetic resonance imaging (MRI).

Design: Prospective study to assess the impact of an advanced radiographic study on the agreement of treatment plan and fracture classification of tibial plateau fractures among three orthopaedic surgeons.

Setting/participants: Patients presenting with tibial plateau fractures to a level I trauma center were evaluated with plain knee radiographs (anteroposterior, lateral, two oblique views), CT scan, and MRI.