Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Trauma 147 articles


Angle Stable Nails Provide Improved Healing for a Complex Fracture Model in the Femur

Meghan R. Kubacki MS, Christopher A. Verioti DO, Savan D. Patel MD, Adam N. Garlock MS, David Fernandez MD, Patrick J. Atkinson PhD

Conventional nails are being used for an expanding range of fractures from simple to more complex. Angle stable designs are a relatively new innovation; however, it is unknown if they will improve healing for complex fractures.

Ipsilateral Proximal Femur and Shaft Fractures Treated With Hip Screws and a Reamed Retrograde Intramedullary Nail

Robert F. Ostrum MD, Paul Tornetta MD, J. Tracy Watson MD, Anthony Christiano BA, Emily Vafek MD

Although not common, proximal femoral fractures associated with ipsilateral shaft fractures present a difficult management problem. A variety of surgical options have been employed with varying results.

Retained Bullet Removal in Civilian Pelvis and Extremity Gunshot Injuries: A Systematic Review

John T. Riehl MD, Adam Sassoon MD, Keith Connolly BS, George J. Haidukewych MD, Kenneth J. Koval MD

Although gunshot injuries are relatively common, there is little consensus about whether retained bullets or bullet fragments should be removed routinely or only in selected circumstances.

Postoperative Opioid Administration Inhibits Bone Healing in an Animal Model

Jesse Chrastil MD, Christopher Sampson BS, Kevin B. Jones MD, Thomas F. Higgins MD

The current mainstay of orthopaedic pain control is opioid analgesics but there are few studies in the literature evaluating the effects of opioids on bone healing.

Do Psychiatric Comorbidities Influence Inpatient Death, Adverse Events, and Discharge After Lower Extremity Fractures?

Mariano E. Menendez BS, Valentin Neuhaus MD, Arjan G. J. Bot MD, Mark S. Vrahas MD, David Ring MD, PhD

Psychiatric comorbidity is known to contribute to illness (the state of feeling unwell/unable to rely on one’s body) and increased use of healthcare resources, but the effect on inpatient outcomes in fracture care is relatively unexplored.

The Initial Trauma Center Fluid Management of Penetrating Injury: A Systematic Review

Nicole M. Tapia MD, James Suliburk MD, Kenneth L. Mattox MD

Damage-control resuscitation is the prevailing trauma resuscitation technique that emphasizes early and aggressive transfusion with balanced ratios of red blood cells (RBCs), plasma (FFP), and platelets (Plt) while minimizing crystalloid resuscitation, which is a departure from Advanced Trauma Life Support (ATLS) guidelines. It is unclear whether the newer approach is superior to the approach recommended by ATLS.

Acute Complications of Patients With Pelvic Fractures After Pelvic Angiographic Embolization

Amir Matityahu MD, Meir Marmor MD, Joshua Knute Elson MPH, Corey Lieber MD, Gregory Rogalski MD, Cindy Lin MPH, Tigist Belaye MS, Theodore Miclau MD, Utku Kandemir MD

Hemodynamically unstable patients with a pelvic fracture and arterial pelvic bleeding frequently are treated with pelvic angiographic embolization (PAE). PAE is reported to be a safe and effective method of controlling hemorrhage. However, the loss of blood supply and subsequent ischemia from embolization may lead to adverse consequences.

Severity of Injury Predicts Subsequent Function in Surgically Treated Displaced Intraarticular Calcaneal Fractures

Stefan Rammelt MD, PhD, Hans Zwipp MD, PhD, Wolfgang Schneiders MD, PhD, Constanze Dürr MD

The treatment of displaced, intraarticular calcaneal fractures (DIACFs) remains challenging and the best treatment choices remain controversial. The majority of patients will have some lasting functional restrictions. However, it is unclear which patient- or surgeon-related factors predict long-term function.

Retrograde Versus Antegrade Intramedullary Nailing of Gunshot Diaphyseal Femur Fractures

Paul J. Dougherty MD, Petra Gherebeh MD, Mark Zekaj BS, Sajiv Sethi BS, Bryant Oliphant MD, Rahul Vaidya MD

The use of retrograde nailing for gunshot wound femur fractures is controversial due to concerns of knee sepsis after this procedure since the knee is entered to introduce the nail into the canal.

Trauma Care in India and Germany

Hans-Joerg Oestern MD, Bhavuk Garg MD, Prakash Kotwal MD

Road traffic accidents are among the leading causes of death worldwide in individuals younger than 45 years. In both India and Germany, there has been an increase in registered motor vehicles over the last decades. However, while the number of traffic accident victims steadily dropped in Germany, there has been a sustained increase in India. We analyze this considering the sustained differences in rescue and trauma system status.