Post-traumatic osteoarthritis (PTOA) occursfollowing an injury such as Anterior CruciateLigament (ACL) rupture. Clinically, ACLreconstruction surgery is performedfollowing injury. However, it is unclear howeffective knee restabilization is in slowingPTOA progression. This study hypothesized that knee restabilization would slow the progression of PTOA, but the procedure itself would have some mild PTOA-like joint degeneration.
Injections for De Quervain’s Tenosynovitis (DQT) are traditionally performed within the sheath, often done blind or based on external landmarks.
A common anatomic variant, (septated or separate sub-sheaths) makes it even more challenging to properly inject within the affected sub-sheaths when blind.Some recent studies have shown ultrasound guided injections as a potential viable alternative.
This study aimed to compare revision ratesand associated complications in femoral shaftfractures, with and without reduction of thesebutterfly fragments.
Intramedullary nailing is considered the gold-standard treatment for tibial shaft fractures. The goals of treatment for these fractures are correction of axial and rotational alignment and adequate mechanical stability, allowing for optimal healing. The nail is secured in place using screws or other fasteners that are placed through the bone and into the nail itself.2 Another benefit is the ability to preserve the soft tissue around the fracture to safeguard the extraosseous blood supply and minimize soft tissue damage.3 In reference to tibial intramedullary nailing, a start point is the location where a hole is drilled in the tibia to insert the intramedullary nail. The ideal starting point for guide wire placement for the average tibia is described as 2 mm medial to the lateral tibial eminence on AP imaging and just anterior to articular surface and parallel to the anterior tibia cortex on lateral imaging.6,7 It is a critical part of the procedure because it determines the trajectory and positioning of the nail within the medullary canal.7 Having a good, ideal starting point can prevent valgus angulation and translation at the fracture site. If the start point is too far off center or at the wrong angle, the nail may be inserted incorrectly and not provide the necessary support for the bone to heal, leading to malalignment or nonunion. It is believed that different approaches to tibial intramedullary nailing may have differing abilities to achieve an optimal start point due to associated anatomical visualization and access. These approaches include suprapatellar, parapatellar, and infrapatellar nailing. The suprapatellar approach involves making an incision above the patella and placing instruments across the patellofemoral joint, potentially damaging the joint surface. However, the nail can be inserted at the start point with the knee extended, which leads to better alignment and stability of the fractured bone. Most importantly, the main advantage of the suprapatellar approach is that it reduces anterior angulation by eliminating the extension force of the quadriceps and aids fracture reduction by preventing proximal fragment migration.4,5 The parapatellar approach, proven to be effective and reliable, involves making a smaller incision below the patella with the knee in hyperflexion. This approach is less invasive than the suprapatellar approach regarding the patellofemoral joint, but the patellar tendon needs to be circumnavigated leading to potential for higher incidence of anterior knee pain.6 Also, it can be more difficult to achieve proper alignment and increases the risk of apex anterior deformities.4 The infrapatellar approach is split into transtendinous approach and paratendinous approach where the starting point is established by splitting the patellar tendon or making an incision on either side of the knee, respectively.6 This approach provides good visualization, but it can increase the risk of damage to the patellar tendon and other soft tissue structures around the knee.
Our study examined the effect of developing a reliable protocol for prescribing opioids for postoperative pain following ACS surgery. Our goal was to progress toward completion of an effective, research-based, and consistent opioid prescription protocol. This protocol proved to effectively reduce total MME administration. Long-term, we hope this study may assist in the development of opioid prescribing protocols for other orthopaedic procedures at UC Davis Medical Center.
Our study aimed to characterize presentations andassess the treatment of firearm-induced NVI in pediatricpatients at a level-1 pediatric trauma center.
The aging population are participating in more athletic and physically demanding activities longer and later in life. The debate over the best graft for ACL reconstructions has been ongoing for years and there are numerous studies supporting all types, but none focus on the older population. This study aims to report allografts are an equally viable and effective option for ACL reconstruction in patients over 40 years of age with no difference in re-rupture rates.
osteoporosis is a major public health issue, with more than 53 million people in the United States either having osteoporosis or at increased risk for developing osteoporosis.Several guidelines urge bone health evaluation and treatment for adults diagnosed with fragility fractures; however, two recentstudies from UC Davis Health have reported sub-optimal rates of DEXA evaluation, endocrinology referrals, and osteoporosismedication use. We sought to bridge the inpatient and outpatient osteoporosiscare gap by sending a detailed letter for primary care providers (PCP) summarizing osteoporosis treatment guidelines.
Therefore, the primary aim of this study was to determine the rates of change in osteoporosis evaluation and treatment in adultpatients after fragility fracture since implementation of this PCP letter system.
The orthopedic match is highly competitive, and successful orthopedic applicants havehistorically had high Step 1 scores. Step 1 is Pass/Fail after January 26, 2022. Programs must change applicant assessment, and students must understand how to build asuccessful orthopedic application.
Cerebral palsy (CP) is the most common pediatric motor disability in the United States of America today and has been associated with many etiologies. Literature on Cerebral Palsy and Social Determinants of Health (SDoH) is lacking, even though it is a crucial component of medicine. There is little evidence analyzing that the effect of socioeconomic status (SES) based on area-based analysis and the prevalence and severity of CP. The relationship between zip code tabulation areas and CP prevalence or severity is unknown.
