Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Trauma 147 articles


Does Integrated Fixation Provide Benefit in the Reconstruction of Posttraumatic Tibial Bone Defects?

Mitchell Bernstein MD, Austin T. Fragomen MD, Samir Sabharwal BA, Jonathan Barclay BA, S. Robert Rozbruch MD

Limb salvage in the presence of posttraumatic tibial bone loss can be accomplished using the traditional Ilizarov method of distraction osteogenesis with circular external fixation. Internal fixation placed at the beginning of the consolidation phase, so-called integrated fixation, may allow for earlier removal of the external fixator but introduces concerns about cross-contamination from the additional open procedure and maintenance of bone regenerate stability.

Does Blast Medium Affect Heterotopic Ossification in a Blast-amputation Model?

David E. Jaffe MD, David Yoo MS, Jason Blevins BA, Gregory Gasbarro MS, Tyler Hughes BA, Ebrahim Paryavi MD, MPH, Thao Nguyen MD, William L. Fourney PhD, Vincent D. Pellegrini MD

Heterotopic ossification (HO) develops after nearly 2/3 of traumatic blast amputations in the contemporary battlefield. This phenomenon has potentially devastating consequences for servicemen and women and its pathophysiology warrants further investigation using a previously developed animal blast model.

Whole-body Vibration at Thoracic Resonance Induces Sustained Pain and Widespread Cervical Neuroinflammation in the Rat

Martha E. Zeeman MS, Sonia Kartha BS, Nicolas V. Jaumard PhD, Hassam A. Baig MS, Alec M. Stablow, Jasmine Lee, Benjamin B. Guarino BS, Beth A. Winkelstein PhD

Whole-body vibration (WBV) is associated with back and neck pain in military personnel and civilians. However, the role of vibration frequency and the physiological mechanisms involved in pain symptoms are unknown.

Preventing Heterotopic Ossification in Combat Casualties—Which Models Are Best Suited for Clinical Use?

Keith A. Alfieri MD, Benjamin K. Potter MD, Thomas A. Davis PhD, Matthew B. Wagner PhD, Eric A. Elster MD, Jonathan A. Forsberg MD

To prevent symptomatic heterotopic ossification (HO) and guide primary prophylaxis in patients with combat wounds, physicians require risk stratification methods that can be used early in the postinjury period. There are no validated models to help guide clinicians in the treatment for this common and potentially disabling condition.

Treatment With the SIGN Nail in Closed Diaphyseal Femur Fractures Results in Acceptable Radiographic Alignment

Sasha Carsen MD, MBA, Sam Si-Hyeong Park MD, David A. Simon MD, Robert J. Feibel MD

The burden of orthopaedic trauma in the developing world is substantial and disproportionate. SIGN Fracture Care International is a nonprofit organization that has developed and made available to surgeons in resource-limited settings an intramedullary interlocking nail for use in the treatment of femoral and tibial fractures. Instrumentation also is donated with the nail. A prospectively populated database collects information on all procedures performed using this nail. Given the challenging settings and numerous surgeons with varied experience, it is important to document adequate alignment and union using the device.

What Risk Factors Predict Recurrence of Heterotopic Ossification After Excision in Combat-related Amputations?

Gabriel J. Pavey MD, Elizabeth M. Polfer MD, Kyle E. Nappo MD, Scott M. Tintle MD, Jonathan A. Forsberg MD, Benjamin K. Potter MD

Heterotopic ossification (HO) is common after combat-related amputations and surgical excision remains the only definitive treatment for persistently symptomatic HO. There is no consensus in the literature regarding the timing of surgery, and recurrence frequency, reexcision, and complications have not been reported in large numbers of patients.

Mortality and Revision Surgery Are Increased in Patients With Parkinson’s Disease and Fractures of the Femoral Neck

Mark S. Karadsheh MD, Michael Weaver MD, Kenneth Rodriguez MD, PhD, Mitchel Harris MD, David Zurakowski PhD, Robert Lucas BA

Patients with Parkinson’s disease are at increased risk for falls and associated hip fractures as a result of tremor, bradykinesia, rigidity, and postural instability. The available literature is limited and conflicting regarding the optimal surgical treatment and risk for postoperative complications and mortality in this unique patient population.

What Is the Magnitude and Long-term Economic Cost of Care of the British Military Afghanistan Amputee Cohort?

D. S. Edwards FRCS(Tr&Orth), Rhodri D. Phillip FRCP, Nick Bosanquet MSc, Anthony M. J. Bull PhD, Jon C. Clasper FRCS(Tr&Orth)

Personal protection equipment, improved early medical care, and rapid extraction of the casualty have resulted in more injured service members who served in Afghanistan surviving after severe military trauma. Many of those who survive the initial trauma are faced with complex wounds such as multiple amputations. Although costs of care can be high, they have not been well quantified before. This is required to budget for the needs of the injured beyond their service in the armed forces.

Analysis of Orthopaedic Research Produced During the Wars in Iraq and Afghanistan

George C. Balazs MD, Jonathan F. Dickens MD, Alaina M. Brelin MD, Jared A. Wolfe MD, John-Paul H. Rue MD, Benjamin K. Potter MD

Military orthopaedic surgeons have published a substantial amount of original research based on our care of combat-wounded service members and related studies during the wars in Iraq and Afghanistan. However, to our knowledge, the influence of this body of work has not been evaluated bibliometrically, and doing so is important to determine the modern impact of combat casualty research in the wider medical community.

Which Surgical Treatment for Open Tibial Shaft Fractures Results in the Fewest Reoperations? A Network Meta-analysis

Clary J. Foote MD, Gordon H. Guyatt MD, MSc, FRCPC, K. Nithin Vignesh BHSc, Raman Mundi MD, Harman Chaudhry MD, Diane Heels-Ansdell MSc, Lehana Thabane PhD, Paul Tornetta MD, Mohit Bhandari MD, PhD, FRCSC

Open tibial shaft fractures are one of the most devastating orthopaedic injuries. Surgical treatment options include reamed or unreamed nailing, plating, Ender nails, Ilizarov fixation, and external fixation. Using a network meta-analysis allows comparison and facilitates pooling of a diverse population of randomized trials across these approaches in ways that a traditional meta-analysis does not.