Adult Traumatic Heel Pad Avulsion Repair with Polydioxanone Suture, Sterile Buttons, and Wound Vac-Assisted Closure: A Case Report.

Case: A 28-year-old woman with no medical history involved in a motor vehicle collision presented with deformity of the right leg and traumatic right heel pad avulsion. Radiographs demonstrated a right foot mid-tarsal fracture-dislocation, open cuboid, closed right tibia, and segmental fibula fractures. The heel pad was repaired using polydioxanone suture in a quilted technique with sterile buttons.

Acute toxic shock syndrome associated with intra-operative debridement and instrumentation removal for chronic osteomyelitis: A report of two cases.

Gram-positive organisms are known causative agents in toxic shock syndrome (TSS), an acute disease caused by bacterial exotoxins. During routine instrumentation removal for chronic osteomyelitis, intraoperative debridement, reaming, and irrigation can lead to cell lysis and subsequent dissemination of the bacterium exotoxin, which can result in acute cardiovascular compromise. We present two cases of chronic osteomyelitis in healed long-bone fractures that were treated with deep instrumentation removal and surgical debridement using a reamer-irrigator-aspirator (RIA) system.

Allograft reconstruction for humeral head defects in the setting of shoulder instability: a systematic review.

Background: Glenohumeral joint instability and dislocation are common orthopedic pathologies that can produce osseous humeral head defects such as Hill-Sachs (HS) or Reverse Hill-Sachs (RHS) lesions. Numerous reconstruction techniques have been reported in the literature, including remplissage, disimpaction, and allograft reconstruction. No group has previously assessed the outcomes of allograft reconstruction for RHS lesions, nor compared the outcomes of allograft reconstruction for HS and RHS lesions.

Variability in physical therapy protocols following total shoulder arthroplasty.

Background: Physical therapy (PT) plays an important role in the recovery of function following anatomic total shoulder arthroplasty (aTSA). While several PT protocols have been published for these patients, there is no standardized protocol for aTSA rehabilitation. This lack of standardization may lead to confusion between patients and physicians, possibly resulting in suboptimal outcomes.

Postfasciotomy Classification System for Acute Compartment Syndrome of the Leg.

Objective: Acute compartment syndrome (ACS) is a true emergency. Even with urgent fasciotomy, there is often muscle damage and need for further surgery. Although ACS is not uncommon, no validated classification system exists to aid in efficient and clear communication.

The incidence of shoulder arthroplasty infection presents a substantial economic burden in the United States: a predictive model.

Background: Periprosthetic joint infections (PJIs) are a major cause of morbidity after shoulder arthroplasty. Prior national database studies have estimated the trends of shoulder PJI up to 2012. Since 2012, the landscape of shoulder arthroplasty has changed drastically with the expanding popularity of reverse total shoulder arthroplasty.

Cubital Tunnel Syndrome: Does a Consensus Exist for Diagnosis?

Purpose: Cubital tunnel syndrome (CuTS) is the second most common compressive neuropathy of the upper extremity. We aimed to determine a consensus among experts using the Delphi method for clinical criteria that could be validated further for the diagnosis of CuTS.

Methods: The Delphi method was used for establishing a consensus among a group of expert panelists, comprising 12 hand and upper-extremity surgeons, who ranked the diagnostic clinical importance of 55 items related to CuTS on a scale from 1 (least important) to 10 (most important).

Transverse posterior wall acetabular fracture pattern is associated with increased risk of periprosthetic joint infection after conversion total hip arthroplasty.

Introduction: Acetabular fracture subtypes are associated with varying rates of subsequent conversion total hip arthroplasty (THA) after open reduction internal fixation (ORIF) with transverse posterior wall (TPW) patterns having a higher risk for early conversion. Conversion THA is fraught with complications including increased rates of revision and periprosthetic joint infections (PJI). We aimed to determine if TPW pattern is associated with higher rates of readmissions and complications including PJI after conversion compared to other subtypes.

More anterior placement of femoral tunnel position in ACL-R is associated with postoperative meniscus tears.

Purpose: The purpose of this study was to investigate the relationship between tunnel position in ACL reconstruction (ACL-R) and postoperative meniscus tears.

Methods: This was a single institution, case-control study of 170 patients status-post ACL-R (2010-2019) separated into two matched groups (sex, age, BMI, graft type). Group 1-symptomatic, operative meniscus tears (both de novo and recurrent) after ACL-R.

Superficial Surgical Site Infections in Primary Total Joint Arthroplasty: A Retrospective Analysis of Topical Anti-Biofilm Therapy.

Introduction Surgical site infections (SSI) following orthopedic procedures can cause significant morbidity and mortality, particularly in total joint arthroplasty. Biofilm formation in surgical wounds has made it difficult to prevent and treat these infections. SURGX® Antimicrobial Wound Gel (Next Science, Jacksonville, Florida, USA) was developed to disrupt biofilm formation but has not been evaluated in prophylactic use in total joint arthroplasty to prevent superficial SSI.

Gender Disparities Among Professional Team Sports Medicine Physicians.

Objective: Although recent trends from the Accreditation Council for Graduate Medical Education (ACGME) present encouraging growth of female representation in sports medicine, the field is still lagging behind other specialties. This study investigates gender disparities among physicians providing care for professional sports teams in male and female sports leagues.

Design: Information regarding physicians providing sports medicine care to professional teams obtained by database queries (May 2021).

Standard versus low-dose computed tomography for assessment of acetabular fracture reduction using novel step and gap measurement technique.

Purpose: Quality of reduction is of paramount importance after acetabular fracture and is best assessed on computed tomography (CT). A recently proposed measurement technique for assessment of step and gap displacement is reproducible but has not been validated. The purpose of this study is to validate a well-established measurement technique against known displacements and to determine if it can be used with low dose CT.

Direct Anterior Approach Total Hip Arthroplasty Is Associated With Reduced 1-Year Mortality and Surgical Complications After Femoral Neck Fracture.

Background: In some studies, the direct anterior approach (DAA) for elective total hip arthroplasty (THA) is associated with decreased dislocation and greater functional gains compared to the posterior approach (PA), as well as higher functional outcomes compared to the direct lateral approach (LA) at 2 weeks postoperatively. Given the paucity of literature on femoral neck fracture (FNF), we aspired to determine the association between the surgical approach used in THA and outcomes.

Methods: We conducted a retrospective review of patients undergoing THA for FNF at 9 institutions from 2010 to 2019.

Teaching of Cost-Effective Care in Orthopaedic Surgery Residency Training: A Survey of Residency Programs in the US.

Unlabelled: Costs of healthcare in the US continue to rise at rates that are unsustainable. Prior studies, most of which come from non-surgical specialties, indicate that a variety of strategies to teach this material are utilized but without consensus on best practices. No studies exist regarding the teaching of cost-effective care in orthopaedic residency training programs.

Location variance of the great vessels while undergoing side-bend positioning changes during lateral interbody fusion.

Background: Minimally invasive lateral lumbar interbody fusion (LLIF) is an increasingly popular surgical technique that facilitates minimally invasive exposure, attenuated blood loss, and potentially improved arthrodesis rates. However, there is a paucity of evidence elucidating the risk of vascular injury associated with LLIF, and no previous studies have evaluated the distance from the lumbar intervertebral space (IVS) to the abdominal vascular structures in a side-bend lateral decubitus position. Therefore, the purpose of this study is to evaluate the average distance, and changes in distance, from the lumbar IVS to the major vessels from supine to side-bend right and left lateral decubitus (RLD and LLD) positions simulating operating room positioning utilizing magnetic resonance imaging (MRI).

Home-based physical therapy results in similar outcomes to formal outpatient physical therapy after reverse total shoulder arthroplasty: a randomized controlled trial.

Background: Outcomes following reverse total shoulder arthroplasty (RTSA) are influenced by surgical indications, surgical technique, implant design, and patient variables. The role of self-directed postoperative physical therapy after RTSA is poorly understood. The purpose of this study was to compare the functional and patient-reported outcomes (PROs) of a formal physical therapy (F-PT) program vs.

Diversity in Orthopaedic Surgery Residencies Based on Allopathic Medical School Affiliation.

Unlabelled: Orthopaedic surgery is one of the most competitive and least diverse specialties in medicine. Affiliation of an orthopaedics with an allopathic medical school impacts research opportunities and early exposure to clinical orthopaedics. The purpose of this study is to examine the potential effect allopathic medical school affiliation has on orthopaedic surgery resident demographics and academic characteristics.

How Has Statistical Testing in Orthopedics Changed Over Time? An Assessment of High Impact Journals Over 25 Years.

Background: It is important for physicians to be familiar with statistical techniques commonly used in published medical research. Statistical errors in medical literature are common, and there is a reported lack of understanding regarding statistical knowledge necessary for data interpretation and journal reading. As study design has become increasingly complex, peer-reviewed literature poorly addresses and explains the most common statistical methods utilized across leading orthopedic journals.