Publications by authors named "Tornetta P"
Importance: Fracture-related infection (FRI) is a serious complication following fracture fixation surgery. Current treatment of FRIs entails debridement and 6 weeks of intravenous (IV) antibiotics. Lab data and retrospective clinical studies support use of oral antibiotics, which are less expensive and may have fewer complications than IV antibiotics.
View Article and Find Full Text PDFLow Rate of Teriparatide Supplementation for the Treatment of Osteoporotic Pelvic Fractures in Elderly Females.
Geriatr Orthop Surg Rehabil
November 2024
Article Synopsis
- - This study investigates the initiation rates of Teriparatide, a medication that can help older women with osteoporotic pelvic fractures, at a hospital, noting a significant gap where 93% of eligible patients did not receive it.
- - Researchers conducted a chart review of 118 elderly female patients with stable lateral compression pelvic fractures, finding that only a small percentage were evaluated for or prescribed Teriparatide despite its documented benefits.
- - The study highlights that while orthopedic services recommended Teriparatide in all cases, the actual initiation of treatment was low due to insufficient evaluations and insurance barriers, emphasizing the need for improved actions in managing these injuries.
Diversity on the American Academy of Orthopaedic Surgeons National Meeting Podium: Changes Over Two Decades.
J Am Acad Orthop Surg
September 2024
Background: There has been an increase in diversity initiatives regarding selecting speakers for the American Academy of Orthopaedic Surgeons (AAOS) annual meeting and courses. The purpose of this study was to determine the percentage of female or underrepresented minority (URM) speakers for instructional course lectures (ICLs) and AAOS courses over the past 2 decades including a surrogate for expertise.
Methods: For 2002, 2012, and 2022, the academic and demographic information of speakers and the number of publications at the time of their speaking role were obtained and compared by sex and URM status.
Objectives: To study the results of displaced femoral neck fractures (FNFs) in adults less than 60 years of age by comparing patients, injury, treatment, and the characteristics of treatment failure specifically according to patients' age at injury, that is, by their "decade of life" [ie, "under 30" (29 years and younger), "the 30s" (30-39 years), "the 40s" (40-49 years), and "the 50s" (50-59 years)].
Design: Multicenter retrospective comparative cohort series.
Setting: Twenty-six North American Level 1 Trauma Centers.
Objectives: The objective of this study was to determine the difference in failure rates of surgical repair for displaced femoral neck fractures in patients younger than 60 years of age according to fixation strategy.
Design: This is a retrospective, comparative cohort study.
Setting: Twenty-six Level 1 North American trauma centers.
Background: The Short Musculoskeletal Function Assessment (SMFA) is a well validated, widely used patient-reported outcome (PRO) measure for orthopaedic patients. Despite its widespread use and acceptance, this measure does not have an agreed upon minimal clinically important difference (MCID). The purpose of the present study was to create distributional MCIDs with use of a large cohort of research participants with severe lower extremity fractures.
View Article and Find Full Text PDFObjectives: The goal of this trial was to determine whether coronal plane angulation affects functional and clinical outcomes after the fixation of distal femur fractures.
Design: Multicenter, randomized controlled trial SETTING: 20 academic trauma centers PATIENTS/PARTICIPANTS: 156 patients with distal femur fractures were enrolled. 123 patients were followed 12 months.
Objectives: The objective of this study was to compare the biomechanical properties of locked and nonlocked diaphyseal fixation in a model of distal femur fractures using osteoporotic and nonosteoporotic human cadaveric bone.
Methods: A supracondylar osteotomy was created to mimic a fracture (OTA/AO 33A3) in osteoporotic (n = 4) and nonosteoporotic (n = 5) cadaveric distal femurs. The left and right femurs of each pair were instrumented with a distal femoral locking plate and randomly assigned to have diaphyseal fixation with either locked or nonlocked screws.
Objectives: To evaluate the timing of definitive fixation of tibial plateau fractures relative to fasciotomy closure with regard to alignment and articular reduction.
Design: Retrospective case series.
Setting: Four Level I trauma centers.
Article Synopsis
- The study evaluated the statistical stability of outcomes from randomized controlled trials (RCTs) focusing on the management of femoral neck fractures, using metrics like fragility index (FI), reverse fragility index (rFI), and fragility quotient (FQ).
- After screening 985 articles, 71 studies were analyzed, revealing a median FI of 4, indicating that a small number of event reversals could change the statistical significance of findings.
- The results suggest that many outcomes in these RCTs are fragile, prompting the authors to recommend standardized reporting of P-values to improve the reliability of the data.
Hip Fracture Repair by the Post-Call Surgeon: A Multicenter Retrospective Review.
J Am Acad Orthop Surg Glob Res Rev
February 2024
Introduction: The purpose of this study was to evaluate surgeons' ability to perform or supervise a standard operation with agreed-upon radiologic parameters after being on call.
Methods: We reviewed a consecutive series of patients with intertrochanteric hip fractures treated with a fixed angle device at 9 centers and compared corrected tip-apex distance and reduction quality for post-call surgeons versus those who were not. Subgroup analyses included surgeons who operated the night before versus not and attending-only versus resident involved cases.
Article Synopsis
- The study explores the use of machine-learning prediction models in orthopaedic trauma, aiming to provide an overview, review reporting practices using the TRIPOD statement, and assess bias with the PROBAST tool.
- Out of 3,252 studies screened, 45 ML models were identified, with most focusing on hip fractures, and common outcomes being mortality and length of hospital stay.
- Findings reveal that while many models exist, they often have poor transparency in reporting (62% completeness) and a high risk of bias, primarily due to small sample sizes and inadequate analysis methods.
Objectives: To compare clinical and radiographic outcomes after retrograde intramedullary nailing (rIMN) versus locked plating (LP) of "extreme distal" periprosthetic femur fractures, defined as those that contact or extend distal to the anterior flange.
Design: Retrospective review.
Setting: Eight academic level I trauma centers.
Objective: To identify patient, injury, and treatment factors associated with the development of avascular necrosis (AVN) after talar fractures, with particular interest in modifiable factors.
Design: Retrospective chart review.
Setting: 21 US trauma centers and 1 UK trauma center.
Introduction: The purpose of this study was to utilize the fragility index to assess the robustness of randomized controlled trials (RCTs) evaluating the management of calcaneus fractures. We hypothesize that the dichotomous outcomes in calcaneus fracture literature will be statistically fragile and comparable to other orthopedic specialties.
Methods: We performed a PubMed search for calcaneus fracture RCTs from 2000 to 2022 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
Background: Patients with a tibial shaft fracture experiencing their first postoperative complication following treatment with intramedullary nails may be at greater risk of subsequent complications than the whole population. We aimed to determine whether the initial method of nail insertion influences outcome in patients with a tibial shaft fracture requiring multiple reoperations.
Methods: Using the Study to Prospectively Evaluate Reamed Intramedullary Nails in Tibial Shaft Fractures trial data, we categorized patients as those not requiring reoperation, those requiring a single reoperation and those requiring multiple reoperations, and we compared them by nail insertion technique (reamed v.
Objectives: To evaluate the effect of translation on a large series of low-energy proximal humerus fractures initially treated nonoperatively.
Design: Retrospective multicenter analysis.
Setting: Five level-one trauma centers.
Article Synopsis
- The study aimed to assess the statistical fragility of research on distal fibular fractures by using the fragility index (FI) and fragility quotient (FQ).
- Researchers searched through clinical trials from 2000 to 2022 and analyzed 23 relevant studies, focusing on significant and non-significant outcomes to calculate FI and FQ values.
- Findings suggest that the reliability of randomized controlled trials in this area may be overstated, as relying solely on p-values can be misleading; the study advocates for better reporting standards to enhance clinical interpretation of results.
Background: Trochlear dysplasia is a known risk factor for patellar instability. Multiple radiographic measurements exist to assess trochlear morphology, but the optimal measurement technique and threshold for instability are unknown.
Purpose: To describe the optimal measurements and thresholds for trochlear dysplasia on magnetic resonance imaging (MRI) that can identify knees with patellar instability in male and female patients.
Objectives: To evaluate whether augmenting traditional fixation with a femoral neck buttress plate (FNBP) improves clinical outcomes in young adults with high-energy displaced femoral neck fractures.
Design: Multicenter retrospective matched cohort comparative clinical study.
Setting: Twenty-seven North American Level 1 trauma centers.
Objectives: The main 2 forms of treatment for extraarticular proximal tibial fractures are intramedullary nailing (IMN) and locked lateral plating (LLP). The goal of this multicenter, randomized controlled trial was to determine whether there are significant differences in outcomes between these forms of treatment.
Design: Multicenter, randomized controlled trial.
Objective: To evaluate the effect of technical errors (TEs) on the outcomes after repair of femoral neck fractures in young adults.
Design: Multicenter retrospective clinical study.
Setting: 26 North American Level 1 Trauma Centers.
Objectives: To compare anterior hook plating with established fixation constructs biomechanically and report outcomes and complications in a cohort of patella fractures treated with the technique.
Design: Laboratory-based biomechanical study and clinical multicenter retrospective cohort study.
Setting: 2 US Level 1 trauma centers.
Purpose: The purpose of this study was to apply both the fragility index (FI) and fragility quotient (FQ) to evaluate the degree of statistical fragility in the distal femur fracture (DFF) literature. We hypothesized that the dichotomous outcomes within the DFF literature are statistically fragile.
Methods: Using preferred reporting items for systematic reviews and meta-analyses, we performed a PubMed search for distal femur fractures clinical trials from 2000 to 2022 reporting dichotomous outcomes.