The effect of obesity on post-operative complications and functional outcomes after surgical treatment of torsional ankle fracture: A matched cohort study.

Background: Obesity is a growing public health concern. While diabetes mellitus is associated with obesity and is a risk for infection and other complications, effects of obesity on outcomes remains less clear. The purpose was to determine effect of obesity on complications, secondary operations, and functional outcomes after surgical treatment of ankle fracture.

Lifetime Asthma Prevalence and Correlates Among US Youths by Sexual Identity and Race/Ethnicity, 2009-2017.

To comprehensively assess asthma disparities and identify correlates in youths at the intersections of sex, sexual identity, and race/ethnicity in the United States. We obtained a diverse sample of youths (n = 307 073) from the Centers for Disease Control and Prevention's Youth Risk Behavior Survey. We pooled data across 107 jurisdiction-years (2009-2017).

Smoking Is Associated With Longer Intensive Care Unit Stays in Spine Trauma Patients.

Objective: To determine the impact of smoking on intensive care unit (ICU) outcomes in patients who underwent operative fixation for spine trauma.

Design: Retrospective cohort study.

Setting: Single academic level I trauma center.

Early Complications Following Articular Calcaneus Fracture Repair: Evaluation of Open Versus Percutaneous Techniques.

Objectives: To assess complications and secondary operations in patients treated with either open reduction and internal fixation (ORIF) versus percutaneous fixation of displaced intra-articular calcaneus fractures.

Design: Retrospective comparative study.

Setting: Level 1 trauma center.

Open ankle fractures are associated with complications and reoperations.

Objectives: To assess clinical and functional outcomes after open versus closed ankle fracture.

Design: Retrospective comparative study.

Location: Level 1 Trauma Center.

Implementing recovery resources in trauma care: impact and implications.

Objectives: To identify resources that patients perceive as helpful to their recovery and to characterize the impact of the Trauma Survivor Network (TSN), a program committed to enhancing recovery through education and engagement.

Design: Prospective cohort study.

Setting: Level 1 trauma center.

Management of the Floating Knee: Ipsilateral Fractures of the Femur and Tibia.

The "floating knee" is defined as fractures of the ipsilateral femur and tibia, which consists of a spectrum of injury, and may be in isolation or part of multiple system trauma for a given patient. A floating knee may compromise limb viability due to severe soft-tissue and vascular injury. Expeditious fracture reduction and patient resuscitation are crucial, while type and timing of provisional and definitive management is guided by the extent of injury to the involved extremity and associated systemic injuries.

Variations in Revenue Generation for the Care of Orthopaedic Trauma Patients.

Background: In the background of increasing competition between trauma centers, this study investigated the relative reimbursement of trauma care provided in an urban trauma setting, comparing patients previously unknown (new) to the system, representing potential sources of new revenue, and those who were known (established), having received medical care previously in the same system.

Methods: A retrospective review of 440 patients with high-energy fractures at a single level 1 trauma center was conducted. Payment to charge (P/C) ratios for professional and facilities services within 6 months of injury were calculated.

Mental illness is associated with more pain and worse functional outcomes after ankle fracture.

Objectives: To assess clinical and functional outcomes after ankle fracture in patients with preexisting mental illness.

Design: Retrospective study.

Setting: Level 1 trauma center.

Contrast blush on CT is a poor predictor of active bleeding on pelvic angiography.

Objective: Determine if contrast extravasation (CE) on computed tomography (CT), also called CT blush, is a reliable predictor of clinically relevant arterial bleeding from pelvic ring injury.

Design: Retrospective cohort.

Setting: Single level I trauma center.

Understanding the Opioid Epidemic: Factors Predictive of Inpatient and Postdischarge Prescription Opioid Use After Orthopaedic Trauma.

Objective: The purpose of this study was to determine which factors influence inpatient and postdischarge opioid use after orthopaedic trauma.

Design: Retrospective cohort study.

Setting: Single Level 1 trauma center.

Clinical Characteristics of Children Needing Inpatient Treatment after Failed Outpatient Treatment for Fecal Impaction.

Purpose: Treatment of chronic constipation and fecal impaction is usually outpatient and requires high or frequent doses of laxatives. However, there are children who fail outpatient treatments, sometimes repeatedly, and are ultimately hospitalized. We sought to compare the characteristics of the children who failed outpatient treatment and needed inpatient treatment vs those who achieved success with outpatient treatment, in an effort to identify attributes that might be associated with a higher likelihood towards hospitalization.

Outcomes of tibia shaft fractures caused by low energy gunshot wounds.

Background: The purpose of this project was to compare the rates of infections, nonunions, malunions, and secondary operations in tibia fractures resultant from low energy GSWs versus those seen in open and closed tibia fractures resultant from blunt trauma. A secondary objective was to assess the utility of using the traditional Gustilo-Anderson classification system for open fractures to describe fractures secondary to low energy GSW.

Methods: A retrospective review of 327 patients with tibia shaft fractures was conducted at our level I trauma center.

Early Tracheostomy in Patients With Traumatic Cervical Spinal Cord Injury Appears Safe and May Improve Outcomes.

Study Design: Retrospective case series.

Objective: To characterize outcomes associated with tracheostomy timing following traumatic cervical spinal cord injury (CSCI).

Summary Of Background Data: The morbidity associated with cervical spine trauma is substantially increased in the setting of concomitant CSCI.

Hexapod Stacked Transport for Tibial Infected Nonunions With Bone Loss: Long-Term Functional Outcomes.

Objectives: To analyze long-term functional outcomes in patients with posttraumatic infected tibial nonunions having undergone bone transport with hexapod external fixator.

Design: Retrospective cohort study.

Setting: Level 1 trauma center.

Perioperative Considerations When Treating Isolated Periprosthetic Distal Femur Fractures.

Background: Periprosthetic distal femur (PPDF) fractures occur most frequently via low energy mechanisms in elderly patients. This population is often frail and ill-suited to the physiologic burden of trauma and surgery. Here, we describe the perioperative and early hospital course for patients with PPDF fractures, and identify risk factors for poor outcomes.

Hexapod Frame Stacked Transport for Tibial Infected Nonunions With Bone Loss: Analysis of Use of Adjunctive Stability.

Objectives: The stacked hexapod bone transport technique is an effective treatment for infected tibial nonunions with bone loss. The purpose of this study was to evaluate the patients' risk factors and timing for requiring adjunctive stabilization.

Design: Retrospective cohort study.

Economic Benefit of Calcium and Vitamin D Supplementation: Does It Outweigh the Cost of Nonunions?

Objectives: The purpose was to evaluate economic benefit of calcium and vitamin D supplementation in orthopaedic trauma patients. We hypothesized that reduced nonunion rates could justify the cost of supplementing every orthopaedic trauma patient.

Design: Retrospective, economic model.

Noncontiguous and open fractures of the lower extremity: Epidemiology, complications, and unplanned procedures.

Introduction: Isolated fractures of the lower extremity are relatively common injuries while multifocal injuries resulting from high-energy trauma are less frequently encountered. Our objectives are to characterise patients who sustained multiple noncontiguous fractures and open fractures of the lower extremity, report the incidence of major complications, and identify factors that may contribute to complications and unplanned re-operations.

Patients And Methods: A retrospective review of patients was performed at a Level 1 trauma centre from 2000 to 2013.

Complications are reduced with a protocol to standardize timing of fixation based on response to resuscitation.

Background: Our group developed a protocol, entitled Early Appropriate Care (EAC), to determine timing of definitive fracture fixation based on presence and severity of metabolic acidosis. We hypothesized that utilization of EAC would result in fewer complications than a historical cohort and that EAC patients with definitive fixation within 36 h would have fewer complications than those treated at a later time.

Methods: Three hundred thirty-five patients with mean age 39.

American Spinal Injury Association Impairment Scale Predicts the Need for Tracheostomy After Cervical Spinal Cord Injury.

Study Design: Retrospective review.

Objective: The objective of this study was to evaluate the ability of the American Spinal Injury Association (ASIA) Impairment Scale and neurological level of injury to predict the need for mechanical ventilation as well as tracheostomy.

Summary Of Background Data: High-level cervical spinal cord injuries, high Injury Severity Score, and low Glasgow Coma Scale have been shown to predict tracheostomy.

Drill down analysis of door-to-needle time of acute ischemic stroke patients treated with intravenous tissue plasminogen activator.

Objective: Target stroke guidelines recommend a door-to-needle time of ≤60 minutes for acute ischemic stroke (AIS) patients treated with intravenous (IV) tissue-type plasminogen activator (tPA). We sought to analyze all diagnostic steps involved in the acute evaluation and treatment of AIS with IV tPA and to look for causes of delay in door to needle time (DNT).

Methods: A review of AIS patients treated in the emergency department with IV tPA.