Injury
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Although vaccines have been hailed as one of the greatest advances in medicine based on their unparalleled cost-effectiveness in eradicating life-threatening infectious diseases, their role in orthopedic trauma-related infections is unclear. This is largely because vaccines are primarily made against pathogens that cause communicable diseases rather than opportunistic infections secondary to trauma, and most successful vaccines are against viruses rather than biofilm forming bacteria. Nonetheless, the tremendous costs to patients and healthcare systems warrant orthopedic trauma vaccine research, which has been a focal topic in recent international consensus meetings on musculoskeletal infection. This subject was also covered at the 2023 Osteosynthesis and Trauma Care Foundation (OTCF) meeting in Rome, Italy, and the purpose of this supplement article is to (1) highlight the osteoimmunology, animal models, translational research and clinical pilots that were discussed, (2) the proposed future directions that could lead to diagnostics and prognostics that are critically needed for evidence-based decision making, and (3) vaccines and passive-immunization strategies that could potentially be utilized to treat patients with orthopedic infections.
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Hoverboards are a popular means of recreation in the United States and are associated with significant injury risk, leading to recent efforts to improve their safety. Prior studies on hoverboard-related injuries were either conducted prior to implementation of safety regulations, consisted of short study intervals, or did not place a focus on injuries as they pertain to the orthopedic specialist. The purpose of this study is to provide an updated assessment of the epidemiology of orthopedic hoverboard-related injuries presenting to US emergency departments. ⋯ Hoverboard-related injuries continue to be a common presentation to US emergency departments, though injury rates appear to be decreasing. Orthopedic injuries consistently account for the majority of hoverboard-related injuries reporting to emergency departments, with fractures of the forearm and wrist being most common. Continued efforts toward improving safety measures regarding hoverboard use are warranted.
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Case Reports
Morel-Lavallee associated lymphedema treated with lymphovenous anastomosis: A case report.
Morel-Lavallee Lesions lead to disruption of lymphatic anatomy that require early identification and may necessitate lymphatic reconstruction. We present the case of a 59-year-old male with lower extremity lymphedema resulting after a severe Morel-Lavallee lesion and treated using lymphovenous anastomoses. He was initially managed with multiple aspirations followed by repeat incision and drainage. ⋯ At 5 months postoperatively, his volumetric lower extremity measurements showed a decrease by 314 mL and he began walking again in 20-minute intervals. Lymphedema may be an important consideration following severe Morel-Lavallee lesions. Using modern diagnostic and supermicrosurgical techniques, plastic surgeons can help treat this long-term morbidity.
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This study aimed to use machine learning (ML) to establish risk factor and prediction models of osteonecrosis of the femoral head (ONFH) in patients with femoral neck fractures (FNFs) after internal fixation. ⋯ The logistic regression model had excellent performance in predicting ONFH in patients with FNFs after internal fixation and could provide valuable guidance in clinical decision-making. When choosing treatment options for patients with FNFs, doctors should identify the risk factors and consider using the presented models to help anticipate outcomes and select individualised treatment.
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This paper evaluates the accuracy and safety of a long bone fracture reduction robot under different surgical modes. ⋯ Based on CT imaging verification, the accuracy of the robot in both autonomous and master-slave surgical modes meets clinical requirements. Future work will focus on further optimizing the robot system.