Diagnosing posterior tibial tendon tear with dynamic ultrasound following tibial intramedullary nailing.

Complications following tibial intramedullary nailing include anterior knee pain, malunion, nonunion, and symptomatic/prominent interlocking screws. We report a case of a posterior tibial tendon tear caused by placement of a distal interlocking screw which was detected via dynamic ultrasound. This is a rare and possibly underreported complication which could be the cause of persistent medial sided ankle pain following locked tibial nail placement.

Cost Determinants in the 90-Day Management of Isolated Ankle Fractures at a Large Urban Academic Hospital.

Objectives: To determine the independent risk factors associated with increasing costs and unplanned hospital readmissions in the 90-day episode of care (EOC) for isolated operative ankle fractures at our institution.

Design: Retrospective cohort study.

Setting: Level I Trauma Center.

Placing femoral intramedullary nails in severely bowed femurs.

The authors describe a novel technique of anterograde femoral intramedullary nail fixation for hip fracture using the starting guide pin as a blocking screw. This cost-effective technique uses fluoroscopic radiography to ensure the guidewire is within the posterior aspect of the femur on a lateral view, thereby minimizing the risk of anterior cortical femoral fractures.

Percutaneous column fixation and total hip arthroplasty for the treatment of acute acetabular fracture in the elderly.

We used our database of primary total hip arthroplasties to identify those patients who had acetabular fractures fixed with percutaneous screws under the same anesthesia as for the arthroplasty procedure. There were 19 patients with the average follow-up of 22 months. Fourteen patients sustained the fracture secondary to a low-energy trauma, while the remaining patients were involved in a high-energy trauma accident.

Incidence of orthopedic surgery intervention in a level I urban trauma center with motorcycle trauma.

Background: This study summarizes orthopedic injuries sustained in motorcycle collisions in patients presenting to a Level I trauma center.

Methods: We performed a retrospective review of orthopedic injuries in motorcycle trauma victims brought into the emergency department. Of 2,634 presenting cases, 151 were identified as involving motorcycle collisions.

Pelvic fractures in professional cyclists: a report of 3 cases.

Background: Professional riders demonstrate increased risk factors for such injuries including both extensive time on the bike in addition to a possible underlying osteopenia secondary to the nonimpact nature of the sport.

Hypothesis: Nonoperative management of stable, nondisplaced pelvic fractures in professional cyclists offers excellent results.

Study Design: Case series.

Surgical outcomes after traumatic open knee dislocation.

The purpose of this study is to describe the types of injuries and surgical treatments associated with open knee dislocations and to present the functional outcomes of these patients. Between 2001 and 2005, the medical records of patients that sustained traumatic open knee dislocations at our Level 1 Trauma Center were retrospectively reviewed. Initial surgical intervention was performed in all patients including placement of spanning external fixator, repair of vascular injuries if necessary, and irrigation and debridement of the open wounds.

Percutaneous fixation of the medial condyle in bicondylar tibial plateau fractures: novel use of the 3.5-mm medial distal tibia plate.

Internal fixation for fractures involving the medial tibial plateau is a controversial topic. Surgical options include buttress plating with antiglide plate, T-shaped proximal tibia plates, external fixation, and isolated screw fixation. Operative management is often complicated by soft-tissue concerns.