A Targeting Arm for Interlocking Screws Reduces Radiation Exposure: Results of a Prospective Randomized Controlled Trial.

Objectives: To compare time, fluoroscopic utilization, and number of misses for placement of far interlocking screws in tibial and femoral nails using a targeting arm (Targeter) versus perfect circle technique (Control).

Methods Design: Prospective randomized controlled trial.

Setting: Single-center, large, urban, level 1 trauma center.

Opinions Regarding Dual-Implant Fixation and Weight-Bearing in Distal Femur Fractures: A Survey From the 2022 Orthopaedic Trauma Association Traveling Fellowship.

Introduction: To describe current opinions of staff orthopaedic trauma surgeons on the surgical treatment of distal femur fractures, with attention to indications for dual-implant constructs, application techniques, and postoperative rehabilitation.

Methods: A 22-question survey was given to fellowship-trained orthopaedic trauma surgeons at institutions visited by the 2022 Orthopaedic Trauma Association Fellows to characterize opinions on techniques, indications, and postoperative weight-bearing status for five example distal femur fractures. Demographic data were collected.

Expedited Hip Fracture Surgery in Patients on Direct Oral Anticoagulants Does Not Increase Perioperative Blood Loss.

Objectives: To compare blood loss and transfusion rates in geriatric patients with hip fracture on direct oral anticoagulants undergoing surgery ≤24 hours from admission (Expedited group) versus 24-72 hours from admission (Delayed group).

Design: Retrospective cohort study.

Setting: Level I trauma center.

Mid to long term follow up of early weightbearing after open reduction internal fixation of ankle fractures.

Introduction: Studies have demonstrated successful outcomes with early weightbearing following open reduction internal fixation (ORIF) of specific ankle fractures. The external validity of an early weightbearing protocol and its effects on patient-reported outcome information scores (PROMIS) has yet to be investigated. This study aimed to investigate the effects of an early weightbearing protocol for all operatively treated ankle fractures and its impact on clinical outcomes and complications.

Comparison of software-assisted and freehand methods of rotational assessment for diaphyseal femur fractures.

Objective: Accurate rotational reduction following femoral shaft fracture fixation is absent in up to 28% of cases yet is critical for lower extremity biomechanics. The objective of this cadaveric study was to compare the results of freehand methods of rotational reduction with software-assisted rotational reduction.

Methods: Four fellowship-trained orthopedic trauma surgeons attempted rotational correction in a cadaveric model with fluoroscopic assistance using (1) their method of choice (MoC) and (2) software assistance (SA).

Current Management of Acute and Posttraumatic Critical Bone Defects.

Limb reconstruction in patients with critical-sized bone defects remains a challenge due to the availability of various technically demanding treatment options and a lack of standardized decision algorithms. Although no consensus exists, it is apparent from the literature that the combination of patient, surgeon, and institutional collaborations is effective in providing the most efficient care pathway for these patients. Success relies on choosing a particular surgical approach that manages infection, soft tissue defects, stability, and alignment.

Expedited surgery does not increase transfusion rates for patients with geriatric hip fracture taking factor Xa inhibitors.

Objectives: Geriatric patients who sustain hip fractures and are taking factor Xa inhibitors (Xa-I) experience surgical delay. Our institution developed a pharmacokinetic protocol to formally guide and expedite surgical timing for these patients. The protocol is based on the patient's renal function and timing of last Xa-I dose.

Axial Plane Deformity: How to Avoid It and How to Correct It.

Malreductions in the axial plane (ie, length and rotation) are common when managing long bone fractures. Careful attention to detail during the initial treatment can prevent these malreductions. Various fluoroscopy-based techniques exist for the prevention of malrotation and limb-length discrepancy during surgery for fracture.

Racial/Ethnic and Gender Diversity of Orthopaedic Journal Editorial Boards.

Background: In the current era of evidence-based medicine, scientific publications play a crucial role in guiding patient care. While the lack of diversity among orthopaedic surgeons has been well documented, little is known about the diversity of orthopaedic journal editorial boards. The purpose of this study was to assess the racial/ethnic and gender diversity of U.

Orthopaedic Advances: Use of Three-Dimensional Metallic Implants for Reconstruction of Critical Bone Defects After Trauma.

Multiple successful strategies exist for the management of critical-sized bone defects. Depending on the location and etiology of an osseous defect, there are nuances that must be considered by the treating surgeon. The induced membrane technique and various modifications of the Ilizarov method (bone transport by distraction osteogenesis) have been the most common methods for biologic reconstruction.

Optimizing the Entry Point for Reconstruction Nailing of the Femur.

Introduction: Varus after antegrade medullary nailing of the proximal femur is associated with worse outcomes. Anecdotally, a more medialized "trochiformis" entry is beneficial to avoid varus with valgus-bend (greater trochanteric entry) femoral nails. However, the optimal entry point remains unknown.

Phosphaturic Mesenchymal Tumor-induced Osteomalacia Masquerading as an Orthopedic Polytrauma Patient: A Case Report and Review of the Literature.

Introduction: Phosphaturic mesenchymal tumor (PMT) is a rare benign tumor (500 cases to date) that can present in combination with a paraneoplastic syndrome called tumor-induced osteomalacia (TIO). To the best of our knowledge, it is the first case to date that presented as an orthopedic trauma patient.

Case Report: This is a case of a 61-year-old male who initially presented as a polytrauma patient, but further investigation revealed a PMT causing TIO.

Racial and Sex Disparities in Resident Attrition Among Surgical Subspecialties.

Importance: Racial and sex disparities are prevalent in surgical trainees. Although retrospective studies on resident attrition have been conducted for individual specialties, this study analyzes racial and sex differences in resident attrition among all surgical subspecialties over an 18-year period.

Objective: To evaluate the racial and sex differences in resident attrition among surgical specialties over an 18-year period.

Trust but Verify: Discordance in Opioid Reporting Between the Electronic Medical Record and a Statewide Database.

Introduction: The electronic medical record (EMR) is often used as the primary source for patient medication lists and history. We sought to determine the accuracy of the EMR in documenting opioid prescriptions in patients undergoing fracture repair compared to a statewide database.

Methods: This retrospective study was conducted at an urban level 1 trauma center.

Chronic Warfarin Anticoagulation in Hip Fracture Patients Delays Surgery and Is Associated With Increased Risk of Postoperative Complications: A Multicenter Propensity-Score-Matched Analysis.

Objective: To evaluate the effect of warfarin on blood transfusion and postoperative complications in a low-energy hip fracture population compared with a non-anticoagulated comparison group.

Design: Multicenter Retrospective Cohort.

Setting: Three Urban Level I Academic Trauma Centers.

Survey Analysis of Orthopedic Call Compensation.

We sought to determine the type, frequency, and compensation details of orthopedic call for orthopedic traumatologists. We administered a 24-question survey to all members of the Orthopaedic Trauma Association regarding the number and type of orthopedic surgeons within the call pool, frequency of call, number of hospitals covered, and compensation for weekday, weekend, holiday, and pediatric calls. A total of 105 orthopedic surgeons replied.

Understanding postoperative rehabilitation preferences in operatively managed proximal humerus fractures: do trauma and shoulder surgeons differ?

Background: Proximal humerus fractures (PHFs) are common, and their incidence is increasing as the population ages. Despite this, postoperative rehabilitation remains unstandardized and little is known about surgeon preferences. The aim of this study was to assess differences in postoperative rehabilitation preferences and patient education between orthopedic trauma and shoulder surgeons.