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Related Articles

Internal Fixation of the Distal Humerus: A Comprehensive Biomechanical Study Evaluating Current Fixation Techniques.

J Orthop Trauma. 2013 Jul 29;

Authors: Caravaggi P, Laratta JL, Yoon RS, Biasio JD, Ingargiola M, Frank MA, Capo JT, Liporace FA

Abstract
OBJECTIVES:: The purpose of this study was to evaluate current fixation techniques in the operative fixation of distal humerus fractures, both with conventional and locked plating in both parallel and orthogonal orientation.
METHODS:: Twenty-eight upper extremities from fourteen cadavers were prepared to create four implant testing constructs: Synthes locking plates (IMP1), medial and posterolateral with lateral flange), Acumed parallel locking plates (IMP2), Smith & Nephew orthogonal locking plates (IMP3), and Synthes orthogonal 3.5-reconstruction plating (IMP4), one posterolateral and one medial). A 5mm supracondylar osteotomy was made to simulate the fracture. Stiffness in axial and sagittal-plane loading, fatigue properties (over 5000 cycles), and ultimate strength were determined for each construct via biomechanical testing.

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Health Literacy in an Orthopaedic Trauma Patient Population: Improving Patient Comprehension with Informational Intervention.

J Orthop Trauma. 2013 Jul 29;

Authors: Tsahakis JM, Issar NM, Kadakia RJ, Archer KR, Barzyk T, Mir HR

Abstract
OBJECTIVES:: This study aims to evaluate the change in comprehension of diagnoses, treatment plans, and discharge instructions after orthopaedic trauma patients are given an informational document that includes pictorial representations at the time of discharge. It also seeks to determine if the intervention has a greater impact on patients with lower educational backgrounds.
DESIGN:: Prospective comparative cohort study.
SETTING:: Academic Level 1 trauma center.
PATIENTS:: From April to December 2011, 529 orthopaedic trauma patients with an operatively fixed isolated fracture were eligible for inclusion. 299 eligible questionnaires were collected (56.5% response rate).
INTERVENTION:: Patients were administered a questionnaire regarding their treatment and discharge instructions during their first postoperative clinic visit prior to being seen by a physician. The questionnaire included demographic information and questions regarding: (1) which bone was fractured; (2) type of implanted fixation; (3) weight-bearing status; (4) expected recovery time; and (5) need for DVT prophylaxis. All patients had received verbal instructions outlining this information

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Lack of Proficiency in Musculoskeletal Medicine Amongst Emergency Medicine Physicians.

J Orthop Trauma. 2013 Jul 29;

Authors: Comer GC, Liang E, Bishop JA

Abstract
OBJECTIVES:: Emergency medicine physicians are frequently responsible for evaluating and treating patients with urgent or emergent musculoskeletal conditions, so it is critical that they achieve a basic level of proficiency in musculoskeletal medicine. However, inadequacies in musculoskeletal education have previously been documented amongst medical students, residents and attending physicians in a number of specialties. The goal of this study was to assess the proficiency with musculoskeletal medicine amongst emergency medicine physicians in particular.
METHODS:: A validated musculoskeletal medicine competency examination was administered to the emergency medicine residents and faculty at a university-affiliated level 1 trauma center. Demographic data and satisfaction with musculoskeletal education were also surveyed.
RESULTS:: Twenty-three emergency medicine residents and twenty-one attending physicians completed the survey. 35% of residents and 43% of attending physicians failed to demonstrate proficiency on the examination. Pass rates were not significantly different amongst junior residents, senior residents or attending physicians. 23% of respondents indicated that they were dissatisfied with their musculoskeletal education.

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Low Wear of a Second-generation Highly Crosslinked Polyethylene Liner: A 5-year Radiostereometric Analysis Study.

Clin Orthop Relat Res. 2013 Jul 27;

Authors: Callary SA, Field JR, Campbell DG

Abstract
BACKGROUND: A sequentially irradiated and annealed, second-generation highly crosslinked polyethylene (XLPE) liner was introduced clinically in 2005 to reduce in vivo oxidation. This liner design has also been shown to reduce wear in vitro when compared with conventional and first-generation crosslinked liners. To date, there is only one study reporting an in vivo wear rate of this liner at 5 years' followup. However, that study used measurements made from plain radiographs, which have limited sensitivity, particularly when monitoring very low amounts of wear.
QUESTIONS/PURPOSES: What is the amount and direction of wear at 5 years using radiostereometric analysis (RSA) in patients who had THAs that included second-generation XLPE?
METHODS: We prospectively reviewed 21 patients who underwent primary cementless THA with the same design of XLPE acetabular liner and 32-mm articulation. Tantalum markers were inserted during surgery and all patients had RSA radiographs at 1 week, 6 months, and 1, 2, and 5 years postoperatively. Femoral head penetration within the acetabular component was measured with UmRSA(®) software. One patient died and two had incomplete radiographs leaving 18 radiographic series for analysis.

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What Is the Current Status of Global Health Activities and Opportunities in US Orthopaedic Residency Programs?

Clin Orthop Relat Res. 2013 Jul 27;

Authors: Clement RC, Ha YP, Clagett B, Holt GE, Dormans JP

Abstract
BACKGROUND: Interest in developing national health care has been increasing in many fields of medicine, including orthopaedics. One manifestation of this interest has been the development of global health opportunities during residency training.
QUESTIONS/PURPOSES: We assessed global health activities and opportunities in orthopaedic residency in terms of resident involvement, program characteristics, sources of funding and support, partner site relationships and geography, and program director opinions on global health participation and the associated barriers.
METHODS: An anonymous 24-question survey was circulated to all US orthopaedic surgery residency program directors (n = 153) by email. Five reminder emails were distributed over the next 7 weeks. A total of 59% (n = 90) program directors responded.

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Evaluation of reduction and fixation of calcaneal fractures: a Delphi consensus.

Arch Orthop Trauma Surg. 2013 Jul 28;

Authors: Beerekamp MS, Luitse JS, Ubbink DT, Maas M, Schep NW, Goslings JC

Abstract
BACKGROUND: Postoperative radiological assessment of the quality of reduction and fixation of calcaneal fractures is essential when evaluating treatment success. However, a universally accepted radiological evaluation protocol is currently unavailable. The aim of this study was to obtain an expert-based consensus on the most important criteria for the radiological assessment of the quality of reduction and fixation of calcaneal fractures.
METHODS: The Delphi method, consisting of three rounds, was used to obtain consensus. Each round focused on four main topics of calcaneal fracture evaluation: imaging technique (38 items), anatomical landmarks (21 items), fracture reduction (16 items) and position of the fixation material (9 items). We invited ten radiologists and 44 surgeons from the USA and Europe (all calcaneus experts) to complete online questionnaires. They were asked which aspects require evaluation to determine the quality of fracture reduction and fixation. Agreement was expressed as the percentage of respondents with identical answers. Consensus was defined as an agreement of at least 80 %.

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The pattern of acute injuries in patients from alpine skiing accidents has changed during 2000-2011: analysis of clinical and radiological data at a level I trauma center.

Arch Orthop Trauma Surg. 2013 Jul 28;

Authors: Wick MC, Dallapozza C, Lill M, Grundtman C, Chemelli-Steingruber IE, Rieger M

Abstract
OBJECTIVES: During the last decade, many educational efforts and technological improvements have been made to protect skiing athletes from injuries. Whether these efforts have changed the pattern of acute injuries from skiing casualties has not yet been shown on a medical basis, which this longitudinal study examines.
METHODS: All patients transferred to the Department of Radiology of our level I trauma center for acute emergency computed tomography (CT) after alpine skiing accidents from 2000 to 2011 were included. We hypothesized that only patients with clinical suspicion for injuries were admitted for acute CT.

Related Articles

Operative treatment for volar plate avulsion fractures of the fingers.

Arch Orthop Trauma Surg. 2013 Jul 28;

Authors: Lee S, Jung EY, Kim JY

Abstract
We present our experience with 14 volar plate avulsion fractures of the fingers that were treated by excision or internal fixation and discuss the factors affecting the operative techniques and results. Fourteen cases were divided into two groups: the volar plate avulsions with excision (eight cases) and the volar plate avulsions with fixation (six). We compared clinical factors between fracture groups and between fixation methods. Fractures treated with fixation had the larger fragment, a shorter preoperative period, and the larger articular surface involvement than fractures treated with excision. Postoperative pain, average age, patients' satisfaction measured by VAS, DASH scores, grip, and pinch strength were not different between two groups. All fixated fractures healed and the time to union did not differ based on fixation method. The true size of the fracture fragment was larger than expected based on the X-ray and the fragments were usually rotated by pull of the volar plate or ligament. The size and shape of the avulsed fragment might be important factors to determine the treatment method, but the results after operation were not significantly different whether the fragment was excised or fixed.

PMID: 23892555 [PubMed - as supplied by publisher]

Read more... http://www.ncbi.nlm.nih.gov/pubmed/23892555?dopt=Abstract

Related Articles

Infection as a cause of primary total hip arthroplasty revision and its predictive factors.

Orthop Traumatol Surg Res. 2013 Jul 25;

Authors: Reina N, Delaunay C, Chiron P, Ramdane N, Hamadouche M, the Société française de chirurgie orthopédique et traumatologique

Abstract
INTRODUCTION: Infection is a serious complication of total hip arthroplasty (THA) and is one of the most frequent causes of failure. The goal of this study was to evaluate the importance of infection among the different causes of revision THA and identify any risk factors specifically associated with this cause of revision.
MATERIALS AND METHODS: All patients who underwent a first revision of THA were included in a prospective multicenter study. Postoperative clinical and radiological evaluation and follow-up of morbidity and mortality were performed at 3months.