Long non-coding RNA fine-tunes bone homeostasis and repair by orchestrating cellular crosstalk and β-catenin-OPG/Jagged1 pathway.

The IncRNA was initially believed to be dispensable for physiology due to the lack of observable phenotypes in knockout (KO) mice. However, our study challenges this conclusion. We found that both KO and conditional KO mice in the osteoblast lineage exhibit significant osteoporosis.

Anterior Iliac Crest Bone Graft Harvest Using Acetabular Reamers.

https://ota.org/education/ota-online-resources/video-library-procedures-techniques/anterior-iliac-crest-bone-0.

Intraosseous Shelf Plate Fixation for Depressed Articular Fragments in Tibial Plateau Fractures: A Technical Trick and Case Series.

Tibial plateau fractures with severely displaced articular injuries and significant deformity to the surrounding metaphyseal bone (including the hyperextension varus bicondylar pattern) can be challenging to stabilize due to resulting large bone voids uncontained by metaphyseal cortex. The purpose of this report was to describe a technique to support the plateau articular surface in these cases and report on outcomes of a small series. This technique uses a small or mini fragment plate, contoured to function as an intraosseous shelf plate, with the "shelf" portion inserted into the bone beneath the articular surface to support it.

Locked plate constructs are not necessarily stiffer than nonlocked constructs: A biomechanical investigation of locked versus nonlocked diaphyseal fixation in a human cadaveric model of nonosteoporotic and osteoporotic distal femoral fractures.

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.

Dorsal Hook Plating of Patella Fractures With Immediate Range of Motion Results in Reliable Fixation, Low Implant Removal Rates, and Satisfactory Clinical Outcomes.

Objectives: To evaluate radiographic and clinical patient-reported outcomes following dorsal hook plating of displaced patella fractures with permittance of immediate postoperative active closed chain range of motion.

Design: Retrospective review of prospectively collected data.

Setting: Urban academic level 1 trauma center.

Hip Fracture Repair by the Post-Call Surgeon: A Multicenter Retrospective Review.

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.

Long non-coding RNA Malat1 fine-tunes bone homeostasis and repair by orchestrating cellular crosstalk and the β-catenin-OPG/Jagged1 pathway.

The IncRNA Malat1 was initially believed to be dispensable for physiology due to the lack of observable phenotypes in Malat1 knockout (KO) mice. However, our study challenges this conclusion. We found that both Malat1 KO and conditional KO mice in the osteoblast lineage exhibit significant osteoporosis.

Stability of Intertrochanteric Femur Fractures.

The stability of intertrochanteric fractures depends upon multiple factors including the fracture displacement, location and pattern, the type of fixation used for stabilization, and the loading that the fracture undergoes postfixation. Traditional classification systems are of limited utility because they typically stratify intertrochanteric fractures as stable or unstable based purely on the fracture pattern without consideration of the stability after fixation. Biomechanical studies evaluating the stability of various fixation constructs should include physiologic loading, including rotation around the axis of the femoral neck, and reproduce clinical failure modes to be clinically relevant.

Distal Tibia Apex Posterior Angulation: A Normal Anatomic Variant Related to Hindfoot Alignment With Side-to-Side Symmetry.

Objectives: The sagittal plane of the distal tibia has not been well-described. This study sought to characterize sagittal plane morphology, determine symmetry from side to side, and identify differences based on hindfoot alignment.

Methods: One hundred twelve bilateral lateral weight-bearing ankle radiographs were retrospectively evaluated (224 ankles).

Updated Blocking Techniques for Lower Extremity Medullary Nailing: Beyond the Concavity of Deformity.

Modern blocking techniques are useful to achieve anatomic alignment and stable fixation during end-segment nailing. Whether with screws or drill bits, blocking implants can correct both angular and translational deformities. Understanding the biomechanics of blocking implants allows the surgeon to properly plan their placement based on principles rather than dogma.

Syndesmotic Suture Button Fixation Results in Higher Tegner Activity Scale Scores When Compared to Screw Fixation: A Multicenter Investigation.

Background: Suture buttons and metal screws have been used and compared in biomechanical, radiographic, and clinical outcome studies for syndesmotic injuries, with neither implant demonstrating clear superiority. The aim of this study was to compare clinical outcomes of both implants.

Methods: Patients who underwent syndesmosis fixation at 2 separate academic centers from 2010 through 2017 were compared.

Great debates in trauma biomechanics.

At the 2021 annual meeting of the Orthopaedic Trauma Association, the Basic Science Focus Forum hosted its first ever debate-style symposium focused on biomechanics and fracture repair. The 3 subjects of debate were "Mechanics versus Biology-Which is 'More Important' to Consider?" "Locked Plate versus Forward Dynamization versus Reverse Dynamization-Which Way Should I Go?" and "Sawbones versus Cadaver Models-What Should I Believe Most?" These debates were held because fracture healing is a highly organized synergistic response between biological factors and the local mechanical environment. Multiple studies have demonstrated that both factors play roles in governing bone healing responses, and the causal relationships between the 2 remain unclear.

Krackow Suture Technique Effect on Patella Tendon Vascularity: Quantitative MRI Analysis.

Objectives: To assess the effects of Krackow suture technique on the vascularity of the patellar tendon.

Methods: Six fresh-frozen matched pair cadaveric knee specimens were used. The superficial femoral arteries were cannulated in all knees.

Efficacy and safety of non-steroidal anti-inflammatory drugs (NSAIDs) for the treatment of acute pain after orthopedic trauma: a practice management guideline from the Eastern Association for the Surgery of Trauma and the Orthopedic Trauma Association.

Objectives: Fracture is a common injury after a traumatic event. The efficacy and safety of non-steroidal anti-inflammatory drugs (NSAIDs) to treat acute pain related to fractures is not well established.

Methods: Clinically relevant questions were determined regarding NSAID use in the setting of trauma-induced fractures with clearly defined patient populations, interventions, comparisons and appropriately selected outcomes (PICO).

Warm temperature-triggered developmental reprogramming requires VIL1-mediated, genome-wide H3K27me3 accumulation in Arabidopsis.

Changes in ambient temperature immensely affect developmental programs in many species. Plants adapt to high ambient growth temperature in part by vegetative and reproductive developmental reprogramming, known as thermo-morphogenesis. Thermo-morphogenesis is accompanied by massive changes in the transcriptome upon temperature change.

Locked Plating versus Nailing for Proximal Tibia Fractures: A Multicenter RCT.

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.

Apex posterior angulation of the humerus: A characterization of normal sagittal plane anatomy with implications for surgical fixation.

Introduction: An understanding of the sagittal plane morphology of the humerus is relevant during surgical fixation of humeral fractures but is not well described in the literature. The purpose of this study was to better characterize the native sagittal plane morphology of the humerus.

Materials And Methods: 170 patients with uninjured full length lateral humerus radiographs were retrospectively evaluated.

Locked Lateral Plating Versus Retrograde Nailing for Distal Femur Fractures: A Multicenter Randomized Trial.

Objectives: The 2 main forms of treatment for distal femur fractures are locked lateral plating and retrograde nailing. The goal of this trial was to determine whether there are significant differences in outcomes between these forms of treatment.

Design: Multicenter randomized controlled trial.

Pain, Analgesic Use, and Patient Satisfaction With Spinal Versus General Anesthesia for Hip Fracture Surgery : A Randomized Clinical Trial.

Background: The REGAIN (Regional versus General Anesthesia for Promoting Independence after Hip Fracture) trial found similar ambulation and survival at 60 days with spinal versus general anesthesia for hip fracture surgery. Trial outcomes evaluating pain, prescription analgesic use, and patient satisfaction have not yet been reported.

Objective: To compare pain, analgesic use, and satisfaction after hip fracture surgery with spinal versus general anesthesia.

Relative Sagittal Alignment of the Medial and Lateral Articular Surfaces of the Tibial Plateau Using Radiographic Parameters: A Radiographic Cadaveric Study.

Objectives: To characterize anatomic slope (sagittal alignment) of medial and lateral articular surfaces of the tibial plateau using x-ray and computed tomography (CT).

Methods: Fluoroscopy was used to acquire "perfect" anteroposterior (AP) images of 8 cadaveric knees by tilting a C-arm through a 30-degree cranial/caudal arc in 0.5-degree increments.

Proximal tibia fracture dislocations: Management and outcomes of a severe and under-recognized injury.

Introduction: Proximal tibia fracture dislocations (PTFDs) are a subset of plateau fractures with little in the literature since description by Hohl (1967) and classification by Moore (1981). We sought to evaluate reliability in diagnosis of fracture-dislocations by traumatologists and to compare their outcomes with bicondylar tibial plateau fractures (BTPFs).

Methods: This was a retrospective cohort study at 14 level 1 trauma centers throughout North America.