Value driven outcome (VDO) assessment for the treatment of olecranon fractures.

Purpose: Controversy remains about the ideal construct for certain olecranon fractures. The purpose of this study was to compare cost-effectiveness with the value driven outcomes tool between fixation strategies of olecranon fractures.

Methods: All surgically treated isolated proximal ulna fractures (CPT code 24,685) at a level 1 trauma center from 2013 to 2023 were retrospectively reviewed.

Ankle-Brachial Index Is an Effective Screening Tool for Vascular Injury in Schatzker Type-4 to 6 Tibial Plateau Fractures with Symmetric Pulses.

Background: Schatzker type-4 to 6 tibial plateau fractures most commonly occur when the distal femur is driven through the proximal tibial articular surface. This mechanism of injury can be equivalent to a knee dislocation and carries an increased risk of vascular injury. Our institution screens all Schatzker type-4 to 6 tibial plateau fractures with symmetric pulses for a vascular injury by measuring the ankle-brachial index (ABI).

Formal Physical Therapy Improves PROMIS PF for High Anxiety Patients Following Ankle ORIF.

Objective: To compare outcomes after ankle fracture fixation between those receiving formal physical therapy (PT) vs. no formal PT and those with high vs. low PROMIS anxiety score (AS), and to evaluate the effect of PT in the setting of PROMIS AS scores.

From willpower to strategies: Existing insights and outstanding issues in self-control strategy use in daily life.

This paper focuses on recent advances in research on strategies that support self-control in everyday life. No one strategy or set of strategies appears to be effective at all times and in all situations. To understand effective self-control, we must expand our understanding of how strategies fit the situation and the person.

Changing Epidemiology of Distal Femur Fractures: Increase in Geriatric Fractures and Rates of Distal Femur Replacement.

Introduction: Distal femur fractures (DFFs) are associated with high complication and mortality rates in the elderly. Using the National Inpatient Sample and Medicare data, we describe trends in the incidence of DFFs by fixation type and associated healthcare costs.

Methods: Annual population rates and volume of inpatient DFFs were estimated using Poisson regression with the US Census as a denominator.

Dual Plating of Distal Femoral Fractures.

Background: Dual plating of the distal femur is indicated for the treatment of complex intra-articular fractures, supracondylar femoral fractures, low periprosthetic fractures, and nonunions. The aim of this procedure is anatomical alignment of the articular surface, restoration of the articular block, and prevention of varus collapse.

Description: Following preoperative planning, the patient is positioned supine with the knee flexed at 30°.

A Novel Bone-Screw-Fastener Demonstrates Greater Maximum Compression Force Before Failure Compared With a Traditional Buttress Screw.

Objectives: This study compared the maximal compression force before thread stripping of the novel bone-screw-fastener (BSF) with the traditional buttress screw (TBS) in synthetic osteoporotic and cadaveric bone models.

Methods: The maximum compression force of the plate-bone interface before loss of screw purchase during screw tightening was measured between self-tapping 3.5-mm BSF and 3.

Evaluation and Management of Posterior Tibial Plateau Fractures.

Tibial plateau fractures are caused by high-energy or low-energy trauma and result in complex injuries that require careful management of both osseous injuries and associated soft tissues. The posterior aspect of the tibial plateau can be involved in a variety of fracture patterns, requiring systematic evaluation, imaging, and advanced surgical planning to address these complex injuries. Early classification systems failed to classify posterior plateau fractures; however, three-dimensional imaging and newer classification schemes, including the Quadrant System and 3D systems, have incorporated posterior column lesions.

Examining racial disparities in utilization rate and perioperative outcomes following knee and hip arthroplasty.

Background: Previous arthroplasty utilization research predominantly examined Black and White populations within the US. This is the first known study to examine utilization and complications in poorly studied minority racial groups such as Asians and Native Hawaiian/Pacific-Islanders (NHPI) as compared to Whites.

Results: Data from 3304 primary total hip and knee arthroplasty patients (2011 to 2019) were retrospectively collected, involving 1789 Asians (52.

Patient-Reported Outcome Measurement Information Systems Physical Function and Pain Interference Scores Are Correlated With Tibial Shaft Fracture Nonunion Following Intramedullary Nailing.

Objectives: To assess trends in Patient-Reported Outcome Measurement Information Systems (PROMIS) Physical Function (PF) and Pain Interference (PI) in surgically treated tibial shaft fracture patients progressing to union versus nonunion.

Design: Retrospective cohort study.

Setting: Level 1 trauma center.

Recovery Curves for Lisfranc ORIF Using PROMIS Physical Function and Pain Interference.

Objectives: To determine the postoperative trajectory and recovery of patients who undergo Lisfranc open reduction and internal fixation using Patient-Reported Outcomes Measurement Information System (PROMIS) physical function (PF) and pain interference (PI).

Design: Retrospective cohort study.

Setting: Level 1 trauma center.

The MCID of the PROMIS physical function instrument for operatively treated tibial plateau fractures.

Introduction: Understanding minimal clinically important differences (MCID) in patient reported outcome measurement are important in improving patient care. The purpose of this study was to determine the MCID of Patient-Reported Outcome Measurement System (PROMIS) Physical Function (PF) domain for patients who underwent operative fixation of a tibial plateau fracture.

Methods: All patients with tibial plateau fractures that underwent operative fixation at a single level 1 trauma center were identified by Current Procedural Terminology codes.

An Inclusive Analysis of Racial and Ethnic Disparities in Orthopedic Surgery Outcomes.

Background: Despite increasing attention, disparities in outcomes for Black and Hispanic patients undergoing orthopedic surgery are widening. In other racial-ethnic minority groups, outcomes often go unreported. We sought to quantify disparities in surgical outcomes among Asian, American Indian or Alaskan Native, and Native Hawaiian or Pacific Islander patients across multiple orthopedic subspecialties.

Posterior Approach for Open Reduction and Internal Fixation for Scapular Fractures.

Background: This technique utilizes a full-thickness flap to provide a posterior approach to the scapula for open reduction and internal fracture fixation. The present video article outlines the Judet approach along with an incision modification tip for the surgeon's consideration.

Description: Prior to making the incision, perform preoperative planning, patient and C-arm positioning, and identification of the primary fragments of the fracture that necessitate fixation on imaging.

Risk of reverse golf club deformity with medial plating of distal femur fracture.

Introduction: This study described a deformity induced by medial plating of supracondylar distal femur fractures using plates that are precontoured for other anatomic locations.

Materials And Methods: OTA/AO 33A fractures were created in 12 sawbone femurs and fixed with either a proximal humerus locking plate (PH), an ipsilateral lateral tibial plateau plate (LTP), or an ipsilateral medial distal tibial plate (MDT). A motion capture system measured changes in length and rotation of the distal femur as the plate was applied.

A comprehensive analysis of intraoperative factors associated with acute-on-chronic kidney injury in elderly trauma patients: blood loss as a key predictor.

Background: Postoperative acute kidney injury (AKI) is a critical issue in geriatric patients with pre-existing chronic kidney disease (CKD) undergoing orthopedic trauma surgery. The goal of this study was to investigate modifiable intraoperative risk factors for AKI.

Methods: A retrospective study was conducted on 206 geriatric patients with CKD, who underwent orthopedic trauma surgery.

Update on Current Concepts of Blood Flow Restriction in the Perioperative Period of Anterior Cruciate Ligament Reconstruction.

Anterior cruciate ligament tears or ruptures are common orthopedic injuries. Anterior cruciate ligament reconstruction (ACLR) is an orthopedic procedure allowing for earlier return to sports, improved maintenance of lifestyle demands, and restored knee stability and kinematics. A perioperative rehabilitative adjunct recently gaining interest is blood flow restriction (BFR), a method in which temporary restriction of blood flow to a chosen extremity is introduced and can be used as early as a few days postoperative.

The trajectory of patient-reported outcomes and minimal clinically important differences in isolated and polytraumatic pelvis and acetabular fractures.

Purpose: Patient-reported minimal clinically important differences (MCID) provide a standard to compare clinical outcomes. The purpose of this study was to calculate the MCID of PROMIS Physical Function (PF), Pain Interference (PI), Anxiety (AX), and Depression (DEP) scores in patients with pelvis and/or acetabular fractures.

Methods: All patients with operatively treated pelvic and/or acetabular fractures were identified.

Minimal Clinically Important Differences of Patient-Reported Outcomes Measurement Information System Physical Function in Patients With Tibial Shaft Fracture.

Objective: To calculate the minimal clinically important differences (MCIDs) of patient-reported outcomes measurement information system physical function (PROMIS PF) scores for patients with operatively treated tibial shaft fractures.

Design: Retrospective Cohort Study.

Setting: A Level 1 trauma center.

No Increased Risk of Nonunion with Bisphosphonate Use in a Medicare Claims Cohort Following Operatively Treated Long-Bone Fractures.

Background: The diagnosis of a fragility fracture represents an important intervention event for the initiation of medical osteoporosis treatments. However, it is unclear if osteoporosis medications increase the risk of nonunion if administered in the setting of acute fracture. The purpose of the present study was to investigate whether bisphosphonates or selective estrogen receptor modulators/hormone replacement therapy (SERM/HRT) are associated with nonunion following fracture in a Medicare population.

Validation of a novel large animal intra-articular tibial plafond fracture model.

Background: Large animal fracture models that allow for anatomic fracture fixation are currently lacking. It was hypothesized that a compressed air impaction system can generate a reproducible tibial plafond fracture and be adjustable to create fractures consistent with high and low energy fractures seen in humans.

Methods: Pilot testing of the impaction system was done by impacting polyurethane foam blocks at varying compressed air pressures.

Impact of intraoperative fluoroscopic beam positioning relative to the hip and pelvis on perceived acetabular component position.

Background: Parallax is poorly understood and can mislead surgeons using intraoperative fluoroscopy (IF) to guide cup placement during anterior approach (AA) total hip arthroplasty. The purpose of this study was to examine how changes in fluoroscopic beam positioning in relation to the hip and pelvis affects the projected acetabular image.

Methods: An acetabular component was positioned in an anatomic pelvis model in 45° and 20° of abduction and anteversion, respectively using a computer assisted cup targeting system.