Orthopedics最新文献

{"title":"Epidemiology of Lumbar Spine Fractures: Twenty-Year Assessment of Nationwide Emergency Department Visit Data.","authors":"Michael J Kuharski, Mohammad Daher, Jack J Zhou, Chibuokem P Ikwuazom, Carolyn Andrews, Juhayer Alam, Ryan C Scheer, Mary Lou, Daniel Alsoof, Mariah Balmaceno-Criss, Neil V Shah, Jad Bou Monsef, Bassel G Diebo, Carl B Paulino, Alan H Daniels","doi":"10.3928/01477447-20240918-02","DOIUrl":"10.3928/01477447-20240918-02","url":null,"abstract":"<p><strong>Background: </strong>Lumbar spine fractures are common injuries associated with substantial morbidity for patients and socioeconomic burden. This study sought to epidemiologically analyze lumbar spine fractures by mechanism of injury and identify temporal trends in patient demographics and disposition, which few studies have previously evaluated.</p><p><strong>Materials and methods: </strong>A retrospective analysis was done of the US National Electronic Injury Surveillance System (NEISS) database between 2003 and 2022. The sample contained all patients 2 to 101 years old with product-related lumbar fractures presenting to participating institutions' emergency departments. A total of 15,196 unweighted injuries (642,979 weighted injuries) were recorded.</p><p><strong>Results: </strong>Overall, there was a 20-year incidence rate of 10.14 cases per 100,000 person-years with a 2-fold increase in fracture incidence. Females were more prone to lumbar fracture than males (<i>P</i>=.032). Injuries primarily stemmed from a fall (76.6%). The incidence of lumbar fracture increased most significantly in older patients, with patients 80 years and older showing the greatest annual increase (β=8.771, <i>R</i>²=0.7439, <i>P</i><.001) and patients 60 to 69 years showing the greatest percent increase with a 3.24-fold increase in incidence. Most (58.9%) of the fractures occurred at home. Females were more often injured at home compared with males (<i>P</i><.001), who more often sustained lumbar fractures during recreational or athletic activity (<i>P</i><.001). All patients older than 40 years showed at least a doubling in incidence rate of lumbar fracture between 2003 and 2022.</p><p><strong>Conclusion: </strong>These data demonstrate the pressing need to address poor bone health in the aging population, shown here to have an increasing fracture burden. [<i>Orthopedics</i>. 2024;47(6):e297-e302.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e297-e302"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health Disorders and Surgical Outcomes in Patients With Bone and Soft Tissue Sarcoma.","authors":"MaKenzie M Chambers, Caroline T Gutowski, Pietro Gentile, Krystal Hunter, Tae Won B Kim, Christina J Gutowski","doi":"10.3928/01477447-20240809-04","DOIUrl":"10.3928/01477447-20240809-04","url":null,"abstract":"<p><strong>Background: </strong>We conducted a study to investigate the relationship between a mental health diagnosis (MHD) and postoperative outcomes in orthopedic patients with bone and soft tissue sarcoma. We hypothesized that patients with sarcoma with a preoperative MHD would have worse outcomes and more postoperative complications.</p><p><strong>Materials and methods: </strong>A retrospective review was performed of 356 patients who underwent surgical treatment for bone or soft tissue sarcoma. Patients were divided into two groups: those with a diagnosis of depression, anxiety, bipolar disorder, and/or schizophrenia and those with no previous MHD. Statistical analysis was performed using independent <i>t</i>, Mann-Whitney <i>U</i>, and chi-square tests.</p><p><strong>Results: </strong>Statistical analysis demonstrated significant differences between the MHD group and the control group in three outcomes: length of stay, 90-day readmission rate, and incidence of surgical site infections. Subgroup analysis of the MHD group yielded significantly higher 90-day readmission rates for patients who were diagnosed during sarcoma treatment.</p><p><strong>Conclusion: </strong>Patients with sarcoma and an MHD had a longer postoperative hospital stay, an increased 90-day readmission rate, and a greater risk of surgical site infection. Given the rising prevalence of mental health disorders nationwide, orthopedic surgeons should be aware of differences in postoperative outcomes between patients with sarcoma with and without mental illness. [<i>Orthopedics.</i> 2024;47(6):337-342.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"337-342"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Eponymous History of Hemostatic, Tissue, and Reduction Clamps in Orthopedic Surgery.","authors":"Kendall H Derry, Isaac Dayan, Allison M Morgan, Kevin Lehane, Nina D Fisher, Andrew S Bi","doi":"10.3928/01477447-20241104-01","DOIUrl":"10.3928/01477447-20241104-01","url":null,"abstract":"<p><p>Eponyms are widely used in the field of orthopedic surgery, including for surgical instruments. Although their use is at times controversial, an appreciation of the history behind eponymous terms allows one to both recognize the shortcomings of the past and simultaneously be inspired by ingenious inventors. The primary purpose of this review is to provide a historical perspective of clamps and forceps commonly used in orthopedic surgery, to better appreciate the evolution of their use over time, and to inspire innovation to constantly improve upon surgical instrumentation as the field of orthopedic surgery advances. [<i>Orthopedics</i>. 2024;47(6):e287-e291.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e287-e291"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peer-Reviewed Publications by Successfully Matched Orthopedic Surgery Residency Applicants in the 2022-2023 Match.","authors":"Joseph Brenner,Braden Womack,Maverick Delp,David Yatsonsky,Maged Hanna,Christopher Sanford","doi":"10.3928/01477447-20240913-01","DOIUrl":"https://doi.org/10.3928/01477447-20240913-01","url":null,"abstract":"BACKGROUNDThe Orthopaedic Surgery Match is highly competitive, with more applicants than residency spots. With the Step 1 Exam moving to a pass/fail result, residency programs and applicants have fewer objective data to determine applicants' relative competitiveness. Through this study, we sought to provide the mean number of accepted publications on PubMed a successfully matched orthopedic surgery applicant has by the time of submission of their application.MATERIALS AND METHODSOrthopedic surgery residency programs participating in the National Resident Matching Program were identified by their ranking on the Doximity Residency Navigator. Each program's intern class and their medical schools were identified. Their names were searched in PubMed and Scopus and articles with their name and affiliations were recorded.RESULTSIn total, 877 orthopedic surgery interns published a mean of 3.30±5.27 articles each on PubMed. They were first or second author on 1.44±2.58, and 1.96±3.89 publications were related to orthopedic surgery. There were no statistical differences between degree, sex, or residency program rank from the Doximity Residency Navigator. The mean number of publications from a successful applicant was approximately 3. There was a great range in the number of publications, and 27.3% of successful applicants did not have a single publication.CONCLUSIONFuture applicants and programs can use this number to gauge relative research output. [Orthopedics. 202x;4x(x):xx-xx.].","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"8 1","pages":"1-4"},"PeriodicalIF":1.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ranking the Orthopedic Procedures With the Highest Morbidity and Mortality.","authors":"Brady S Ernst,Nicholas R Kiritsis,Phillip B Wyatt,Charles R Reiter,Conor N O'Neill,James R Satalich,Alexander R Vap","doi":"10.3928/01477447-20240913-02","DOIUrl":"https://doi.org/10.3928/01477447-20240913-02","url":null,"abstract":"BACKGROUNDMusculoskeletal conditions currently affect more than one-third of the US population and orthopedic procedures play a pivotal role in managing them. Like any invasive intervention, these carry a wide spectrum of risk, necessitating a comprehensive understanding of the associated morbidity and mortality. This study sought to provide a global perspective of the risks and complications associated with these procedures to establish an easy to understand risk stratification tool for both patients and providers.MATERIALS AND METHODSCurrent Procedural Terminology codes associated with orthopedic surgery were identified in the American College of Surgeons National Surgical Quality Improvement Program database from 2018 to 2020. Each code was associated with its rate of 30-day mortality as well as any adverse event (AAE) and then ranked for descriptive analysis.RESULTSIn total, there were 698,549 patients who underwent orthopedic procedures associated with 94 CPT codes with at least 1 morbidity event and 144 CPT codes with at least 1 AAE. The CPT code associated with the highest mortality was 27590 or above knee amputation. The CPT code associated with the highest rate of AAE was 27507 or open treatment of femoral shaft fracture with plate and screws.CONCLUSIONThis is the first study to compare the rates of morbidity and mortality in all patients with orthopedic procedures. There was a strong bias toward increased risk associated with lower extremity surgery and surgery most often performed in the geriatric population. [Orthopedics. 202x;4x(x):xx-xx.].","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"31 1","pages":"1-5"},"PeriodicalIF":1.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Kienböck's Disease Using Fourth and Fifth Extensor Compartmental Artery Vascularized Bone Grafts.","authors":"Byung Sung Kim,Joo Young Cha,Jaehyun Kim,Ki Jin Jung,Jae-Hwi Nho","doi":"10.3928/01477447-20240913-03","DOIUrl":"https://doi.org/10.3928/01477447-20240913-03","url":null,"abstract":"BACKGROUNDThis study evaluated the radiological and clinical outcomes of bone grafts using fourth and fifth extensor compartmental arteries (4+5 ECAs) for the treatment of Kienböck's disease.MATERIALS AND METHODSIn total, 21 patients (12 men and 9 women; mean age, 41 years; range, 19-59 years) were followed for a mean of 33 months. Radiological images were analyzed for the Lichtman stage, carpal height ratio, radioscaphoid angle, and Stahl's index. Clinical evaluation included range of motion, visual analog scale (VAS) score, grip strength, modified Mayo wrist score (MMWS), Lichtman outcome score, and Disabilities of the Arm, Shoulder and Hand (DASH) score. At the time of surgery, 6, 14, and 1 patients had Lichtman stages II, IIIA, and IIIB, respectively.RESULTSAt the final follow-up visit, grip strength had improved from 65.4% to 79.7%, wrist extension had improved from 43° to 57°, and flexion had improved from 42° to 50°. There were no significant changes in the carpal height ratio, Stahl's index, or radioscaphoid angle. The mean VAS score was 1.7, and the mean DASH score was 6.9. The mean MMWS was 87.9, with excellent and good outcomes in 6 and 11 patients, respectively. Satisfactory Lichtman outcome scores were observed in 81%. Body mass index had a strong correlation and age had a weak correlation with MMWS (coefficient=-0.534, P=.013, and coefficient=-0.393, P=.078, respectively).CONCLUSIONThe 4+5 ECA bone graft is effective for the treatment of Kienböck's disease in young patients with low body mass index. [Orthopedics. 202x;4x(x)xx-xx.].","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"15 1","pages":"1-5"},"PeriodicalIF":1.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiphospholipid Syndrome Increases Postoperative Complications After Total Hip and Knee Arthroplasty.","authors":"Ankit Hirpara, Melissa Carpenter, Michael Dayton, Craig Hogan","doi":"10.3928/01477447-20240619-03","DOIUrl":"10.3928/01477447-20240619-03","url":null,"abstract":"<p><strong>Background: </strong>Antiphospholipid syndrome (APS) is a systemic autoimmune condition that predisposes patients to venous thromboembolism (VTE). Although many studies have explored risk factors for VTE after joint reconstructive procedures, the impact of APS is still unclear.</p><p><strong>Materials and methods: </strong>A retrospective cohort study was conducted using TriNetX, a health care database that includes 442,494 patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA). Ninety-day postoperative complications and 1- and 2-year surgical complications were compared between patients with and without preexisting APS. Patients underwent propensity score matching in a 1:1 ratio based on relevant comorbidities.</p><p><strong>Results: </strong>Patients undergoing THA or TKA with APS, compared with those without, had higher rates of deep venous thrombosis (hip: 9.2% vs 6.0%, odds ratio, 1.589, <i>P</i>=.022; knee: 10.5% vs 4.1%, odds ratio, 2.763, <i>P</i><.001), pulmonary embolism (hip: 6.9% vs 3.6%, odds ratio, 1.992, <i>P</i>=.005; knee: 8.4% vs 3.0%, odds ratio, 2.989, <i>P</i><.001), and anemia (hip: 24.8% vs 18.6%, odds ratio, 1.447, <i>P</i>=.004; knee: 18.5% vs 13.9%, odds ratio, 1.406, <i>P</i>=.007). Patients undergoing THA with APS also had higher rates of urinary tract infection (5.0% vs 2.8%, odds ratio, 1.842, <i>P</i>=.029) and pneumonia (3.7% vs 1.8%, odds ratio, 2.119, <i>P</i>=.025). APS did not impact rates of surgical complications or revision surgery.</p><p><strong>Conclusion: </strong>Overall, APS heightens patients' risk for complications after THA and TKA. Specific anticoagulation protocols and preoperative risk stratification should be implemented to reduce the risk of adverse events. [<i>Orthopedics</i>. 2024;47(5):301-307.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"301-307"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141469871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid Use After Robotic-Assisted Versus Conventional Total Hip Arthroplasty: A National Database Analysis.","authors":"Thompson Zhuang, Bill Young, Jessica Hooper, Derek F Amanatullah, Lauren Shapiro, Robin N Kamal","doi":"10.3928/01477447-20240702-03","DOIUrl":"10.3928/01477447-20240702-03","url":null,"abstract":"<p><strong>Background: </strong>In this study, we tested the null hypothesis that robotic-assisted total hip arthroplasty (THA) vs conventional THA was not associated with (1) the amount of postoperative opioid use and (2) the incidence of new, persistent opioid use.</p><p><strong>Materials and methods: </strong>We used a large, national administrative database to identify patients 50 years and older undergoing primary robotic or conventional THA. Patients with hip fractures or a history of malignancy, hip infection, or opioid use disorder were excluded. Patients who filled an opioid prescription within 1 year to 30 days preoperatively or who underwent a subsequent procedure within 1 year after THA were excluded. Outcomes included the morphine milligram equivalents (MMEs) filled within the THA perioperative period and the incidence of new, persistent opioid use. Multivariable logistic regression models were used to evaluate associations between robotic-assisted THA and new, persistent opioid use, adjusting for age, sex, insurance plan, region, location of surgery, and comorbidities.</p><p><strong>Results: </strong>In the postoperative period, robotic-assisted THA, compared with conventional THA, was associated with a lower mean total MMEs filled per patient (452.2 vs 517.1; <i>P</i><.001) and a lower mean MMEs per patient per day (71.53 vs 74.64; <i>P</i><.001). Patients undergoing robotic-assisted THA had decreased odds of developing new, persistent opioid use compared with patients undergoing conventional THA (adjusted odds ratio, 0.82 [95% CI, 0.74-0.90]).</p><p><strong>Conclusion: </strong>Robotic-assisted THA is associated with lower postoperative opioid use and a decreased odds of developing new, persistent opioid use compared with conventional THA. For the purposes of reducing opioid use, our results support the adoption of robotic-assisted THA. [<i>Orthopedics</i>. 2024;47(5):289-294.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"289-294"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventing Iatrogenic Fibula Fractures Using the Push-Pull Technique: A Biomechanical Comparison of Unicortical Versus Bicortical Post Screws.","authors":"Sheldon A McCown, Paul J Weatherby, Randal P Morris, Vinod K Panchbhavi, John C Hagedorn, William M Weiss, Jie Chen","doi":"10.3928/01477447-20240702-02","DOIUrl":"10.3928/01477447-20240702-02","url":null,"abstract":"<p><strong>Background: </strong>Displaced diaphyseal fractures can be reduced using the push-pull technique, wherein a plate is affixed to the distal fragment of the fracture, a post screw is placed proximal to the plate, and a lamina spreader creates distraction. This study evaluated the load to failure and mechanism of failure of bicortical and unicortical post screws during reduction.</p><p><strong>Materials and methods: </strong>Four matched pairs of cadaver legs were subjected to a 2-cm oblique osteotomy simulating a displaced, oblique diaphyseal fracture. A 6-hole compression plate was affixed to the distal fragment with 2 unicortical locking screws, and a 12-mm unicortical or 20-mm bicortical screw was inserted as a post screw proximal to the plate. A lamina bone spreader was used to exert a distraction force between the plate and the post screw. A mechanical actuator simulated the distraction procedure until failure. Maximum applied load, displacement, and absorbed energy were recorded and compared across unicortical and bicortical groups by paired <i>t</i> tests.</p><p><strong>Results: </strong>At maximum load, we found statistically significant differences in displacement (<i>P</i>=.003) and energy absorbed (<i>P</i>=.022) between the two groups. All unicortical screws failed through screw toggle and bone cut-out. Bicortical screws failed through bending, with no visible damage to the bone at the screw site.</p><p><strong>Conclusion: </strong>When diaphyseal fractures are significantly shortened and require a greater distraction force to achieve reduction, bicortical screws demonstrate a higher mechanical load to failure and increased bone loss from the screw-removal site. A unicortical post screw may be used if minimal distraction is needed. [<i>Orthopedics</i>. 2024;47(5):308-312.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"308-312"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tranexamic Acid Reduces the Amount of Blood Transfused in Revision Total Hip Arthroplasty for Vancouver B2/B3 Periprosthetic Femur Fractures.","authors":"John Patrick Connors, Robert James Magaldi, Sara Elaine Strecker, Robert James Carangelo, Dan Witmer","doi":"10.3928/01477447-20240718-05","DOIUrl":"10.3928/01477447-20240718-05","url":null,"abstract":"<p><strong>Background: </strong>Periprosthetic fractures around total hip arthroplasty (THA) represent a significant source of morbidity and mortality. The use of tranexamic acid (TXA) in arthroplasty is well described, yet little literature supports its role in periprosthetic femur fractures (PFFs). This study investigated the effect of preoperative TXA administration on transfusion rate and volume, length of stay, and 90-day complication rates in patients undergoing revision THA for PFF.</p><p><strong>Materials and methods: </strong>All patients undergoing revision THA for PFF (Vancouver B2/B3) at our institution from August 2016 to June 2022 were identified. Routine TXA administration at surgical start was introduced in 2018. Patient demographics, operative time, blood product use, length of stay, and 90-day complications were collected. Patients were divided into those who received TXA preoperatively and those who did not.</p><p><strong>Results: </strong>A total of 56 patients were included. There was no difference in age, sex, anesthetic type, fracture classification, or preoperative blood values between cohorts. TXA significantly lowered the amount of blood product required (2.3 units vs 3.2 units, <i>P</i>=.023). Preoperative TXA did not independently reduce length of stay; however, blood transfusion was associated with increased length of stay (7 days vs 4.7 days, <i>P</i>=.003). There were no differences in 90-day complications.</p><p><strong>Conclusion: </strong>Among patients who underwent revision THA for Vancouver B2/B3 PFF, TXA did not affect transfusion rates but did result in the use of fewer blood products without an increase in complications. We support routine use of TXA in this patient population. Future studies should assess earlier administration of TXA in the emergency department or once patients' conditions have been medically optimized. [<i>Orthopedics</i>. 2024;47(5):e261-e267.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e261-e267"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}