Frequent Sural Nerve Injury with Posterior Approach for Ankle Fracture Fixation.

Introduction: The purpose of this study was to report the incidence of iatrogenic sural nerve injury in a large, consecutive sample of surgically managed ankle fractures and to identify factors associated with sural nerve injury and subsequent recovery. We hypothesize that a direct posterior approach may be associated with higher risk of iatrogenic sural nerve injury.

Methods: A retrospective cohort study of 265 skeletally mature patients who sustained ankle fractures over a 2-year period was done.

Education via a mobile application improves health literacy after orthopaedic trauma.

Objectives: Health literacy is often poor among trauma patients. We introduced an educational mobile application to newly injured patients. We hypothesized that patients who utilized the app would be more informed about their injury and treatment recommendations, and that app users would demonstrate greater adherence to treatment recommendations.

Gender Diversity, Leadership, Promotion, and Opportunity Among the Members of the Orthopaedic Trauma Association (OTA).

Objectives: To demonstrate the gender distribution in leadership positions and academic promotion of Orthopaedic Trauma Association (OTA) members.

Methods: We conducted a cross-sectional examination of the 2020-2021 OTA membership cohort dataset provided by the OTA. Professional and academic information of OTA members at their site of appointment was also abstracted from publicly available online resources.

Missed anti-D immune globulin administration to postpartum patients in 2 health systems: an unrecognized patient safety risk.

Background: Maternal-fetal Rh-alloimmunization is a rare but potentially fatal event, most often caused by maternal exposure to D-antigen-presenting Rh-positive erythrocytes at the time of delivery. Prophylaxis with anti-D immune globulin is highly effective with a low side-effect profile and results in a dramatically decreased risk of alloimmunization. Postpartum anti-D immune globulin prophylaxis is recommended by national societies to reduce Rh-alloimmunization.

Enhancing Interpretation of One-Time Body Composition Measurement at Near-Term Gestation in Preterm Infants: An Exploratory Study.

In preterm infants, longitudinal growth patterns have a stronger association with clinical outcomes than cross-sectional metrics. For qualitative growth, a one-time body composition measurement at near term is common, and here we explore the potential use of a novel estimated longitudinal body composition metric (adjusted fat-free mass deficit) using birth anthropometrics. KEY POINTS: · Longitudinal growth patterns are better linked with clinical outcomes in preterm infants.

Functional outcomes more than 5 years following acetabulum fracture.

Objectives: The purposes of this project were to evaluate functional outcomes more than 5 years after acetabulum fracture and to determine factors related to function.

Methods: This retrospective study consisted of 205 adult patients treated for acetabulum fracture who completed the Musculoskeletal Function Assessment (MFA) a minimum of 5 years following injury. The MFA includes survey of daily activities, gross and fine mobility, social and work function, sleeping, and mood.

Surgical Versus Nonsurgical Management of Acetabular Fractures With Associated Patterns in Elderly Patients: Factors Affecting Outcomes.

Introduction: Among elderly patients, anterior column posterior hemitransverse (ACPHT) and associated both column (ABC) are common acetabular fracture patterns after low-energy mechanisms. Given the paucity of outcomes data in this cohort, the goal of this study was to determine the favorability of results with surgical versus nonsurgical management. Secondarily, factors linked with poor functional outcomes were assessed.

Single dose IV Antibiotic for Low-Energy Extremity Gunshot Wounds: A Prospective Protocol.

Objective: To prospectively determine infection rate following low-energy extremity GSWs with a single dose IV antibiotic protocol.

Summary Background Data: Previous work suggests that a single IV antibiotic dose, without formal surgical debridement, mitigates infection risk.

Methods: Over 35 months 530 adults with low-energy GSWs to the extremities were included.

Tobacco smoking is associated with more pain and worse functional outcomes after torsional ankle fracture.

Objective: The purpose of this study was to assess the impact of current and remote tobacco smoking on clinical and functional outcomes after torsional ankle fracture.

Methods: Nine hundred thirty-five patients treated surgically for torsional ankle fracture over 9 years were reviewed. Tobacco smoking status at the time of injury was defined as current (48.

Effect of parenteral nutrition duration on patterns of growth and body composition in very low-birth-weight premature infants.

Background: Parenteral nutrition (PN) is essential to support premature infants' growth and varies with enteral nutrition (EN) advancement rates. Data on PN duration's impact on premature infants' growth are limited. The aim of this multicenter observational study was to determine the effect of early PN duration on body composition at term corrected gestational age (CGA) in very low-birth-weight (VLBW) premature infants.

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.

Survivorship of the Hip Joint After Acetabulum Fracture.

Purpose: The purposes of this study were to determine the rate of failure of the hip joint after acetabulum fracture and to identify risk factors.

Methods: Acetabulum fractures treated over 17 years at a level-1 trauma center were reviewed. Patient, injury, and treatment factors were assessed regarding possible association with failure of the hip joint: end-stage arthrosis and/or total hip arthroplasty (THA).

Infant body composition assessment in the neonatal intensive care unit (NICU) using air displacement plethysmography: Strategies for implementation into clinical workflow.

Nutritional management is integral to infant care in the neonatal intensive care unit (NICU). Recent research on body composition that specifically evaluated fat and fat-free mass has improved our understanding of infant growth and nutritional requirements. The need for body composition monitoring in infants is increasingly recognized as changes in fat mass and fat-free mass associated with early growth can impact clinical outcomes.

Ankle fractures in patients over age 55 years: Predictors of functional outcome.

Objectives: To identify predictors of functional outcomes following treatment of ankle fracture in patients 55 years or older.

Setting: Level 1 Trauma Center.

Patients/participants: Four hundred twenty-nine patients with torsional ankle fractures (44A-C): 233 patients (54%) were ages 55 to 64, 25% were between the ages 65 and 74; 21% were 75 years or older.

Factors associating with surgical site infection following operative management of malleolar fractures at an urban level 1 trauma center.

Objectives: To identify comorbidities and injury characteristics associated with surgical site infection (SSI) following internal fixation of malleolar fractures in an urban level 1 trauma setting.

Design: Retrospective.

Setting: Level 1 trauma center.

Are we missing the mark? Relationships of psychosocial issues to outcomes after injury: A review of OTA annual meeting presentations.

Objectives: To observe the availability of information about social, emotional, and psychological factors in abstracts presented at the Orthopaedic Trauma Association (OTA) annual meeting.

Data Source: OTA website (https://ota.org/education/meetings-and-courses/meeting-archive/).

A salvage strategy for heel pad degloving injury: A case report.

Case: A 50-year-old female experienced a crush injury to the foot resulting in open degloving of her heel pad. This study details a surgical strategy to achieve healing and limb salvage.

Conclusion: Heel pad injuries with degloving are difficult to salvage and have a poor prognosis.

Risk factors for nonunion after traumatic humeral shaft fractures in adults.

Introduction: Humeral shaft fractures account for 3% of adult fractures. Optimal management remains a topic of debate given variable union rates reported in the literature after surgery or functional bracing. The primary aim was to compare these 2 cohorts of patients and their primary fracture union rates.

Reliability of routine anthropometric measurements to estimate body composition in term infants.

Background: Birth weight percentiles provide limited information on qualitative infant growth. Body composition provides estimates of fat mass, fat-free mass, and body fat percentage (adiposity). We sought to implement assessment of body composition at birth into clinical practice using a validated anthropometric equation and to evaluate measurement reliability.

Five-year Trends in Opioid Prescribing Following Orthopaedic Trauma.

Introduction: Legislatures across the country are passing new opioid prescribing laws. To understand the effects of this legislation, baseline autonomous shifts in physician opioid prescribing must be evaluated.

Methods: The purpose of this retrospective dual cohort comparison study was to evaluate 5-year opioid prescribing trends in orthopaedic trauma patients.

Effects of Diabetes Mellitus on Functional Outcomes and Complications After Torsional Ankle Fracture.

Introduction: It is well known that patients with diabetes mellitus experience higher complication rates after torsional ankle fracture; however, the functional consequences remain less clear. The goal of this study was to determine the effects of diabetes on complications, secondary operations, and functional outcomes after torsional ankle fracture.

Methods: Nine hundred seventy-nine adult patients treated surgically for a torsional ankle injury (Orthopaedic Trauma Association 44B, 44C) over 13 years were retrospectively reviewed.

Patient Satisfaction Is Improved With Exposure to Trauma Recovery Services.

Introduction: The purpose of this study is to assess the impact of Trauma Recovery Services (TRS), a program facilitating engagement and recovery on satisfaction after orthopaedic trauma.

Methods: Two hundred ninety-four patients with surgically managed extremity fractures were prospectively surveyed. Satisfaction was assessed after 12 months using a 13-question telephone survey, rated on a Likert scale from 1 to 5 (with five being excellent).

What Is the Financial Impact of Orthopaedic Sequelae of Intravenous Drug Use on Urban Tertiary-care Centers?

Background: Orthopaedic sequelae such as skin and soft-tissue abscesses are frequent complications of intravenous drug use (IVDU) and comprise many of the most common indications for emergency room visits and hospitalizations within this population. Urban tertiary-care and safety-net hospitals frequently operate in challenging economic healthcare environments and are disproportionately tasked with providing care to this largely underinsured patient demographic. Although many public health initiatives have been instituted in recent years to understand the health impacts of IVDU and the spreading opioid epidemic, few efforts have been made to investigate its economic impact on healthcare systems.