External Validation of the Radiographic Investigation of the Distal Extension of Fractures Into the Articular Surface of the Tibia (RIDEFAST Study).

Objective: To test the external validity of the fracture to plafond (FTP-length of fracture/distance to plafond) ratio to rule out distal intra-articular fractures (DIA) in distal tibial shaft fractures at an independent tertiary trauma center.

Design: Retrospective cohort study.

Setting: Two Level 1 trauma centers.

Novel Treatment for Recurrent Posttraumatic Hip Instability: A Case Report.

Case: A 26-year-old woman sustained a traumatic right hip dislocation with posterior wall component in a motor vehicle collision. Initial treatment consisted of open reduction internal fixation of her posterior wall fracture. Six years later, she developed low-energy recurrent hip instability.

"Jelly VAC" for Negative-Pressure Therapy for Complex Wound Closure: A Report of Two Cases.

Case: A 35-year-old man sustained an open calcaneal fracture with bone loss, and a 57-year-old woman sustained an avulsion of the entirety of the plantar skin. Both patients were treated with multiple debridements and soft-tissue coverage. "Jelly-VAC" (vacuum-assisted closure) therapy was used after each debridement and during the soft-tissue coverage.

Patient Mortality in Geriatric Distal Femur Fractures.

Objectives: To estimate 1-year mortality rates in elderly patients who undergo operative treatment for distal femur fractures and identify potential risk factors for mortality.

Design: Retrospective chart review.

Setting: Level 1 and Level 2 trauma centers.

Intraosseous Plating for the Management of Cortical Defects.

The management of fractures with segmental bone loss or abundant comminution on the far cortex is often complicated by deformity or frank hardware failure. Using plate constructs that rely on off-axis loading may not be sufficient to support the limb until healing occurs. There are a number of techniques to mitigate this problem, notably the use of intramedullary nails and bicolumnar plating of the fracture.

Inpatient soft tissue protocol and wound complications in calcaneus fractures.

Background: Operative treatment of calcaneus fractures is associated with the risk of early wound complications. Though accepted practice dictates surgery should be delayed until soft tissues recover from the initial traumatic insult, optimal timing of surgery has not been delineated.

Methods: A retrospective chart and radiographic review at a level I trauma center was performed to determine if an aggressive inpatient soft tissue management protocol designed to decrease the time delay from injury to surgery is effective at reducing complications.

Normal tibiofibular relationships at the syndesmosis on axial CT imaging.

Objectives: Computed tomography (CT) is reported to be superior to plain radiography for imaging the syndesmosis, but CT criteria differentiating normal from abnormal tibiofibular relationships do not exist. The purpose of this study was to define normal tibiofibular relationships at the syndesmosis on axial CT imaging and to report the reliability of these measurements.

Methods: Thirty healthy volunteers underwent CT evaluation of bilateral ankles.

Treatment of large segmental bone defects with reamer-irrigator-aspirator bone graft: technique and case series.

Treatment of large segmental defects using conventional autogenous iliac crest bone graft can be limited by volume of cancellous bone and donor site morbidity. The reamer-irrigator-aspirator (RIA) technique allows access to a large volume of cancellous bone graft containing growth factors with potency equal to or greater than autograft material from the iliac crest. The purpose of this study was to evaluate the effectiveness of RIA-harvested autogenous bone graft for treating large segmental defects of long bones.

An alternative source of autograft bone for spinal fusion: the femur: technical case report.

Objective: Autograft bone obtained from the iliac crest remains the "gold standard" for spinal fusion. For various reasons, including previous harvesting or pelvic dysmorphism, the iliac crest bone graft may not be available to the spinal surgeon. We present a novel use of a common orthopedic procedure, intramedullary reaming, for obtaining autograft for revision spinal fusion.

Comparison of plate and screw fixation and screw fixation alone in a comminuted talar neck fracture model.

Background: Talar neck fracture fixation has been studied in noncomminuted fracture models, but no large clinical series of comminuted fracture patterns have been published and no biomechanical studies have compared plate fixation with screw fixation in comminuted talar neck fractures.

Methods: Nine matched pairs of fresh frozen talar specimens were stripped of soft tissue and mounted in a cylindrical jig. The talar neck was fractured using a dorsally directed shear force at a rate of 200 mm/min, and dorsal comminution was simulated by removing a 2-mm section of bone from the distal fracture fragment.