Low Rates of Conversion to Total Elbow Arthroplasty and Olecranon Osteotomy-Related Complications Following Open Reduction and Internal Fixation for Intraarticular Distal Humerus Fractures.

Introduction: The purpose of this study was to determine the rate of conversion to total elbow arthroplasty (TEA) following open reduction and internal fixation (ORIF) with olecranon osteotomy for intraarticular distal humerus fractures.

Methods: This retrospective case series included adult patients who underwent ORIF with olecranon osteotomy for AO/OTA 13C distal humerus fractures between January 2010 and April 2024 at two academic level 1 trauma centers. The primary outcome was the rate of conversion to TEA.

Femoral bowing in the coronal plane: A computed tomography analysis of 1313 femurs.

Introduction: Appreciation of femoral bowing in the sagittal plane has led to optimization of implant design and placement techniques. However, little is known about femoral bowing in the coronal plane. The objective of this study was to describe coronal bowing of the femur and how demographic characteristics were associated with bowing.

Risk factors for failure of distal femoral nonunion repair.

Introduction: There is limited evidence to guide treatment strategies for native and periprosthetic distal femoral nonunions. The aim was to determine factors associated with failure of distal femoral nonunion repair.

Methods: All adult patients undergoing operative repair for a distal femoral nonunion from 2004 to 2023 at two Level 1 Trauma Centers with ≥ 6 months follow-up were identified.

Bicondylar tibial plateau fracture dislocations with an intact anterolateral cortical Rim: Prevalence, fracture characteristics, and complications.

Purpose: Bicondylar tibial plateau (BTP) fracture-dislocations with an intact anterolateral (AL) cortical rim present a unique treatment challenge due to posterolateral joint impaction. The purpose of this study was to determine the prevalence of this pattern within a large cohort of bicondylar tibial plateau fractures and describe fracture characteristics and complication rates.

Methods: Patients undergoing open reduction and internal fixation of a BTP fracture at two Level 1 trauma centers between 2010 and 2023 were identified.

Nicotine, tobacco smoking, and pain in orthopedic trauma settings: a conceptual framework for practice and research.

Nicotine and tobacco use are more common among orthopedic trauma patients than in the general population and have significant implications for pain management and recovery outcomes. This narrative review synthesizes clinical, epidemiological, and mechanistic research to examine the bidirectional relationship between nicotine/tobacco use and pain. We explore how nicotine/tobacco exposure disrupts pain modulation, delays healing, and increases the risk of chronic pain, while also highlighting evidence that acute pain relief reinforces nicotine/tobacco dependence through negative reinforcement processes.

Clinical and patient-reported outcomes of distal femur fracture fixation in adults aged 18-50 years.

Purpose: To describe nonunion and fracture-related infection (FRI) rates and patient-reported outcomes following operative treatment for distal femur fractures in young patients.

Methods: We retrospectively identified all patients (aged 18-50) who were operatively treated for a distal femur fracture between 2006 and 2023 with ≥ 3-month clinical follow-up at two Level 1 Trauma Centers. Outcomes included reoperation for nonunion and FRI; and PROMIS physical function (PF), depression, and anxiety (reference population mean: 50).

Orthopaedic Slang: Time for a Revision?

Medical slang is commonly used in the orthopaedic community to improve communication, enhance team cohesion, and provide humor in intense work environments. However, when used carelessly, inappropriate terminology can alienate certain groups of physicians. When encountered in clinical settings, these terms can create uncomfortable environments, reduce trust, and discourage trainees from pursuing orthopaedics.

Early routine radiographic follow-up at 2-3 weeks for operatively treated tibia, fibula or ankle fractures does not contribute to identification of complications: A two center case series of 628 patients.

Objectives: To determine (1) if early routine radiographic follow-up at 2-3 weeks for patients with operatively treated tibia, fibula or ankle fractures identified complications (i.e., complications only visible on radiographs and not associated with symptoms on history taking or clinical examination) and (2) if these complications were clinically relevant (i.

Secondary Displacement of Nonsurgically Managed Greater Tuberosity Fractures: Rates, Risk Factors, and Range of Motion.

Background: This study evaluated secondary displacement rates for nonsurgically managed greater tuberosity (GT) fractures using a validated radiographic measurement method.

Methods: This retrospective study included adults with GT fractures (AO/OTA 11A1.1) managed nonsurgically between 2010 and 2023 with a minimum radiographic follow-up of 6 weeks at two level 1 trauma centers.

Preoperative planning in orthopaedic trauma surgery: a lost art?

Background: Preoperative planning is a helpful tool for orthopaedic trauma cases, but clinical experience dictates that its use remains inconsistent. The primary aim of this cross-sectional survey study was to investigate practices and applications of preoperative planning for orthopaedic trauma cases and to identify factors influencing its use.

Methods: A cross-sectional 26-item survey was distributed to members of the Orthopaedic Trauma Association and The Netherlands Orthopaedic Trauma Association between April 2024 and August 2024.

Time to Minimal Clinically Important Difference in Patients Undergoing Conversion Total Hip Arthroplasty After Femoral Neck Fracture: A Propensity Score Matched Study.

Background: Conversion total hip arthroplasty (cTHA) is commonly used for patients with persistent osteoarthritis or failed fixation following femoral neck fracture (FNF). There are limited data comparing patient-reported outcomes between patients undergoing cTHA after FNF and primary THA (pTHA) patients. This study aimed to compare the time to reach the minimal clinically important difference for improvement (MCID) for the Hip Disability and Osteoarthritis Outcomes Score-Physical Function Short Form, Patient-Reported Outcomes Measurement Information System (PROMIS) Global Physical, and PROMIS Physical Function short form 10a (PF-10a).

Outcomes of Clavicle Nonunion Repair: A Retrospective Cohort Study of 125 Patients.

Objectives: To describe outcomes following operative repair of clavicle nonunions and identify risk factors for recalcitrant nonunion.

Methods: Design: Retrospective cohort study.

Setting: Two academic Level-1 trauma centers.

Risk Factors for Nonunion After Lateral Locked Plating of Periprosthetic Distal Femur Fractures.

Objectives: To determine the rate of and risk factors for reoperation to promote fracture union of periprosthetic distal femur fractures treated with lateral locked plating.

Methods: Design: Retrospective cohort study.

Setting: Two Level 1 Trauma Centers.

Double-Stacked One-Third Tubular Plating for Suprasyndesmotic Fibula Fractures Technique Description and Clinical Case Series.

Fixation for suprasyndesmotic fibula fractures (AO/OTA type 44C, consistent with Weber C) is classically achieved using a single one-third tubular plate. However, these fractures may sometimes require stronger fixation due to the diaphyseal fracture location and the lack of structural support from injured ligaments. To increase stability, 3.

Safety of Magnetic Resonance Imaging in Orthopaedic Trauma Patients With External Fixation: A Two-Center Case Series.

Objectives: To report on adverse events during magnetic resonance imaging (MRI) in patients with external fixators.

Design: Retrospective case series.

Setting: Two Level 1 trauma centers.

Long-term patient reported outcomes after revision surgery for lower extremity nonunion: A retrospective cohort study.

Introduction: Ongoing lower extremity long-bone nonunion is a devastating condition and associated with substantial patient morbidity. There is limited evidence regarding physical and mental function after surgical management of lower extremity nonunions. The purpose of this study was to assess general physical and mental health and lower extremity specific physical function of patients that underwent surgery for a lower extremity long-bone nonunion.

A Cadaveric Study: Does Ankle Positioning Affect the Quality of Anatomic Syndesmosis Reduction?

Objective: The objective of this study was to compare the quality of syndesmotic reduction with the ankle in maximal dorsiflexion versus neutral plantarflexion (normal resting position).

Methods: Baseline computed tomography (CT) imaging of 10 cadaveric ankle specimens from 5 donors was obtained with the ankles placed in normal resting position. Two fellowship-trained orthopaedic surgeons disrupted the syndesmosis of each ankle specimen.

Two big bones, one big decision: When to fix bilateral femur fractures.

Purpose: For polytrauma patients with bilateral femoral shaft fractures (BFSF), there is currently no consensus on the optimal timing of surgery. This study assesses the impact of early (≤ 24 h) versus delayed (>24 h) definitive fixation on clinical outcomes, especially focusing on concomitant versus staged repair. We hypothesized that early definitive fixation leads to lower mortality and morbidity rates.

A Fracture Liaison Service to Address Vitamin D Deficiency for Patients Hospitalized for Osteoporotic Fracture.

Context: Addressing vitamin D deficiency (VDD) is important for fracture secondary prevention.

Objectives: To explore the function of a fracture liaison service (FLS) to address VDD.

Design Setting And Patients: An observational study of patients admitted to the Massachusetts General Hospital with fractures between January 1, 2016, and October 31, 2023, cared for by the FLS.

Safety of Inpatient Zoledronic Acid in the Immediate Postfracture Setting.

Context: Zoledronic acid (ZA) administered during the initial hospitalization for a fragility fracture improves the osteoporosis pharmacotherapy rate. Distinguishing the safety profile of inpatient ZA (IP-ZA) in this context is crucial if this approach is to be widely adopted.

Objective: To study the acute safety profile of IP-ZA.