Abstract:
OBJECTIVE:To determine whether an injectable thrombin product [thrombin hemostatic matrix (THM)] at closure of a Kocher-Langenbeck approach reduces the risk of heterotopic ossification (HO) formation after an acetabular fracture. DESIGN:Case control. SETTING:Two Level 1 trauma centers. PATIENTS:Patients with operatively treated acetabulum fractures fixed through Kocher-Langenbeck from 2013 to 2018. INTERVENTION:Records were reviewed for demographics, history of traumatic brain injury, HO medication or radiation prophylaxis, THM (Surgiflo, Ethicon, Bridgewater New Jersey) administration, and length of follow-up. Radiographs were reviewed for dislocation, fracture, Letournel and Orthopaedic Trauma Association classifications, HO, and Brooker grade if applicable. Patients receiving HO prophylaxis (eg, nonsteroidal anti-inflammatory drugs and radiation) were excluded. Remaining patients were divided into 2 groups: THM administration (intervention) and no THM. Continuous variables were compared using t-tests and categorical variables with chi-square or Fisher's exact tests. MAIN OUTCOME MEASUREMENTS:Risk ratios for the association between HO occurrence and THM administration. RESULTS:Three-hundred and twenty-eight acetabular fractures met inclusion criteria (126 intervention, 202 control) in patients with a mean age of 38.7 ± 15.9 years; 62.2% were male, and 42.1% were African American. Traumatic brain injury and posterior dislocation rates were equivalent between groups (P = 0.505, 0.754, respectively). HO rate in the control group was 42.6% compared with 21.4% in the THM group (P < 0.001). Booker grade 3/4 in control group was 17.3% versus 3.2% in the THM group (P < 0.001). Patients receiving THM had a 50% reduced risk of HO (95% confidence interval 0.35-0.73) compared to those who did not; adjustment for age, gender, ethnicity, and traumatic brain injury did not meaningfully change the association (risk ratio 0.46; 95% confidence interval 0.29-0.73; P < 0.001). CONCLUSION:The use of a surgiflo product at closure of a KO approach may reduce the risk of HO formation by 50% after an acetabular fracture. LEVEL OF EVIDENCE:Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Montgomery T,Pearson J,Agarwal A,Olinger C,Tobey D,Beebe M,McGwin G,Cichos K,Ghanem E,Spitler C,Dubose C,Quade Jdoi
10.1097/BOT.0000000000001783subject
Has Abstractpub_date
2020-09-01 00:00:00pages
451-454issue
9eissn
0890-5339issn
1531-2291pii
00005131-202009000-00001journal_volume
34pub_type
杂志文章abstract:OBJECTIVES:The purpose of this study was to evaluate the loss of strength in the distal humerus that resulted from the creation of two different entry portals used for retrograde humeral nailing. DESIGN:Nine pairs, treated as blocks of size two, of fresh frozen humeri from individuals free of musculoskeletal disease w...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200002000-00005
更新日期:2000-02-01 00:00:00
abstract:OBJECTIVE:To report our experience with computed tomography (CT) scans to detect traumatic arthrotomies of the knee (TAK) joint based on the presence of intra-articular air. DESIGN:Retrospective review. SETTING:Level I trauma center. PATIENTS:Sixty-two consecutive patients (63 knees) underwent a CT scan of the knee ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31828219bc
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVES:This study evaluated whether patients with a left-sided femoral neck fracture (FNF) treated with a sliding hip screw (SHS) had a higher implant failure rate than patients treated for a right-sided FNF. This was performed to determine the clinical relevance of the clockwise rotational torque of the femoral ne...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001934
更新日期:2020-11-01 00:00:00
abstract::A prospective randomized study was set up, comparing a compression hip screw with the Vandeputte (VDP) endoprosthesis treatment for fresh, unstable peritrochanteric fractures, according to the Evans-Jensen and AO systems. Ninety patients, ages > or = 70 years, 47 of whom were treated with a compression hip screw and 4...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005131-199509040-00004
更新日期:1995-01-01 00:00:00
abstract::Limb salvage was successful in 25 patients treated for severe grade III upper extremity injuries. In a retrospective review of 20 men and five women, follow-up time averaged 26 months. These high-energy injuries were characterized by massive soft-tissue injury, highly comminuted fractures, and significant neurovascula...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVE:To determine whether multiple approaches pose an increased risk to fracture healing when compared with a standard single approach in the treatment of pilon (OTA 43C) fractures. DESIGN:Retrospective review of a prospective database. SETTING:Level I academic trauma center and level II community trauma center....
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000728
更新日期:2017-02-01 00:00:00
abstract::Over the last several decades, interest in global health across all fields of medicine, including orthopaedic surgery, has grown markedly. Cross-national collaborations are an effective means of conducting high-quality clinical research and offer many advantages over single-center investigations. Successful collaborat...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000466
更新日期:2015-12-01 00:00:00
abstract::Business intelligence in the field of medicine, particularly with physicians, has been an abstract concept at best with no objective metric. Furthermore, in many arenas, it was taboo for medical students, residents, and physicians to discuss the business and finances of their work for fear that it would interfere with...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000177
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:To characterize the presentation and outcomes of calcaneal avulsion fractures. DESIGN:Case series. SETTING:Two ACS Level I trauma centers. PATIENTS/PARTICIPANTS:Forty-seven calcaneal avulsion fractures isolated from a cohort of 1365 calcaneus fractures treated over a 17-year period. MAIN OUTCOME MEASUREME...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,多中心研究
doi:10.1097/BOT.0000000000001582
更新日期:2019-11-01 00:00:00
abstract::Long-bone deformity may be significantly symptomatic. A uniplanar corrective osteotomy uses a single cut to correct coronal, sagittal, and axial plane deformity simultaneously. Careful preoperative planning is required in addition to a comprehensive understanding of the magnitude and plane of the true deformity of the...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001519
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the difference in quality of fracture reduction between the sinus tarsi approach (STA) and extensile lateral approach (ELA) using postoperative CT scans in displaced intra-articular calcaneal fractures (DIACFs). DESIGN:Retrospective SETTING:: Level 1 and Level 2 academic centers. PATIENTS:Consec...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001971
更新日期:2020-09-18 00:00:00
abstract::Stress fracture of the anterior tibial cortex is an extremely challenging fracture to treat, especially in the high-performance female athlete who requires rapid return to competition. Previous reports have not addressed treating these fractures in the world-class athlete with anterior plating. We hypothesize that ant...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200607000-00011
更新日期:2006-07-01 00:00:00
abstract:OBJECTIVE:Presentation of a new triangular osteosynthesis technique that permits early weight-bearing in vertically unstable sacral fractures. DESIGN:Retrospective evaluation of a consecutive series. SETTING:Level I trauma center. PATIENTS:Thirty-four patients, twenty-eight of whom were polytraumatized, all with ver...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199806000-00002
更新日期:1998-06-01 00:00:00
abstract:SUMMARY:We present the previously unreported complication of symptomatic heterotopic ossification of the quadriceps following placement of a large-diameter Steinmann pin for the purpose of temporary skeletal traction. Following the development of distal quadriceps heterotopic bone formation in three patients, we conduc...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/00005131-200404000-00010
更新日期:2004-04-01 00:00:00
abstract::Standard 5-mm AO Schanz pedicle screws were biomechanically compared with a new design, featuring 6-mm threads with a 5-mm core diameter continuous with the shaft. One each of the two screw designs was surgically inserted into the matching pedicles of 32 cadaveric vertebrae. The pull-out strengths of the screws were t...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199308000-00015
更新日期:1993-01-01 00:00:00
abstract::This case report describes a Gustilo Anderson type IIIB tibia fracture associated with extensive segmental bone loss at the proximal meta-diaphyseal junction associated with a tibial plateau fracture and an avulsion of the tibial tubercle. After the tibial plateau fracture was stabilized using cannulated lag screws, t...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200209000-00010
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVE:To report the results from functional bracing of isolated ulnar shaft fractures. DESIGN:Retrospective review. SETTING:Two university hospitals. PATIENTS:Isolated ulnar shaft fractures in 444 patients were stabilized in functional braces that permitted full range of motion of all joints. INTERVENTION:Prefa...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199808000-00009
更新日期:1998-08-01 00:00:00
abstract:OBJECTIVES:External fixator pins are thought to have improved pullout strength if inserted into both cortices and if pilot holes are drilled. We tested these hypotheses and investigated effects of osteoporosis and pin location on pin pullout strength. METHODS:Self-drilling external fixator pins were inserted using 4 t...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182511ed7
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:Ankle fractures are one of the most common operatively treated lower extremity fractures. Several studies indicate that patients often have residual effects after this injury. The purpose of this study is to use the SF-36 questionnaire at two times to assess patients' functional recovery and residual effects ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200201000-00007
更新日期:2002-01-01 00:00:00
abstract::The stability of patellar fracture fixation protected with a load-sharing cable was studied in cadavers. A transverse patellar osteotomy was produced and stabilized with standard patellar fixation with or without a figure-of-eight cable that extends from the proximal pole of the patella to the tibial tubercle. Standar...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-198802030-00010
更新日期:1988-01-01 00:00:00
abstract::Forty-three patients with 43 comminuted femoral shaft fractures treated with the Brooker-Wills interlocking nail were followed through bony union to determine the device's ability to maintain length and rotational control of these difficult injuries. Only severely comminuted fractures, types III and IV, were included....
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-198702010-00002
更新日期:1987-01-01 00:00:00
abstract::From 1998 to 2006, 578 patients who were skeletally immature with proximal humerus fractures were treated at our institution. During that time period, 4 patients (0.7%) had associated brachial plexus and major peripheral nerve palsies. Average age at the time of injury was 12.3 years (range 10-14 years). Two fractures...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31816b7898
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to evaluate the most appropriate positioning of anatomical locking plates on the distal tibia. METHODS:We positioned 4 types of locking plates (3 straight and 1 bayonet) at anterior, middle, and posterior positions on the medial malleolus on both lower limbs of 15 cadavers. We ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31827cd67d
更新日期:2013-07-01 00:00:00
abstract::Immediate (within 24 h) open reduction and internal fixation of 103 open fractures of one or both bones of the forearm was accomplished in 69 patients between 1980 and 1989. Fifty-four of the 103 patients were reevaluated 1 to 7 years postinjury (average 2.5 years) to determine the efficacy of this treatment. Forty-fi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:
更新日期:1992-01-01 00:00:00
abstract::Periprosthetic acetabular fractures sustained following acute trauma after total hip arthroplasty are rare and historically have poor outcomes. This article reviews 5 cases and the treatment algorithm used by a single orthopaedic surgeon specializing in acetabular fracture care with a co-surgeon specializing in arthro...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001400
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVES:To determine if inpatient counseling with additional counseling could increase smoking cessation. DESIGN:Prospective study. SETTING:Level I trauma center. PATIENTS/PARTICIPANTS:Current smokers with an operative fracture randomly assigned to control (no counseling), brief counseling (inpatient counseling),...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000002028
更新日期:2020-11-25 00:00:00
abstract:OBJECTIVES:Hand dominance has been reported to be an important factor affecting outcomes after upper extremity trauma but remains unstudied after hemiarthroplasty for fracture. This study determined whether dominance affected outcomes after hemiarthroplasty for proximal humerus fractures. DESIGN:Retrospective cohort s...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000294
更新日期:2015-08-01 00:00:00
abstract:INTRODUCTION:External rotation and gravity stress radiographs have been described to distinguish stable supination-external rotation-II (SER-II) ankle fractures from unstable SER-IV fractures. It has been previously shown that both external rotation and gravity stress views are equivalent in their ability to diagnose d...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000817
更新日期:2017-05-01 00:00:00
abstract::The effect of antibiotic bead chains on the evolution of infection cannot be studied entirely in man due to the ethical problems of obtaining valid controls. Therefore, a model of musculoskeletal injury was devised in rabbits by making a paraspinal wound, fracturing a spinous process, and contaminating the wound with ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199212000-00001
更新日期:1992-01-01 00:00:00
abstract::Periprosthetic fractures after shoulder arthroplasty occur in up to 2% of patients. In patients with stable components who fail or cannot undergo nonoperative management, stable fixation is required. We present a new technique to obtain proximal fixation around the humeral component using a 4.5-mm large fragment plate...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000935
更新日期:2017-12-01 00:00:00