The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jun 2015
ReviewSurgical Coaching from Head-Mounted Video in the Training of Fluoroscopically Guided Articular Fracture Surgery.
The evolving surgical skills education paradigm in orthopaedics has generated a strong demand for validated educational tools and methodologies. This study aimed to confirm that a one-on-one faculty coaching review of the head-mounted video recording of a resident's surgical performance on a validated articular fracture simulation trainer would substantially improve subsequent performance. ⋯ Personalized video-based feedback improved performance on a standardized articular fracture trainer for first-year and second-year residents. The described technique may further enhance resident surgical skills education.
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J Bone Joint Surg Am · May 2015
ReviewAcetabular fractures in the elderly: evaluation and management.
Acetabular fracture patterns in the elderly, with increased involvement of the anterior column, quadrilateral plate comminution, medialization of the femoral head, and marginal impaction, differ from those noted among a younger cohort. Poor prognostic factors for open reduction and internal fixation (ORIF) are posterior wall comminution, marginal impaction of the acetabulum, a femoral head impaction fracture, a so-called gull sign, and hip dislocation. The rate of conversion to total hip arthroplasty following formal ORIF has been reported to be 22% at a mean of twenty-nine months. Total hip replacement after an acetabular fracture generally yields good clinical results; however, in the acute setting, it must be combined with proper stable fracture fixation.
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J Bone Joint Surg Am · Apr 2015
ReviewEstablishing a fracture liaison service: an orthopaedic approach.
➤ Bone health evaluations should be incorporated into care pathways for fragility fractures in all patients who are fifty years of age or older.➤ A fracture liaison service (FLS) is an established and proven method to achieve recommended standards of care for fragility fractures, including intervention for osteoporosis, secondary fracture prevention, and bone health evaluation.➤ The FLS facilitates patient care by automatically including all patients with a fragility fracture within a health-care system to provide them with the intervention that they need and to prevent avoidable fracture-related complications or readmissions.➤ An FLS functions with three key personnel: the FLS coordinator (usually an advanced practice provider), a physician champion (usually an orthopaedic surgeon), and a nurse navigator.
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J Bone Joint Surg Am · Mar 2015
ReviewEstimating the global incidence of femoral fracture from road traffic collisions: a literature review.
Worldwide, road injuries cause over 1.3 million deaths and many more disabilities annually, disproportionately affecting the young and the poor. Approximately one in ten road injuries involves a femoral shaft fracture that is most effectively treated with surgery. Current femoral shaft fracture incidence according to country and age group is unknown and difficult to measure directly but is critical to designing and evaluating interventions. ⋯ Our results demonstrate a substantial worldwide burden and disparities in femoral shaft fracture incidence between low to middle income and high income countries, and the young are disproportionately affected, underscoring the potential impact of improved access to treatment. We believe that the methodology of this study can be applied to estimate the burden of other diseases, allowing for better direction of global health efforts.