Screw Apophysiodesis for Chronic Ischial Apophysitis Refractory to Apophyseal Drilling in a Teenage Athlete: A Case Report.

Case: A 17-year-old elite male soccer player, initially treated for chronic ischial apophysitis with transapophyseal drilling 18 months before, presented with persistent apophysitis symptoms and unfused apophysis on imaging. An open screw apophysiodesis was performed. The patient was able to gradually return to play and, within 8 months, was competing symptom-free at a high-level soccer academy.

Impact of Hospital-Employed Physician Assistants on a Level II Community-Based Orthopaedic Trauma System.

Objectives: The American Academy of Orthopedic Surgeons and the Orthopedic Trauma Association have released guidelines for the provision of orthopedic trauma services such as adequate stipends, designated operating rooms, ancillary staff, and guaranteed reimbursement for indigent care. One recommendation included a provision for hospital-based physician assistants (PAs). Given current reimbursement arrangements, PA collections for billable services may not meet their salary and benefit expenses.

Operating Room Efficiency: Benefits of an Orthopaedic Traumatologist at a Level II Trauma Center.

Objectives: Fellowship-trained orthopaedic traumatologists are presumably taught skill sets leading to "best practice" outcomes and more efficient use of hospital resources. This should result in more favorable economic opportunities when compared with general orthopaedic surgeons (GOSs) providing similar clinical services. The purpose of our study was to compare the operating room utilization and financial data of traumatologists versus GOSs at a level II trauma center.

Risk factors for the development of heterotopic ossification after acetabular fracture fixation.

Background: Heterotopic ossification (HO) is a common complication of the operative treatment of acetabular fractures. Although the surgical approach has been shown to correlate with the development of ectopic bone, specific risk factors have not been elucidated.

Questions/purposes: The purposes of this study were to determine specific risk factors associated with the development of severe HO and the frequency with which patients develop severe HO after acetabular fracture fixation through an isolated Kocher-Langenbeck approach.

Operating room efficiency: benefits of an orthopaedic traumatologist at a level II trauma center.

Objectives: Fellowship-trained orthopaedic traumatologists are presumably taught skill sets leading to "best practice" outcomes and more efficient use of hospital resources. This should result in more favorable economic opportunities when compared with general orthopaedic surgeons (GOSs) providing similar clinical services. The purpose of our study was to compare the operating room utilization and financial data of traumatologists versus GOSs at a level II trauma center.

Why veteran orthopaedic trauma surgeons are being fired and what we can do about it?

The financial realities of providing trauma care to injured patients can make it difficult to produce an accurate assessment of the cumulative value orthopaedic trauma surgeons provide to healthcare and university institutions. As with many political battles in the field of medicine, physicians who have been diligently focused on providing patient care were completely unaware of the impending upheaval around them. Whether orthopaedic trauma surgeons are employed or in some type of partnership with hospitals, too often surgeons find the relationship one-sided.

Clinical and financial comparison of operative and nonoperative treatment of displaced clavicle fractures.

Hypothesis: Surgical stabilization of displaced clavicle fractures was once considered to have rare indications. Our purpose was to present the clinical and economic effects of surgical management using data collected from operative and nonoperative patients.

Methods: Our fracture database was queried from January 1, 2005, to January 1, 2010, identifying 204 patients with displaced midclavicular fractures.

Early surgical stabilization of flail chest with locked plate fixation.

Objectives: To compare the results of surgical stabilization with locked plating to nonoperative care of flail chest injuries.

Design: Retrospective case-control study.

Setting: Level II trauma center.

Financial impact of a dedicated orthopaedic traumatologist on a private group practice.

Objective: The purpose of the study was to demonstrate the financial impact of the addition of a dedicated orthopaedic traumatologist to a private group practice at a Level II community-based trauma system.

Design: Retrospective review of financial records.

Setting: Level II trauma center and large group practice.

Scedosporium prolificans osteomyelitis in an immunocompetent child treated with a novel agent, hexadecylphospocholine (miltefosine), in combination with terbinafine and voriconazole: a case report.

We describe an 8-year-old girl who sustained multiple compound fractures in an accident involving agricultural equipment. She developed Scedosporium prolificans osteomyelitis of the pelvis, septic arthritis of the hip, and myositis of adjacent muscles. The infection progressed, despite extensive surgical debridement and joint washouts with 0.

Frequency and fracture morphology of the posteromedial fragment in bicondylar tibial plateau fracture patterns.

Objectives: Bicondylar tibial plateau fracture management remains therapeutically challenging, partly because of multiplanar articular comminution. This study was performed to evaluate the frequency and morphologic characteristics of the posteromedial fragment in this injury pattern.

Design: Retrospective chart and radiographic review.