Open tibial fractures are limb-threatening injuries. While limb loss is rare in children, deep infection and nonunion rates of up to 15% and 8% are reported, respectively. We manage these injuries in a similar manner to those in adults, with a combined orthoplastic approach, often involving the use of vascularised free flaps. We report the […]
Despite long-standing dogma, a clear relationship between the timing of surgical irrigation and debridement (I&D) and the development of subsequent deep infection has not been established in the literature. Traditionally, I&D of an open fracture has been recommended within six hours of injury based on animal studies from the 1970s, however the clinical basis for […]
Open tibial fractures are limb-threatening injuries. While limb loss is rare in children, deep infection and nonunion rates of up to 15% and 8% are reported, respectively. We manage these injuries in a similar manner to those in adults, with a combined orthoplastic approach, often involving the use of vascularised free flaps. We report the […]
Despite long-standing dogma, a clear relationship between the timing of surgical irrigation and debridement (I&D) and the development of subsequent deep infection has not been established in the literature. Traditionally, I&D of an open fracture has been recommended within six hours of injury based on animal studies from the 1970s, however the clinical basis for […]
In the trauma center wards, it is not unusual for patients to have sleep disorders, especially patients with an acute injury. Meanwhile, there is substantial evidence that sleep disorder is a predictor of depression and is an important feature of posttraumatic stress disorder.All orthopedic trauma patients confined in a trauma ward in West China Hospital […]
The purposes of this study were to determine the rate of failure of the hip joint after acetabulum fracture and to identify risk factors.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 […]
Rehabilitation of trauma patients is facilitated by surgical stabilization permitting weight bearing (WB) of the fractured extremity. Both-bone forearm fracture (BBFx) plate osteosynthesis is an accepted technique with high union and low complication rates; yet, postoperative WB protocols have not been adequately investigated. There exists concern for increased complications in plated BBFx fractures for patients […]
The neuropeptide vasoactive intestinal peptide is a 28-amino acid neuropeptide that has been shown to stimulate bone repair and angiogenesis. The purpose of this study was to explore the potential role of serum VIP concentration in osteonecrosis of femoral trauma (ONFH).One hundred five patients diagnosed with non-traumatic ONFH and 103 healthy individuals were enrolled in […]
While evidence indicates that familial predisposition influences the risk of developing degenerative rotator cuff disease (RCD), knowledge of specific genetic markers is limited. We conducted a genome-wide association study of RCD surgery using the UK Biobank, a prospective cohort of 500,000 people (40 to 69 years of age at enrollment) with genotype data.Cases with surgery […]
Selecting the best treatment for patients with severe terminal lower-limb injury remains a challenge. For some injuries, amputation may result in better outcomes than limb salvage. This study compared the outcomes of patients who underwent limb salvage with those that would have been achieved had they undergone amputation.This multicenter prospective observational study included patients 18 […]
Medical decision-making for frail geriatric trauma patients is complex, especially toward the end of life. The goal of this paper is to review aspects of end-of-life decision-making, such as frailty, cognitive impairment, quality of life, goals of care, and palliative care. Additionally, we make recommendations for composing a patient-tailored treatment plan. In doing so, we […]
Established in 2009, the Department of Defense (DoD) Peer-Reviewed Orthopaedic Research Program (PRORP) is an annual funding program for orthopaedic research that seeks to develop evidence for new clinical practice guidelines, procedures, technologies, and drugs. The aim was to help reduce the burden of injury for wounded Service members, Veterans, and civilians and to increase […]
Peritendinous adhesion is among the common complications after tendon injury. Numerous studies have been carried out to prevent its formation, including modifications of surgical procedures, postoperative cares, application of medicines, etc. This study dynamically monitored fluctuations of inflammation, state of oxidative stress, and histopathologic changes around injured tendon to provide theoretical basis for further exploration […]
In tibial plateau fractures (TPF) the restoration of an anatomical joint surface as well as an exact subchondral screw position for postoperative stability is crucial for the outcome. The aim of this study was to determine whether the additional use of an intraoperative 3D imaging intensifier (3D) might help to improve the outcome of complex […]
Lateral tibial plateau fractures (TPFs) are often treated with conventional open reduction and internal fixation (ORIF) through standard anterolateral sub-meniscal arthrotomy. There has been increasing support for “bidirectional rapid redactor” device-assisted closed reduction and internal fixation (CRIF) for treating TPFs. The aim of the present study is to compare the clinical and radiological outcomes between […]
This study reviews the past 30 years of research from the Canadian Orthopedic Trauma Society (COTS), to identify predictive factors that delay or accelerate the course of randomized controlled trials in orthopaedic trauma.We conducted a methodological review of all papers published through the Canadian Orthopaedic Trauma Society or its affiliates. Data abstracted included: year of […]
The use of tourniquets in lower limb trauma surgery to control bleeding and improve the surgical field is a long established practice. In this article, we review the evidence relating to harms and benefits of tourniquet use in lower limb fracture fixation surgery and report the results of a survey on current tourniquet practice among […]
To describe a new technique for implanting a double-bundle titanium cable to treat acromioclavicular (AC) joint dislocation via the new guider, and evaluate clinic outcomes.A retrospective study of patients treated for acute high-grade acromioclavicular joint dislocation from June 2016 to January 2020 in our trauma center, twenty patients with AC joint dislocation were managed with […]
To identify the prevalence of neuropathic pain after lower limb fracture surgery, assess associations with pain severity, quality of life and disability, and determine baseline predictors of chronic neuropathic pain at three and at six months post-injury.Secondary analysis of a UK multicentre randomized controlled trial (Wound Healing in Surgery for Trauma; WHiST) dataset including adults […]
Clinical Practice Guideline for Limb Salvage or Early Amputation is based on a systematic review of current scientific and clinical research. The purpose of this clinical practice guideline is to address treatment for severe lower limb trauma below the distal femur by either amputation or limb salvage by providing evidence-based recommendations for key decisions that […]
Nerve injuries during shoulder arthroplasty have traditionally been considered rare events, but recent electrodiagnostic studies have shown that intraoperative nerve trauma is relatively common.The brachial plexus and axillary and suprascapular nerves are the most commonly injured neurologic structures, with the radial and musculocutaneous nerves being less common sites of injury.Specific measures taken during the surgical […]
Pediatric patients may benefit from extremity amputations with potential prosthetic fitting when addressing limb deficiencies, trauma, infection, limb ischemia, or other pathologies. The performance of a quality amputation is a fundamental skill to an orthopaedic surgeon, yet avoidance of pitfalls can be elusive in children. The need for surgical precision and sound decision-making is amplified […]
Implant-associated infections depict a major challenge in orthopedics and trauma surgery putting a high burden on the patients and health care systems, strongly requiring improvement of infection prevention and of clinical outcomes. One strategy includes the usage of antimicrobial-coated implants. We evaluated outcomes after surgical treatment using a gentamicin-coated nail on (i) treatment success in terms […]
Posterior tibial plateau fractures (PTPF) have a high impact on functional outcome and the optimal treatment strategy is not well established. The goal of this study was to assess the relationship between trauma mechanism, fracture morphology and functional outcome in a large multicenter cohort and define possible strategies to improve the outcome.An international retrospective cohort […]
Despite guidelines recommending postfracture bone health workup, multiple studies have shown that evaluation and treatment of osteoporosis has not been consistently implemented after fragility fractures. The primary aim of this study was to evaluate rates of osteoporosis evaluation and treatment in adult patients after low-energy thoracolumbar vertebral compression fractures (VCFs).We retrospectively reviewed all patients ≥60 […]
Complex fractures of the femur and tibia with associated severe soft tissue injury are often devastating for the individual. The aim of this study was to describe the two-year patient-reported outcomes of patients in a civilian population who sustained a complex fracture of the femur or tibia with a Mangled Extremity Severity Score (MESS) of […]
Concerns of contracting the highly contagious disease COVID-19 have led to a reluctance in seeking medical attention, which may contribute to delayed hospital arrival among traumatic patients. The study objective was to describe differences in time from injury to arrival for patients with traumatic hip fractures admitted during the pandemic to pre-pandemic patients.This retrospective cohort […]
This study sought to compare the rate of deep surgical site infection (SSI), as measured by the Centers for Disease Control and Prevention (CDC) definition, after surgery for a fracture of the hip between patients treated with standard dressings and those treated with incisional negative pressure wound therapy (iNPWT). Secondary objectives included determining the rate […]
The aim of this study was to identify the risk factors for adverse events following the surgical correction of cervical spinal deformities in adults.We identified adult patients who underwent corrective cervical spinal surgery between 1 January 2007 and 31 December 2015 from the MarketScan database. The baseline comorbidities and characteristics of the operation were recorded. […]
Tranexamic acid (TXA) use has expanded across many surgical specialties. It has been shown to reduce blood loss, decrease transfusion rates, and, in some cases, improve mortality. Within orthopaedic surgery, its popularity has primarily grown within arthroplasty and spinal surgery. It has only recently gained traction within the field of orthopaedic trauma and fracture care. […]
The ipsilateral olecranon with associated radial neck fractures does not include in the Bado classification of Monteggia fractures and equivalent lesions. The primary aims of this retrospective multicenter study were to characterize this type of injury and, noting its unique properties, evaluate the results of the treatment, determine the prognostic factors that influence the radiological […]
How to perform minimally-invasive surgery on Tile C pelvic fractures is very difficult, and it is also a hot topic in orthopedic trauma research. We applied minimally-invasive treatment using an anterior internal fixator combined with sacroiliac screws.To compare the biomechanical properties of different fixation models in pelvic facture specimens, using an internal fixation system or […]
COVID-19 was declared a pandemic by the World Health Organization on the 11th of March 2020 with the NHS deferring all non-urgent activity from the 15th of April 2020. The aim of our study was to assess the impact of COVID-19 on Trauma and Orthopaedic trainees nationally.Trauma and Orthopaedic (T&O) specialty trainees nationally were asked […]
Ankle fractures are the most common fracture of the foot and ankle treated at trauma hospitals in the United States, costing millions of dollars yearly. The purpose of this study was to determine whether a standardized care pathway led to a difference in the direct and indirect costs of surgical fixation of ankle fractures at […]
Minimally invasive surgery (MIS) procedures cause less trauma to the patient and might improve recovery. This study aimed to determine the efficacy and safety of condylectomy with MIS to treat interdigital corns of the lesser toes.This prospective cohort study was conducted in seven podiatry centers. Patients with interdigital corns of the lesser toes, progressing for […]
The best treatment for acute Achilles tendon ruptures remains controversial. No cohort studies have compared different immobilisation durations after open surgery. This retrospective cohort study aimed to determine the optimal duration of immobilisation after this surgery.A total of 266 patients with acute Achilles tendon rupture were divided into 4 groups (A, B, C, and D) […]
To investigate risk factors of bone cement leakage in percutaneous vertebroplasty(PVP)for osteoporotic vertebral compression fracture (OVCF).A total of 236 patients (344 vertebrae) who underwent PVP between November 2016 and June 2020 were enrolled in the study. Clinical and radiological characteristics, including age, gender, course of disease, trauma, type of vertebral fracture, cortical continuity of vertebral […]
The purpose of this prospective study was to introduce the application of a double reverse traction repositor (DRTR) in the retrograde intramedullary nailing (RE-IMN) of AO/OTA 33A distal femur fractures.A total of 27 patients with AO/OTA type 33A distal femur fractures who were admitted from January 2015 to May 2017 to a level I trauma […]
Minimally invasive fixation of pelvic fragility fractures is recommended to reduce pain and allow early mobilization. The purpose of this study was to evaluate the outcome of two different stabilization techniques in bilateral fragility fractures of the sacrum (BFFS).A non-randomized, prospective study was carried out in a level 1 trauma centre. BFFS in 61 patients […]
Prior research has demonstrated that physician desire to optimize patient satisfaction is a cause of over-prescription of opioid medications in the healthcare setting. The purpose of this study was to investigate what effect, if any, decreased opioid prescribing following arthroscopic meniscectomy had on Press-Ganey (PG) satisfaction survey scores.A retrospective review of prospectively-collected data was conducted […]
COVID-19 was declared a global emergency in the first quarter of 2020. It is has resulted in and continues in over a million deaths worldwide and halted medical systems and particularly elective surgeries worldwide. The aim of this study was to identify the effect of the initial COVID-19 pandemic months on orthopaedic surgeons in British […]
Fracture, Achilles tendon rupture, or traumatic dislocation of the peroneal tendons are often seen in isolation after a trauma or sports-related injury. However, in rare circumstances, a combination of these injuries can occur simultaneously. Multiple previous case reports describe a combination of 2 of these injuries. Missed or delayed diagnosis is common in these combination […]
The terms “knee dislocation” and “multiligamentous knee injury” (MLKI) have been used interchangeably in the literature, and MLKI without a documented knee dislocation has often been described as a knee dislocation that “spontaneously reduced.” We hypothesized that MLKI with documented tibiofemoral dislocation represents a more severe injury than MLKI without documented dislocation. We aimed to […]
Since its introduction by Smith and Robinson, the anterior approach to the subaxial cervical spine has become one of the standard procedures for numerous cervical spine pathologies, including, but not limited to degenerative disease, trauma, tumor, deformity, and instability. Along with its increasing popularity and improvements in anterior instrumentation techniques, a comprehensive knowledge of the […]
With the fourth largest metropolitan population density, motor vehicle drivers in Adelaide, South Australia, record the most number of motor vehicle insurance claims in Australia. Previous studies have shown a rise in cycling-related emergency department presentations from 2005 to 2010. There is no specific data available specifically related to South Australia. Our institution is the […]
To investigate the clinical outcomes of percutaneous cross screws internal fixation for pelvic Day type II crescent fracture-dislocation.We reviewed 66 consecutive patients undergoing surgical treatment for Day type II crescent fracture-dislocation from June 2005 to December 2017. Percutaneous cross screws internal fixation was performed in 40 patients, and open reduction and internal fixation was performed […]
Introduced in 1963, the orthopaedic in-training examination (OITE) is a standardized, national test administered annually to orthopaedic residents by the American Academy of Orthopaedic Surgeons. The examination consists of 275 multiple-choice questions that cover 11 domains of orthopaedic knowledge, including basic science, foot and ankle, hand, hip and knee, oncology, pediatrics, shoulder and elbow, spine, […]
Diabetes related foot complications are increasing in complexity, frequency and cost. The application of self-management strategies can reduce the risk of individuals developing foot complications. The type, range and nature of the literature focusing on interventions that support patients with diabetic foot self-management is unknown. This scoping review aimed to i) identify self-management actions and […]
A simple antibiotic prophylaxis initiative can effectively decrease the time to antibiotic administration for patients with open fractures. We aim to determine whether adherence to the protocol decreased over time without active input from the orthopaedic trauma team.This retrospective cohort study included adult patients with open fractures (excluding hand) presenting directly to the emergency department […]
The primary aim of this study was to compare the postoperative systemic inflammatory response in conventional jig-based total knee arthroplasty (conventional TKA) versus robotic-arm assisted total knee arthroplasty (robotic TKA). Secondary aims were to compare the macroscopic soft tissue injury, femoral and tibial bone trauma, localized thermal response, and the accuracy of component positioning between […]
Risk stratification of individual patients who are prone to infection would allow surgeons to monitor high-risk patients more closely and intervene early when needed. This could reduce infection-related consequences such as increased health-care costs. The purpose of this study was to develop a machine learning (ML)-derived risk-stratification tool using the SPRINT (Study to Prospectively Evaluate […]
The burden of musculoskeletal trauma is increasing worldwide, especially in low-income countries such as Malawi. Ankle fractures are common in Malawi and may receive suboptimal treatment due to inadequate surgical capacity and limited provider knowledge of evidence-based treatment guidelines.This study was conducted in 3 phases. First, we assessed Malawian orthopaedic providers’ understanding of anatomy, injury […]
Clinical follow-up in orthopaedic trauma is challenging, yet expectations exist that a 1-year follow-up is the minimum requirement for clinical trials and research publications. The primary purpose of our study was to evaluate the rate of follow-up after operative orthopaedic trauma care and the relationship to clinical care. Our secondary aim was to identify any […]
The Major Extremity Trauma and Rehabilitation Consortium and the American Academy of Orthopaedic Surgeons have developed the Appropriate Use Criteria (AUC) for the Diagnosis and Management of Acute Compartment Syndrome (ACS). Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care, aid decision-making, and obtain […]
The Major Extremity Trauma and Rehabilitation Consortium and the American Academy of Orthopaedic Surgeons have developed the Appropriate Use Criteria (AUC) for the Diagnosis and Management of Acute Compartment Syndrome (ACS). Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care, aid decision-making, and obtain […]
Pain is a characteristic, unpleasant sensory and emotional experience associated with actual or potential tissue damage. Pain is a subjective sensation, modulated by many factors such as age, sex, emotional state, national origin, or physical activity. Moreover, it is closely associated with intense physical activity, injuries, and traumas, which can significantly modulate pain tolerance.We postulate […]
Talar osteonecrosis results from trauma to the fragile blood supply to the talus. Many etiologies exist that can cause talar osteonecrosis, with the most common being talar neck fractures. Patients with talar osteonecrosis frequently present with progressive ankle pain and limited range of motion. Treatment strategy depends primarily on the stage of disease. Conservative care […]
Clinical characteristics, anticoagulant protocols, and risk factors of deep vein thrombosis (DVT) in patients with femoral and pelvic fractures were analyzed throughout the perioperative period to provide references for early identification and optimization of risk factors.This was a retrospective study. A total of 569 patients undergoing surgery of femoral and pelvic fractures from May 2018 […]
To investigate the correlation of plasma and local expressions of Circ CDR1as with disease severity in patients with non-traumatic osteonecrosis of femoral head (ONFH).Ninety-nine non-traumatic ONFH patients receiving surgery and 99 healthy individuals were enrolled in our study. Plasma and local Circ CDR1as were detected using real-time quantitative PCR (RT-qPCR). Radiographic progression was determined using […]
Acetabular fracture and concomitant ipsilateral intertrochanteric femur fracture has been suggested as an unusual traumatic presentation and rarely reported in the literature. The aims of this study were (1) to identify the etiological characteristics, (2) to summarize the treatment strategy, and (3) to present the mid- to long-term results of patients with this rare traumatic […]
