Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Trauma 147 articles

Articles

Does Additional Head Trauma Affect the Long-term Outcome After Upper Extremity Trauma in Multiple Traumatized Patients: Is There an Additional Effect of Traumatic Brain Injury?

Hagen Andruszkow MD, Christian Probst MD, Orna Grün MD, Christian Krettek MD, Frank Hildebrand MD

Musculoskeletal injuries are common in patients with multiple trauma resulting in pain, functional deficits, and disability. Traumatic brain injuries (TBIs) are common in severely injured patients potentially resulting in neurological impairment and permanent disability that would add to that from the musculoskeletal injuries. However, it is unclear to what degree the combination affects impairment.

Treatment and Displacement Affect the Reoperation Rate for Femoral Neck Fracture

Donavan K. Murphy MD, MSc, MBA, Timmothy Randell MD, Kindyle L. Brennan PhD, PT, Robert A. Probe MD, Michael L. Brennan MD

Femoral neck fractures (FNFs) comprise 50% of geriatric hip fractures. Appropriate management requires surgeons to balance potential risks and associated healthcare costs with surgical treatment. Treatment complications can lead to reoperation resulting in increased patient risks and costs. Understanding etiologies of treatment failure and the population at risk may decrease reoperation rates.

Can a Modified Anterior External Fixator Provide Posterior Compression of AP Compression Type III Pelvic Injuries?

Richard Martin Sellei MD, Peter Schandelmaier MD, Philipp Kobbe MD, Matthias Knobe MD, Hans-Christoph Pape MD, FACS

Current anterior fixators can close a disrupted anterior pelvic ring. However, these anterior constructs cannot create posterior compressive forces across the sacroiliac joint. We explored whether a modified fixator could create such forces.

Trauma Care in Germany: An Inclusive System

Johannes A. Sturm MD, Hans-Christoph Pape MD, Thomas Dienstknecht MD

Development of trauma systems is a demanding process. The United States and Germany both have sophisticated trauma systems. This manuscript is a summary of political, economic, and medical changes that have led to the development of both trauma systems and the current high-quality standards.

Healing Delayed But Generally Reliable After Bisphosphonate-associated Complete Femur Fractures Treated with IM Nails

Kenneth A. Egol MD, Ji Hae Park BS, Zehava Sadka Rosenberg MD, Valerie Peck MD, Nirmal C. Tejwani MD

Bisphosphonate therapy for osteoporosis has been associated with atypical femoral fractures. To date, there have been few reports in the literature regarding the preoperative and postoperative courses of patients who have sustained bisphosphonate-associated complete atypical femur fractures.

Surgical Technique: Tscherne-Johnson Extensile Approach for Tibial Plateau Fractures

Eric E. Johnson MD, Stephen Timon MD, Chukwunenye Osuji MD

The standard approach to lateral tibial plateau fractures involves elevation of the iliotibial band (IT) and anterior tibialis origin in continuity from Gerdy’s tubercle and metaphyseal flare. We describe an alternative approach to increase lateral plateau joint exposure and maintain iliotibial band insertion to Gerdy’s tubercle.

Statistical Validity and Clinical Merits of a New Civilian Gunshot Injury Classification

Socrates A. Brito MD, Zbigniew Gugala MD, PhD, Alai Tan MD, PhD, Ronald W. Lindsey MD

Despite the high prevalence of civilian gunshot injuries (GSIs) in the United States, no universally accepted classification currently exists. Recently, two of us (ZG, RWL) proposed a GSI classification based on energy transferred, vital structure damage, wound characteristics, fracture, and degree of contamination. This classification has not been validated in a clinical setting.

Submuscular Bridge Plating for Complex Pediatric Femur Fractures Is Reliable

Amr A. Abdelgawad MD, Ryan N. Sieg MD, Matthew D. Laughlin DO, Juan Shunia MD, Enes M. Kanlic MD

Complex, high-energy pediatric femur diaphyseal fractures cannot be treated reliably by conventional methods: casting is not suitable for polytrauma and large children, external fixation is associated with a high rate of malalignment and refractures, elastic nails are unsuitable for unstable fractures and metaphyseal areas, and lateral trochanteric entry rigid nails cannot address proximal and distal fragments and need relatively large medullary canals. A few centers have reported that submuscular bridge plating (SBP) is associated with minimal complications, but these findings require confirmation.

Do Parameters Used to Clear Noncritically Injured Polytrauma Patients for Extremity Surgery Predict Complications?

Thomas Dienstknecht MD, Dieter Rixen MD, Peter Giannoudis MD, Hans-Christoph Pape MD

In multiply injured patients, definitive stabilization of major fractures is performed whenever feasible, depending on the clinical condition.

Are Pentraxin 3 and Transsignaling Early Markers for Immunologic Injury Severity in Polytrauma? A Pilot Study

Christian Kleber MD, Christopher A. Becker MD, Katharina Schmidt-Bleek DVM, PhD, Klaus D. Schaser MD, Norbert P. Haas MD

Inflammatory-related conditions and organ failure (OF) lead to late trauma mortality. Cytokine profiles can predict adverse events and mortality, potentially guiding treatment strategies (damage control surgery versus early total care). However, the specific cytokines to predict the clinical course in polytraumatized patients are not fully identified.