Surgery for clavicular shaft fractures is becoming more common but incisional and chest wall numbness reportedly occurs in 10% to 29% of patients. This may be the result iatrogenic injury supraclavicular nerve branches.We determined if there was a predictable branching pattern at anterior border distances these nerves from landmarks.We performed an anatomic dissection along long axis clavicle 37 cadavers. The branches were identified anterosuperior palpable bony landmarks...

To investigate if the radiographically correct and anatomically safe starting point appropriate sagittal plane vector could be obtained using a retropatellar technique for proximal tibia fractures treated with an intramedullary device.We performed cadaveric radiographic study utilizing 16 limbs. We approach via longitudinal quadriceps split, passed specialized trocar through patellofemoral joint onto superior aspect of tibia, inserted Kirschner wires into anatomic zone tibial plateau at 0,...

Background: The objective of this study is to compare locking and nonlocking single dual plating constructs in maintaining posteromedial fragment reduction a bicondylar tibial plateau fracture model. We hypothesized that fixation with medial lateral nonlocked would tolerate higher loads than locked alone. Methods: Thirty composite tibiae were fractured (AO 41-C1.3). Six tested: (1) 3.5-mm conventional proximal plate (CP); (2) CP + limited contact dynamic compression plate; (3) 1/3 tubular...

Objective: To define spatial relationships between major intra-articular structures of the knee and entry site a tibial nail inserted using retropatellar portal. Design: Cadaveric study 16 fresh-frozen limbs. Setting: University-affiliated cadaver anatomy laboratory. Results: The mean distance medial lateral menisci were 6.6 ± 3.2 mm 6.4 4.4 mm, respectively. to articular surfaces 5.6 3.6 7.4 4.2 anterior cruciate ligament footprint was 7.5 3.5 mm. meniscus never injured during procedure....

Foot and ankle fractures are common injuries for which patients may need urgent evaluation care. Many such managed in emergency departments (EDs), but care facilities sometimes be an appropriate setting. Understanding foot at facility might help define algorithms, improve patient experience, suggest directions containing costs.This retrospective cohort study used the 2010 to 2020 M151 PearlDiver administrative database. Adult less than 65 years old presenting EDs were identified using ICD-9...

Objective Venous thromboembolism (VTE) is an uncommon, but potentially morbid, complication following foot and ankle fractures. Current standard to not administer thromboprophylaxis patients with such injuries. Nonetheless, patient fracture factors might affect this risk/benefit consideration. The goal of study was determine what are most at risk. Methods M53Ortho Pearldiver database used identify fractures isolated the that were treated non-operatively or operatively. Patients pilon, other...

Anteroinferior plating has been described for internal fixation of clavicular fractures, citing improved bicortical fixation, less hardware prominence, and safer drill trajectories compared with other plate configurations. This anatomic study defined structures at risk during anteroinferior plating. Four paired cadaveric specimens (8 clavicles) from ages 75 to 93 years were systematically dissected. Using the screw paths associated an (anteroinferior superoposterior), distance posterior...

Evidence-based medicine in orthopaedic surgery comprises predominantly observational studies. While the gold standard of study methodology is considered to be randomized controlled trials (RCTs), studies provide valuable information regarding disease prevalence and etiology, rare outcomes, adverse treatment effects. Orthopaedic surgeons care for many diseases injuries that are will likely never subject an RCT. Given bias which prone, however, transparent reporting imperative. The...

Purpose: This study evaluated the failure properties of length unstable humerii secured with small or large fragment plates. Methods: Two nonlocking plate constructs were examined, a nine-hole 4.5-mm limited contact dynamic compression (large group) and 12-hole 3.5-mm (small group), both on composite 1-cm defect to simulate comminution (n = 12 for each group). Each construct had similar working lengths number fixation points. Mechanical testing was first randomized stiffness measurements in...

Ankle fractures are common orthopaedic injuries that may be indicated for open reduction internal fixation (ORIF). Although the negative impact of tobacco use on perioperative outcomes ankle fracture ORIF has been described, potential cannabis related is not as well established.Retrospective database study adult patients undergoing closed, isolated, from 2010-2021 Q1 PearlDiver M151 data set. Subcohorts without and with and/or were identified based coding matched patient age, sex, Elixhauser...

Abstract Background The goal of stabilization the femoral neck is to limit morbidity and mortality from fracture. Of three potential methods fixation, (three percutaneous screws, Synthes Femoral Neck System, a dynamic hip screw), each requires guide wire positioning implant(s) in head. Consistent accurate these systems paramount reduce surgical times, stabilize fractures effectively, complications. To help expedite surgery achieve ideal implant geriatric population, we have developed...

We present a 44-year-old man who sustained Lisfranc dislocation complicated by dorsalis pedis pseudoaneurysm. This case represents rare complication of commonly performed orthopaedic procedure.

Objectives: To establish the reliability of 2 radiographic union scoring systems for nonoperative humeral shaft fractures. Design: Retrospective medical record review. Patients identified had fractures and radiographs at various follow-up time points, which were graded according to both standard (RUST) modified (mRUST). Setting: A single North American Level-1 Trauma center in Connecticut, including emergency department clinic visits. Patients/Participants: Forty-five adult patients (162...

A 62-year-old woman with severe seizure disorder presented right ankle and foot pain after being found down, presumably following a recurrence. Imaging showed an acute comminuted fracture of the anterolateral aspect calcaneus, as well avulsion navicular tuberosity at site insertion tibialis posterior tendon. This pattern suggests forced abduction midfoot or forefoot compression lateral column failure medial under tension, entity that has previously been described nutcracker fracture....

Cerclage wiring of the humeral diaphysis entails particular danger to radial nerve and deep brachial artery. We sought delineate safe zones for minimally invasive cerclage diaphysis, specifically in relation accompanying vasculature. wires were percutaneously inserted into three groups fresh‐frozen cadaveric humeri. Group 1—proximal midshaft humerus at 30% height ( n = 4); 2—midshaft spiral groove 45% 3—distal 60% 4). Subsequently, an extensive surgical exploration arteries nerves around was...

Objective: To establish the sural island fasciocutaneous flap as an initial consideration for distal third lower-extremity soft tissue coverage and to provide non-plastic surgeons with a procedure they can perform on their own. Method: Literature reverse flaps was reviewed summarised. We then assessed our case series of from 2008–2011 looked operative technique patient outcomes. Results: Nine patients, aged 12–70 years old, greater than 1 year follow-up, were reviewed. Five patients had...

Direct visualization of the posterior facet in displaced intra-articular calcaneus fractures (DIACF) frequently shows partial or full thickness cartilage delamination. This is felt to be secondary depression an osteoarticular segment within calcaneal body and subsequent contact with fracture edges as it impacts caudally. The purpose this study was determine frequency injury if correlates classification.A single surgeon prospective, observational series 28 patients DIACFs reviewed for patient...

Introduction Geriatric patients who suffer femoral neck fractures have high morbidity and mortality. Prophylactic fixation of the is a potential avenue to reduce incidence fractures. We studied 3 different implants traditionally used stabilize neck: 6.5 mm cannulated screws (CANN), system (FNS) (Depuy Synthes), dynamic hip screw (DHS) Synthes). Materials Methods Five osteoporotic Sawbone femurs were for each model control group. Two scenarios investigated: single leg stance measure construct...

Abstract Objectives: Anatomic rotational reduction of diaphyseal femur fractures is essential in restoring limb mechanics. Errors reproducing anteroposterior (AP) or lateral knee reference radiographs the contralateral could result inaccuracies during reduction. The objective this study was to examine whether fluoroscopic variation can be observed with same degree precision AP and distal projections. Methods: were obtained from intact knees 7 cadaveric specimens using fluoroscopy. condylar...

Introduction: The selection of the most optimal fixation method for fractures distal femur, whether intramedullary nail (NL), lateral locking plate (PL), or nail/plate (NP) is not always clear. This study retrospectively evaluates surgical patients with femur and introduces a pilot using cluster analysis to identify fracture given type. Methods: retrospective cohort 18 years older an isolated who presented our Level-1 trauma center between January 1, 2012, December 31, 2022, obtained NL, PL,...