Complications after low-velocity ballistic femur fractures: a series of 104 patients at a level 1 trauma center.

Objectives: To report outcomes and risk factors of complications following low-velocity ballistic fractures of the femur.

Design: Retrospective case series.

Setting: Academic Level I trauma center.

Pediatric Lateral Condyle Fractures With Elbow Dislocation: Revisiting the Song Classification of the Most Severe Injuries.

Introduction: Lateral condyle fractures are the second most common pediatric elbow fracture and are at risk for malunion, nonunion or avascular necrosis. The Song or Jakob classification guides management and risk of complications. However, many lateral condyle fractures have accompanying bony or soft tissue injuries, including elbow dislocations, which are not represented in the current Song or Jakob classification systems.

All-Suture Anchor Onlay Fixation for Medial Patellofemoral Ligament Reconstruction: A Biomechanical Comparison of Fixation Constructs.

Background: The use of all-suture anchors (ASAs) for onlay patellar and femoral fixation of medial patellofemoral ligament (MPFL) grafts may provide clinical benefit, particularly in the small or pediatric knee; however, biomechanical data supporting the use of ASAs are lacking.

Purpose/hypothesis: The purpose of this study was to compare ASAs to larger interference implants for MPFL reconstruction in a time-zero biomechanical model. It was hypothesized that ASAs would have comparable cyclic elongation to interference fixation and would exceed published biomechanical values for the native human MPFL.

PATELLOFEMORAL INSTABILITY PART 3 (PATELLOFEMORAL CARTILAGE TREATMENT): STATE OF THE ART.

Cartilage lesions around the knee are common injuries in the orthopedic practice. The spontaneous healing capacity of the articular cartilage is limited, and therefore surgical intervention may be necessary. The goal is to improve patients' symptoms, articular functionality, and potentially delay the progression of knee osteoarthritis.

Is the impact of previous rotator cuff repair on the outcome of reverse shoulder arthroplasty clinically relevant? A systematic review of 2879 shoulders.

Background: Outcomes of reverse shoulder arthroplasty (RSA) in patients with prior rotator cuff repair (RCR) remain inconsistent. The purpose of this study, therefore, was to systematically review the current outcomes literature on RSA in patients with prior RCR and to compare the results with controls without prior RCR.

Methods: A systematic review of the literature was performed, and outcome studies reporting on functional and clinical outcomes were included.

Long-Term Surgical Success in Treating Vohwinkel Syndrome: A Case Report.

Case: Vohwinkel syndrome is a rare, inherited condition marked by defective keratinization. The disorder may feature digital constriction bands (pseudoainhum) which can lead to autoamputation. Surgical excision is the only treatment of pseudoainhum; however, it is fraught with recurrence.

The efficacy of tranexamic acid in primary anatomic and reverse total shoulder arthroplasty: A systematic review and meta-analysis of level I randomized controlled trials.

Purpose: The purpose of this study was to systematically review the available level I evidence regarding the impact of tranexamic acid (TXA) on early postoperative outcomes in patients undergoing anatomic total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RTSA).

Methods: A systematic review of the literature through April 2023 was performed to identify level I RCTs examining the use of TXA at the time of primary TSA or RTSA.

Results: Among 5 included studies, a total of 435 patients (219 TXA, 216 control) were identified.

Schmorl's Node Mimicking Spinal Metastatic Disease: A Case Report and Review of the Literature.

In this report, we present a progressively enlarging, degenerative, intraspongious/intravertebral herniated nucleus pulposus, also referred to as a "Schmorl's node," in a 65-year-old patient with a history of prostate cancer. The patient initially presented to our orthopedic oncology clinic for the evaluation of lytic-appearing lesions involving the L4 and L5 vertebral bodies. He had been diagnosed with prostate cancer approximately four years prior and had been previously treated with prostatectomy.

Bony Procedures for surgical patellar stabilization.

Surgery for patellofemoral instability is usually considered in patients with recurrent patellar dislocation and after a first-time patellar dislocation in the presence of either an associated osteochondral fracture or high risk of recurrence due to the presence of several risk factors. Risk factors include demographics such as age, contralateral dislocation, as well as anatomic risk factors (ARF) such as abnormal coronal and rotational alignment, trochlear dysplasia, lateral quadriceps vector, and patella alta. Surgery with soft tissue procedures includes restoring the medial patellar restraints and balancing the lateral side of the joint and can be successful in most patients.

Deep infections after low-velocity ballistic tibia fractures are frequently polymicrobial and recalcitrant.

Objectives: To identify risk factors for developing a fracture-related infection in operatively treated ballistic tibia fractures and to report the microbiologic results of intraoperative cultures.

Design: Retrospective review.

Setting: Level 1 trauma center.

Reliability of a Musculoskeletal Assessment for the Examination of Cervical Spine Pain and Injuries in Special Forces Combat Soldiers.

An assessment of protocol reliability is an essential step prior to human subject testing for injury prevention. The purpose of this study was to examine the inter-rater and intra-rater reliability of a portable cervical range of motion and isometric strength protocol designed for special forces combat soldiers who are at risk for cervical spine pain and injury due to exposure to head-supported mass. Eight individuals were tested three times to assess reliability, the standard error of the measurement (SEM), and the minimal detectable change across six range of motion measures and six strength measures of the cervical spine.

Temporary Reduction Assisting Corridor Constraint Wires for Intramedullary Nailing of Periarticular Fractures: A Technical Trick and Case Series.

Achieving satisfactory alignment during intramedullary nailing of periarticular fractures can be technically challenging due to a combination of deforming forces and the lack of cortical contact by the nail in the articular segment metaphysis allowing malreduction to persist during nail passage. Although blocking screws are described to facilitate reduction, they risk impeding subsequent implant fixation. This article introduces an innovative Temporary Reduction Assisting Corridor Constraint Wires (TRACC-wires) technique to safely correct multiplanar deformities without limiting fixation options.

Sex-differences in psychological readiness for return-to-sport following anterior cruciate ligament reconstruction.

Females are at greatest risk for reinjury after return to sport (RTS) following anterior cruciate ligament (ACL) reconstruction (ACLR). The reasons for these sex differences, however, remain unclear. Psychological factors such as kinesiophobia have been identified as a potential predictor for reinjury following RTS.

Managing Major Peripheral Nerves in Forearm-Level Amputations With TMR and RPNI: What's the Best Recipe?

Background: Targeted muscle reinnervation (TMR) and regenerative peripheral nerve interface (RPNI) prevent symptomatic neuroma formation in amputees. Forearm-level amputations present multiple muscular targets, making it challenging to determine the ideal treatment. The purpose of this study was to evaluate the best TMR targets, role of RPNI, and appropriate patient-selection criteria in forearm-level amputations.

Does Sagittal Alignment Matter? A Biomechanical Look at Pinning Pediatric Supracondylar Humerus Fractures.

Objective: Closed manipulation and percutaneous pinning is standard of care for displaced supracondylar humerus fractures, yet the optimal pin configuration, particularly in the sagittal plane, is not well defined. This study evaluates how sagittal plane pin variations affect construct strength biomechanically.

Methods: One hundred synthetic pediatric humerus models were used to emulate supracondylar humerus fracture.

Clinical Outcomes of a Novel Hybrid Transtibial Technique for Femoral Tunnel Drilling in Anterior Cruciate Ligament Reconstruction: A Large Single-Center Case Series With a Minimum 2-Year Follow-up.

Background: A novel hybrid transtibial (HTT) approach to femoral tunnel drilling in anterior cruciate ligament reconstruction (ACLR) has been developed that circumvents the need for knee hyperflexion and orients the graft in the most anatomic position without sacrificing the tunnel length or aperture.

Hypothesis: Patients who underwent ACLR utilizing the HTT technique would achieve excellent patient-reported outcome scores and experience low rates of graft failure and reoperations.

Study Design: Case series; Level of evidence, 4.

Regional Periprosthetic Joint Infection Centers: The Time Has Come for a Paradigm Change in the Treatment of Periprosthetic Joint Infection.

Background: Periprosthetic joint infection (PJI) is a rare, yet devastating complication with high mortality rates, unpredictable treatment outcomes, and high costs. The purpose of this study was to determine 90-day and 1-year mortality rates at a specialized PJI center, assess the impact of delayed referral to a PJI center on outcomes, and determine the cost of PJI treatment prior to referral to a PJI center.

Methods: A review of our institution's PJI registry was performed to identify patients who had a chronic PJI treated with a 2-stage exchange arthroplasty at our PJI Center from 2017 to 2021.

What Is the Representation of Sexual and Gender Minority Identities Among Orthopaedic Professionals in the United States?

Background: There is substantial corroborating evidence that orthopaedic surgery has historically been the least diverse of all medical and surgical specialties in terms of race, ethnicity, and sex. Growing recognition of this deficit and the benefits of a diverse healthcare workforce has motivated policy changes to improve diversity. To measure progress with these efforts, it is important to understand the existing representation of sexual and gender minorities among orthopaedic professionals.

Minimal Clinically Important Difference (MCID) for the Short Musculoskeletal Function Assessment (SMFA) in Severe Lower Extremity Trauma: Pooled Data from 7 Multicenter, Prospective Clinical Trials.

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.