Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Trauma 147 articles


The Epidemiology and Injury Patterns of Acetabular Fractures: Are the USA and China Comparable?

Cyril Mauffrey MD, FACS, FRCS, Jiandong Hao MD, PhD, Derly O. Cuellar MD, Benoit Herbert MD, Xiao Chen MD, Bo Liu MD, Yingze Zhang MD, Wade Smith MD, FACS

Acetabular fractures are rare injuries in heterogeneous patient groups, making it difficult to develop adequately powered prospective single-center clinical trials in the USA or Europe. Chinese trauma centers treat a high volume of these injuries, and if the patient population and injury patterns are comparable to those in the USA, this might support development of multicenter studies in Level I trauma centers in the two countries.

Treatment of Acetabulum Fractures Through the Modified Stoppa Approach: Strategies and Outcomes

Mark J. Isaacson DO, Benjamin C. Taylor MD, Bruce G. French MD, Attila Poka MD

Since the original description by Letournel in 1961, the ilioinguinal approach has remained the predominant approach for anterior acetabular fixation. However, modifications of the original abdominal approach described by Stoppa have made another option available for reduction and fixation of pelvic and acetabular fractures.

A Model to Predict Limb Salvage in Severe Combat-related Open Calcaneus Fractures

Adam J. Bevevino MD, Jonathan F. Dickens MD, Benjamin K. Potter MD, Theodora Dworak MD, Wade Gordon MD, Jonathan A. Forsberg MD

Open calcaneus fractures can be limb threatening and almost universally result in some measure of long-term disability. A major goal of initial management in patients with these injuries is setting appropriate expectations and discussing the likelihood of limb salvage, yet there are few tools that assist in predicting the outcome of this difficult fracture pattern.

Dual Plating of Humeral Shaft Fractures: Orthogonal Plates Biomechanically Outperform Side-by-Side Plates

Victor Kosmopoulos PhD, Arvind D. Nana MD, MBA

Single large-fragment plate constructs currently are the norm for internal fixation of middiaphyseal humerus fractures. In cases where humeral size is limited, however, dual small-fragment locking plate constructs may serve as an alternative. The mechanical effects of different possible plate configurations around the humeral diaphysis may be important, but to our knowledge, have yet to be investigated.

Are Race and Sex Associated With the Occurrence of Atypical Femoral Fractures?

Alejandro Marcano MD, David Taormina BS, Kenneth A. Egol MD, Valerie Peck MD, Nirmal C. Tejwani MD

Prior studies have suggested that Asian patients and women may be more likely to sustain atypical femoral fractures in association with bisphosphonate use. However, they do not account for confounders such as asymptomatic patients who are long-term bisphosphonate users or patients sustaining osteoporotic fractures.

High-energy Femur Fractures Increase Morbidity but not Mortality in Elderly Patients

Kushal V. Patel MD, Kindyle L. Brennan PhD, Matthew L. Davis MD, Daniel C. Jupiter PhD, Michael L. Brennan MD

Trauma centers are projected to have an increase in the number of elderly patients with high-energy femur fractures. Greater morbidity and mortality have been observed in these patients. Further clarification regarding the impact of high-energy femur fractures is necessary in this population.

Association of a Modified Frailty Index With Mortality After Femoral Neck Fracture in Patients Aged 60 Years and Older

Kushal V. Patel MD, Kindyle L. Brennan PhD, Michael L. Brennan MD, Daniel C. Jupiter PhD, Adam Shar MD, Matthew L. Davis MD

Frailty, a multidimensional syndrome entailing loss of energy, physical ability, cognition, and health, plays a significant role in elderly morbidity and mortality. No study has examined frailty in relation to mortality after femoral neck fractures in elderly patients.

Osteogenic Gene Expression Correlates With Development of Heterotopic Ossification in War Wounds

Korboi N. Evans MD, MS, Benjamin K. Potter MD, Trevor S. Brown PhD, Thomas A. Davis PhD, Eric A. Elster MD, Jonathan A. Forsberg MD

Heterotopic ossification (HO) is a frequent complication of modern wartime extremity injuries. The biological mechanisms responsible for the development of HO in traumatic wounds remain elusive.

The Efficacy of Single-stage Open Intramedullary Nailing of Neglected Femur Fractures

P. R. J. V. C. Boopalan MS, Azad Sait D Ortho, Thilak Samuel Jepegnanam MS, Thomas Matthai MS, Viju Daniel Varghese MS

Neglected femur fractures are not rare in the developing world. Treatment options include single-stage open reduction and intramedullary nailing, or open release, skeletal traction, and then second-stage open intramedullary nailing, with bone grafting. Single-stage procedures have the potential advantage of avoiding neurovascular complications secondary to acute lengthening, but they require a second operation, with potentially increased resource use and infection risk.

Assessing Leg Length After Fixation of Comminuted Femur Fractures

Dolfi Herscovici DO, Julia M. Scaduto ARNP

Nailing comminuted femur fractures may result in leg shortening, producing significant complications including pelvic tilt, narrowing of the hip joint space, mechanical and functional changes in gait, an increase in energy expenditures, and strains on spinal ligaments, leading to spinal deformities. The frequency of this complication in patients managed with an intramedullary (IM) nail for comminuted diaphyseal fractures is unknown.