Managing Posttraumatic Limb Deformity in Pediatric and Adolescent Patients.

Musculoskeletal injuries in children offer unique challenges compared with those in adults. Even low-energy injuries that involve the physis have the potential to cause a growth disturbance that could require treatment. Higher-energy injuries can be complicated by the same soft-tissue disruption, fracture contamination, and bone loss that are seen in adults.

Management of Acute and Subacute Fracture-Related Infection.

Fracture-related infection (FRI) is a serious complication that occurs primarily in surgically treated fractures. FRIs occur when bacteria enter the site of bony injury and alter the healing inflammatory response within the bone. This can prevent bone regeneration and can lead to long-lasting complications such as chronic infection, pain, nonunion, and amputation.

Management Principles of Civilian Ballistic Orthopaedic Trauma.

Gun-related violence is becoming increasingly more common in the United States, and ballistic injuries pose a challenge to the orthopaedic surgeon on trauma call. The guiding principles of trauma care are almost exclusively based on blunt trauma, and the management principles do not always translate. Ballistic long bone fractures, particularly of the lower extremity, can often be managed with similar principles, although the injury pattern can make restoration of anatomic alignment a challenge.

You've Got Some Nerve: Initial Management of Iatrogenic Nerve Injuries.

Orthopaedic surgery has a higher risk of iatrogenic nerve injury than other surgical specialties. The initial management depends on the etiology, which requires early recognition and an appreciation for the injury. Three perspectives are given to guide the surgeon through the initial management of these devastating complications.

Periprosthetic Femur Fracture Around the Hip.

Periprosthetic femur fractures around the hip are one of the most common aseptic complications following total hip arthroplasty. Understanding the risk factors of periprosthetic femur fracture can aid surgeons in the prevention of these injuries. The Vancouver classification provides a reproducible description of the factors that should be considered in the treatment of patients with periprosthetic femur fractures: fracture site, implant stability, and bone stock.

Cartilage Injuries of the Ankle.

Osteochondral lesions of the talus involve injury to the articular cartilage and underlying subchondral bone. These lesions are difficult to treat because of the poor blood supply and poor regenerative capacity of the talar articular cartilage. It is important to provide a comprehensive overview of the clinical presentation, diagnostic tools, and nonsurgical and surgical treatment strategies for osteochondral lesions of the talus.

Neurovascular Compromise in Upper Extremity Surgery: How to Proceed Safely and What to Do If Something Goes Wrong.

Insights into the identification, prevention, and treatment of neurovascular compromise in upper extremity surgery are provided in this chapter, focusing on commonly encountered injuries susceptible to intraoperative or postoperative issues. The authors highlight the importance of knowledge of anatomy, meticulous dissection, and preparation to navigate complex surgical scenarios effectively. Furthermore, proactive approaches to managing difficult situations encountered during surgery are outlined, emphasizing timely recognition and decisive action.

Flexor Tendon Injuries.

Flexor tendon injuries are a commonly encountered hand problem caused by trauma. They can be associated with fractures or neurovascular injury or occur in isolation. Thorough physical examination is an integral aspect of management of these injuries to identify concomitant pathology and to facilitate preoperative planning and timing of surgery to improve outcome.

Injuries of the Extensor Tendons of the Hand and Forearm.

Extensor tendon injuries are commonly encountered after trauma. These injuries often result in acute weakness and have widely differing treatment options depending on the severity and the location of the injury within the upper extremity. Zone I injuries can often be treated nonoperatively with the potential for pinning of any large bony avulsion fragments.

Controversies in Timing of Surgery and Rehabilitation for Multiligamentous Knee Injuries.

With an estimated incidence of 0.02% to 0.2%, multiligamentous knee injuries are rare, often devastating injuries that can occur with concomitant vascular or neurologic involvement.

Management of Partial-Thickness Rotator Cuff Tears: Biologic and Surgical Interventions.

Partial-thickness rotator cuff tears (PTRCTs) are a common source of shoulder pathology, both in the aging population and in younger overhead athletes. Advanced imaging modalities used currently have led to increases in recognition, diagnosis, and treatment of these tears. The anatomy, five-layer histology, and relationship to the Ellman classification of PTRCTs have been well studied, with recent interest in radiographic predictors, such as the critical shoulder angle and acromial index.

Patellofemoral Cartilage Injury and Treatment.

Osteochondral and chondral injuries of the patellofemoral joint are common in active patients, and effective management requires a thorough physical and imaging evaluation, a detailed understanding of the unique anatomic and biomechanical joint properties contributing to these injuries, and an appropriate selection of treatment modality. Diagnosis of patellofemoral chondral injuries can be challenging, and differentiating between various causes of anterior knee pain is crucial to successful outcomes. Once identified, nonsurgical treatments including physical therapy, bracing, and injections are a mainstay of initial management.

Ulnar Collateral Ligament Tears: Rehabilitation and Throwing Programs.

The incidence of ulnar collateral ligament injuries has increased over the past decade. As a result, the rate of ulnar collateral ligament reconstruction has increased dramatically at all levels of competition in overhead athletes. Currently, there is no consensus on milestones during rehabilitation or a largely agreed-upon structured throwing program after ulnar collateral ligament injuries.

Medial Ulnar Collateral Ligament Tears: Reconstruction.

The medial ulnar collateral ligament (MUCL) complex is integral for valgus elbow stability, especially in individuals engaged in repetitive overhead activities such as throwing. MUCL injuries often necessitate surgical intervention to restore elbow stability. Early studies reporting outcomes after MUCL repair demonstrated suboptimal return to play compared with ulnar collateral ligament reconstruction, prompting a shift toward reconstruction techniques.

Ulnar Collateral Ligament Repair.

Ulnar collateral ligament injury of the elbow is a problem most associated with baseball pitchers but can be a challenging pathology for any overhead throwing athlete. The prevalence of these injuries has been steadily increasing over the past several decades, as has the need for surgical management. Surgical reconstruction has long been considered the gold standard for complete ulnar collateral ligament injuries in throwers, but repair has surfaced as a viable option for younger patients or those with isolated proximal or distal injuries with good tissue quality.

Ulnar Collateral Ligament Tears: Evaluation and Nonsurgical Management.

The medial ulnar collateral ligament of the elbow is the primary stabilizer against valgus load. It can tear acutely or through attritional damage as in repetitive overhead sports. Although baseball players, particularly pitchers, are the most vulnerable athletes, these injuries also occur in contact athletes, gymnasts, and javelin throwers.

Optimal Nonarthroplasty Management of Massive Irreparable Rotator Cuff Tears: A Case-Based Approach.

The management of massive irreparable rotator cuff tears is commonly debated without consensus. With reverse shoulder arthroplasty often reserved for the older patient (older than 60 years) with rotator cuff arthropathy, treatment of the younger patient population (younger than 60 years) without arthritis is more complex. When determining a surgical approach, the clinical presentation including history and physical examination plays a vital role in the decision tree.

A Focal Traumatic Injury to the Neonatal Rodent Spinal Cord Causes an Immediate and Massive Spreading Depolarization Sustained by Chloride Ions, with Transient Network Dysfunction.

In clinics, physical injuries to the spinal cord cause a temporary motor areflexia below lesion, known as spinal shock. This topic is still underexplored due to the lack of preclinical spinal cord injury (SCI) models that do not use anesthesia, which would affect spinal excitability. Our innovative design considered a custom-made micro impactor that provides localized and calibrated strikes to the ventral surface of the thoracic spinal cord of the entire CNS isolated from neonatal rats.

History of Multiple Allergies and Gradual Onset Running-Related Injuries in Distance Runners: SAFER XXXV.

Objective: To determine if any gradual onset running-related injury (GORRI) was associated with any allergies, multiple allergies (allergies to animals, plants, medication), and allergy medication use.

Design: Cross-sectional descriptive study.

Setting: Two Oceans Marathons (56 km, 21.

Injury Patterns in Academy-Level Male Youth Soccer Players: A 3-Season Prospective Cohort Study.

Objective: To report injury epidemiology in youth male academy-level athletes in the United States.

Design: An observational study on injury occurrences and playing time over the 2019 to 2020, 2020 to 2021, and 2021 to 2022 soccer seasons.

Setting: Data collected from a single midwestern soccer academy in the United States in partnership with a tertiary care level I pediatric heath institution.

Associations Between Skeletal Alignment and Biomechanical Symmetry Before and After Transfemoral Bone-anchored Limb Implantation.

Background: Patients with transfemoral amputation experience socket-related problems and musculoskeletal overuse injuries, both of which are exacerbated by asymmetric joint loading and alignment. Bone-anchored limbs are a promising alternative to treat chronic socket-related problems by directly attaching the prosthesis to the residual limb through an osseointegrated implant; however, it remains unknown how changes in alignment facilitated through a bone-anchored limb relate to loading asymmetry.

Questions/purposes: What is the association between femur-pelvis alignment and hip loading asymmetry during walking before and 12 months after transfemoral bone-anchored limb implantation?

Methods: Between 2019 and 2022, we performed 66 bone-anchored limb implantation surgeries on 63 individuals with chronic socket-related problems.

Multifunctional NO supramolecular nanomedicine for thrombus risk reduction and intimal hyperplasia inhibition.

Cardiovascular diseases (CVDs) are the foremost cause of mortality worldwide, with incidence and mortality rates persistently climbing despite extensive research efforts. Innovative therapeutic approaches are still needed to extend patients' lives and preserve their health. In the present study, novel supramolecular nanomedicine with both nitric oxide (NO) and antioxidant releasing ability was developed to enhance therapeutic efficacy against vascular injuries.

Integrated Design and Prototyping of a Robotic Head for Ocular and Craniofacial Trauma Simulators.

Background: Medical simulation is relevant for training medical personnel in the delivery of medical and trauma care, with benefits including quantitative evaluation and increased patient safety through reduced need to train on patients.

Methods: This paper presents a prototype medical simulator focusing on ocular and craniofacial trauma (OCF), for training in management of facial and upper airway injuries. It consists of a physical, electromechanical representation of head and neck structures, including the mandible, maxillary region, neck, orbit and peri-orbital regions to replicate different craniofacial traumas.

Effectiveness of the PRPP Intervention after brain injury in home-based rehabilitation: Single-case experimental designs with multiple baselines.

Background: Occupational therapists strive to provide evidence-based cognitive rehabilitation for everyday functional activities in community-based rehabilitation.

Objective: In this study, we investigated the effectiveness of the Perceive, Recall, Plan and Perform (PRPP) Intervention in enhancing and maintaining task performance and cognitive strategy use during home-based rehabilitation for individuals with cognitive challenges following acquired brain injury.

Material And Methods: This study is a systematic replication of a single-case experimental designs using multiple baselines applied to three participants (67+ years old) undergoing nine PRPP Intervention sessions.

Exploring the Phenomenon of Victim Blaming Toward Women With an Intimate Partner Violence Experience and the Role of Empathy.

Women who have experienced intimate partner violence (IPV) often encounter victim blaming from the general population, where individuals attribute responsibility to the victim's behavior for the violent episode. This phenomenon is influenced by levels of empathy, with lower empathy correlating with a higher likelihood of blaming women exposed to partner violence. Two studies were conducted.