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Journal J Orthop Trauma

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In Memoriam: Berton R. Moed, MD (1950-2020).

J Tracy Watson,

J Orthop Trauma (Journal of orthopaedic trauma)
[2021, 35(2):57-58]

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Declining Medicare Reimbursement in Orthopaedic Trauma Surgery: 2000-2020.

Jack M Haglin, Ariana Lott, David N Kugelman, Sanjit R Konda, Kenneth A Egol,

<h4>Objectives</h4>To evaluate monetary trends in government (Medicare) reimbursement rates for 20 commonly used orthopedic trauma surgical procedures over a 20-year period.<h4>Methods</h4>The Physician Fee Schedule Look-Up Tool from the Centers for Medicare & Medicaid Services was queried for the 20 common Current Procedural Terminology (CPT) codes in orthopaedic trauma, and reimbursement ... Read more >>

J Orthop Trauma (Journal of orthopaedic trauma)
[2021, 35(2):79-85]

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Association Between Femoral "Spike" Size After Intramedullary Nailing and Subsequent Knee Motion Surgery.

Michael G Schloss, Nathan N O'Hara, Syed M R Zaidi, Zachary D Hannan, Dimitrius Marinos, Jared Atchison, Alexandra Mulliken, Jason W Nascone, Robert V O'Toole,

<h4>Objectives</h4>To determine the association between displaced femoral shaft bone fragments ("spikes") seen on radiographs after intramedullary nail insertion and the need for future motion surgery.<h4>Design</h4>Retrospective case-control study.<h4>Setting</h4>Academic trauma center.<h4>Patients</h4>We included patients with femoral shaft fractures treated with intramedullary nail insertion. Case patients (n = 22) had developed knee stiffness treated ... Read more >>

J Orthop Trauma (Journal of orthopaedic trauma)
[2021, 35(2):100-105]

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Comparison of Early Fatigue Failure of the TFNa and Gamma 3 Cephalomedullary Nails in the United States From 2015 to 2019.

Matthew L Klima,

<h4>Objectives</h4>To compare reports of implant fatigue failure submitted to the FDA of 2 commonly used cephalomedullary nails.<h4>Methods</h4>In total, 2724 medical device reports from the FDA's MAUDE database from Jan 2015 to Oct 2019 were reviewed for the Trochanteric Femoral Nail-Advanced (TFNa) and Gamma 3 implants.<h4>Results</h4>Data from 342 implant failures included ... Read more >>

J Orthop Trauma (Journal of orthopaedic trauma)
[2021, 35(2):e39-e44]

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Systematic Review and Analysis of the Quality of Randomized Controlled Trials Comparing Reamed and Unreamed Intramedullary Nailing of Tibial Fractures.

DesRaj Clark, Loc-Uyen Vo, Andres S Piscoya, Andrew Chan, John C Dunn,

<h4>Objectives</h4>To evaluate the quality of research and reporting of randomized controlled trials comparing the use of reamed and unreamed intramedullary nails for tibial fractures with validated scoring systems.<h4>Data source</h4>PubMed using the search terms "tibia" AND "reamed OR unreamed" AND "intramedullary OR nail." Filters were applied for the years 1991-2019, full ... Read more >>

J Orthop Trauma (Journal of orthopaedic trauma)
[2021, 35(2):59-64]

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Why Make the Cut? Trochanteric Slide Osteotomy Can Improve Exposure to the Anterosuperior Acetabulum.

Kevin D Phelps, Colin V Crickard, Katherine Li, Luke S Harmer, Erica Andrews McArthur, Katherine Sample Robinson, Stephen H Sims, Joseph R Hsu,

<h4>Objective</h4>To define relative increases in visual bony surface area and access to critical landmarks with the addition of a trochanteric slide osteotomy to a Kocher-Langenbeck approach.<h4>Methods</h4>A Kocher-Langenbeck approach followed by a trochanteric slide osteotomy was sequentially performed on 10, fresh-frozen, hemipelvectomy cadaveric specimens. Visual and palpable access to relevant surgical ... Read more >>

J Orthop Trauma (Journal of orthopaedic trauma)
[2021, 35(2):106-109]

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Medical School or "Provider School".

Timothy J Bray, Justin Walker,

J Orthop Trauma (Journal of orthopaedic trauma)
[2021, 35(2):e64-e65]

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Comminuted Fibular Head Fractures With Posterolateral Knee Instability: A Novel Repair Technique Using a Tension-Slide Device.

David J Cinats, Trevor Stone,

<h4>Summary</h4>Comminuted proximal fibula fractures or arcuate fractures (OTA/AO 4F1B fractures) can defunction the posterolateral corner (PLC) and result in posterolateral knee instability. Ongoing posterolateral knee instability can limit function, cause significant pain, and lead to early knee arthrosis. The anatomy of the PLC and proximal fibula limits the options for ... Read more >>

J Orthop Trauma (Journal of orthopaedic trauma)
[2021, 35(2):e66-e70]

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Lateral Distractor Use During Internal Fixation of Tibial Plateau Fractures Has a Minimal Risk of Iatrogenic Peroneal Nerve Palsy.

Michael J Chen, Brett P Salazar, Seth S Tigchelaar, Christopher S Frey, Malcolm R DeBaun, L Henry Goodnough, Michael J Bellino, Julius A Bishop, Michael J Gardner,

<h4>Objectives</h4>To determine the incidence of iatrogenic peroneal nerve palsy after application of an intraoperative lateral distractor during open reduction and internal fixation of tibial plateau fractures.<h4>Design</h4>Retrospective review.<h4>Setting</h4>Single academic Level I trauma center.<h4>Patients</h4>One hundred forty-seven patients met criteria and were included in the study.<h4>Intervention</h4>Patients with unicondylar and bicondylar tibial plateau fractures ... Read more >>

J Orthop Trauma (Journal of orthopaedic trauma)
[2021, 35(2):e51-e55]

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Contamination and Decontamination of Autologous Bone in the Operating Room: A Systematic Review.

Seyed Mohammad Javad Mortazavi, Mohammad Ali Ghasemi, Furqan Mohammed Yaseen Khan, Mohammad Zarei, Ali Shahabinezhad,

<h4>Objective</h4>To perform a systematic review of the literature to determine the rate of contamination of autologous bone fragments inadvertently dropped on the operating room floor, the microbial profile (contaminating organism), and the outcome of intraoperative decontamination techniques in terms of effectiveness and cellular toxicity.<h4>Data sources</h4>PubMed, Medline, and Embase were searched ... Read more >>

J Orthop Trauma (Journal of orthopaedic trauma)
[2021, 35(2):65-70]

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"Unstable" Pediatric Femoral Shaft Fractures Treated With Flexible Elastic Nails Have Few Complications.

Omar Atassi, Philip B Fontenot, Gennadiy Busel, Guadalupe De La Fuente, David Donohue, Benjamin Maxson, Anjan R Shah, David T Watson, Anthony F Infante, Katheryne Downes, Roy W Sanders, Hassan R Mir,

<h4>Objectives</h4>To determine our complication rate in pediatric femoral shaft fractures treated with flexible elastic nailing and to determine fracture characteristics that may predict complications.<h4>Design</h4>Retrospective cohort study.<h4>Setting</h4>One Level 1 and One Level 2 academic trauma centers.<h4>Patients/participants</h4>One hundred one pediatric femoral shaft fractures treated from 2006 to 2018.<h4>Main outcome measurement</h4>Major and minor ... Read more >>

J Orthop Trauma (Journal of orthopaedic trauma)
[2021, 35(2):e56-e60]

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Commentary on: "Declining Medicare Reimbursement in Orthopaedic Trauma Surgery 2000-2020".

Peter Althausen,

J Orthop Trauma (Journal of orthopaedic trauma)
[2021, 35(2):85-86]

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Optimal Technical Factors During Operative Management of Low-Energy Femoral Neck Fractures.

Patrick C Schottel, Michael Blankstein, Sheila Sprague, Marc Swiontkowski, Sofia Bzovsky, Mohit Bhandari, Emil H Schemitsch, ,

<h4>Objective</h4>To determine if cancellous screw (CS) and sliding hip screw (SHS) technical factors during low-energy femoral neck fracture fixation affects a 24-month revision surgery rate and health-related quality of life (HRQL).<h4>Design</h4>Prospective randomized controlled study.<h4>Setting</h4>International, multicenter.<h4>Patients</h4>Eight hundred ninety-eight femoral neck fracture patients age 50 years and older.<h4>Intervention</h4>Patients were randomized to fracture ... Read more >>

J Orthop Trauma (Journal of orthopaedic trauma)
[2021, 35(2):92-99]

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Costs of Care for Low-Energy Extremity Gunshot Injuries are Reduced With Standardized Treatment.

Mai P Nguyen, Jonathan C Savakus, Michael S Reich, Joseph F Golob, Amy A McDonald, John J Como, Heather A Vallier,

<h4>Objectives</h4>(1) To determine the overall treatment costs associated with isolated low-energy gunshot wounds (GSWs) to the extremity and (2) to estimate cost savings associated with a single-dose IV antibiotic strategy administered in the emergency room for patients with simple GSWs.<h4>Design</h4>Retrospective review.<h4>Setting</h4>Level I trauma center.<h4>Patients/participants</h4>Patients (N = 380) with extremity-only GSW ... Read more >>

J Orthop Trauma (Journal of orthopaedic trauma)
[2021, 35(2):e61-e63]

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Proximal Femoral Shortening and Varus Collapse After Fixation of "Stable" Pertrochanteric Femur Fractures.

David J Ciufo, John P Ketz,

<h4>Objectives</h4>To evaluate and compare femoral neck shortening and varus collapse in stable pertrochanteric femur fractures treated with sliding hip screws (SHSs) or cephalomedullary nails (CMNs).<h4>Design</h4>Retrospective review.<h4>Setting</h4>Academic medical center.<h4>Patients</h4>A total of 290 patients were included in the study. The average age was 82 years, and most were women. All sustained low-energy ... Read more >>

J Orthop Trauma (Journal of orthopaedic trauma)
[2021, 35(2):87-91]

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Commentary on "Classification of Bone Defects: An Extension of the Orthopaedic Trauma Association Open Fracture Classification".

J Lawrence Marsh,

J Orthop Trauma (Journal of orthopaedic trauma)
[2021, 35(2):77-78]

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Comparison of Infrapatellar and Suprapatellar Approaches for Intramedullary Nail Fixation of Tibia Fractures.

Kathryn B Metcalf, Jerry Y Du, Isaac O Lapite, Robert J Wetzel, John K Sontich, Elizabeth R Dachenhaus, Jessica L Janes, George Ochenjele,

<h4>Objective</h4>To assess clinical, radiographic, and functional outcomes after intramedullary nail (IMN) fixation of tibia fractures with an infrapatellar approach compared to a suprapatellar approach.<h4>Design</h4>Retrospective chart review.<h4>Setting</h4>Level 1 trauma center.<h4>Patients/participants</h4>Two hundred four patients with 208 tibia fractures treated with intramedullary nailing between 2008 and 2018.<h4>Methods</h4>A retrospective chart review of tibia fractures ... Read more >>

J Orthop Trauma (Journal of orthopaedic trauma)
[2021, 35(2):e45-e50]

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Classification of Bone Defects: An Extension of the Orthopaedic Trauma Association Open Fracture Classification.

Kevin D Tetsworth, Henry G Burnand, Erik Hohmann, Vaida Glatt,

<h4>Objectives</h4>To develop a post-traumatic bone defect classification scheme and complete a preliminary assessment of its reliability.<h4>Design</h4>Retrospective classification.<h4>Setting</h4>Tertiary referral trauma center.<h4>Patients/participants</h4>Twenty open fractures with bone loss.<h4>Intervention</h4>Assignment of a bone defect classification grade.<h4>Main outcome measurements</h4>Open fractures were classified based on orthogonal radiographs, assessing the extent and local geometry of bone loss, including ... Read more >>

J Orthop Trauma (Journal of orthopaedic trauma)
[2021, 35(2):71-76]

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Do Fully Threaded Transiliac-Transsacral Screws Improve Mechanical Stability of Vertically Unstable Pelvic Fractures? A Cadaveric Biomechanical Analysis.

Steven F Shannon, Giovanni Oppizzi, Michael G Schloss, Jared Atchison, Jason Nascone, Marcus Sciadini, Li-Qun Zhang, Robert V O'Toole, Todd Jaeblon,

<h4>Objective</h4>To determine whether fully threaded transiliac-transsacral (TI-TS) fixation is biomechanically superior to partially threaded TI-TS fixation of vertically unstable transforaminal sacral fractures.<h4>Methods</h4>Vertically unstable zone 2 sacral fractures were created in 20 human cadaveric pelves with a unilateral osteotomy and resection of 1 cm of bone through the foramen of the ... Read more >>

J Orthop Trauma (Journal of orthopaedic trauma)
[2021, 35(1):e18-e24]

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Is Definitive Plate Fixation Overlap With External Fixator Pin Sites a Risk Factor for Infection in Pilon Fractures?

Alexander Dombrowsky, Eildar Abyar, Gerald McGwin, Michael Johnson,

<h4>Objectives</h4>To determine if overlap of definitive plate fixation with external fixator pin sites is a risk factor for infection in pilon fractures.<h4>Design</h4>Retrospective cohort.<h4>Setting</h4>Level 1 trauma center.<h4>Patients</h4>One hundred forty-six patients with pilon fractures treated between 2012 and 2018.<h4>Intervention</h4>Staged treatment with ankle-spanning external fixation, followed by delayed open reduction and internal fixation.<h4>Main ... Read more >>

J Orthop Trauma (Journal of orthopaedic trauma)
[2021, 35(1):e7-e12]

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Blunt End Wire and Lateral Sacral View: A Technical Trick to Precisely Terminate Percutaneous Pelvic Brim Screw Fixation in the Posterior Ilium.

Frank R Avilucea, Milton L Chip Routt,

<h4>Summary</h4>Percutaneous screw fixation in the treatment of a variety of pelvic fractures may involve placement of a pelvic brim or "LC-2" screw. The technique requires the use of the combined obturator oblique inlet view to define the medial and lateral cortical borders of the corridor and an iliac oblique view ... Read more >>

J Orthop Trauma (Journal of orthopaedic trauma)
[2021, 35(1):e34-e36]

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Systemic Absorption and Nephrotoxicity Associated With Topical Vancomycin Powder for Fracture Surgery.

Robert V O'Toole, Yasmin Degani, Anthony R Carlini, Renan C Castillo, Nathan N O'Hara, Manjari Joshi, ,

<h4>Objectives</h4>To determine whether using topical vancomycin powder in fracture surgery may result in low levels of vancomycin in the serum and not result in nephrotoxicity.<h4>Design</h4>Prospective observational at a single site as a substudy of the VANCO trial.<h4>Setting</h4>Single, large urban level I trauma center.<h4>Patients/participants</h4>Fifty-eight patients with tibial plateau and pilon fractures ... Read more >>

J Orthop Trauma (Journal of orthopaedic trauma)
[2021, 35(1):29-34]

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In response.

Matthew Klima,

J Orthop Trauma (Journal of orthopaedic trauma)
[2021, 35(1):e37-e38]

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Distal Femur Replacement Versus Surgical Fixation for the Treatment of Geriatric Distal Femur Fractures: A Systematic Review.

Brett P Salazar, Aaron R Babian, Malcolm R DeBaun, Michael F Githens, Gustavo A Chavez, L Henry Goodnough, Michael J Gardner, Julius A Bishop,

<h4>Objectives</h4>The management of geriatric distal femur fractures is controversial, and both primary distal femur replacement (DFR) and surgical fixation (SF) are viable treatment options. The purpose of this study was to compare patient outcomes after these treatment strategies.<h4>Data sources</h4>PubMed, Embase, and Cochrane databases were searched for English language articles up ... Read more >>

J Orthop Trauma (Journal of orthopaedic trauma)
[2021, 35(1):2-9]

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Intraoperative Tobramycin Powder Prevents Enterobacter cloacae Surgical Site Infections in a Rabbit Model of Internal Fixation.

Kristen Brao, Patrick Greenwell, Kuei Ling Hsu, Dimitrius Marinos, Joseph P Stains, James P Hovis, Manjari Joshi, Mark E Shirtliff, Robert V O'Toole, Janette M Harro,

<h4>Objectives</h4>To evaluate the efficacy of intraoperative tobramycin powder in preventing surgical site infection (SSI) and implant colonization with Enterobacter cloacae in a rabbit fixation model. Gram-negative rods, particularly Enterobacter species, comprise an increasing percentage of SSI at our institution.<h4>Methods</h4>Eighteen New Zealand White rabbits underwent surgical fixation of the left tibia ... Read more >>

J Orthop Trauma (Journal of orthopaedic trauma)
[2021, 35(1):35-40]

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