Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews最新文献

{"title":"Coincidence of Congenital Pseudarthrosis of the Tibia and Hemihypertrophy in a Patient With Neurofibromatosis Type 1.","authors":"Fahad A Alshayhan, Reggie C Hamdy","doi":"10.5435/JAAOSGlobal-D-25-00030","DOIUrl":"10.5435/JAAOSGlobal-D-25-00030","url":null,"abstract":"<p><p>Neurofibromatosis type 1 (NF-1) leads to cutaneous, neurological, and musculoskeletal manifestations. Congenital pseudarthrosis of the tibia treatment is considered aggressive in achieving bone union. Most of those patients get a short limb at the end of treatment because of pathological bone resection and malalignment. One of the manifestations that can appear in patients is localized hemihypertrophy of the limb. In our case, we present the first time a coexistence of congenital pseudarthrosis of the tibia and hemihypertrophy in the same leg was reported.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 7","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12189972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Civilian Ballistic Proximal Femur Fractures and Blunt Proximal Femur Fractures: Comparing Outcomes and Complications.","authors":"Clayton Farris, Matthew Yeager, Rodney Y Arthur, Cole Garrison, Samuel Schick, David A Patch, Clay A Spitler, Joey P Johnson","doi":"10.5435/JAAOSGlobal-D-24-00263","DOIUrl":"10.5435/JAAOSGlobal-D-24-00263","url":null,"abstract":"<p><strong>Introduction: </strong>To assess ballistic proximal femur fracture outcomes in comparison with proximal femur fractures sustained by blunt mechanisms. We hypothesized that ballistic proximal femur fractures would have higher rates of infection, nonunion, and compartment syndrome than nonballistic fractures.</p><p><strong>Methods: </strong>A retrospective cohort was collected from the electronic medical record of a single, Level I, trauma center over a 10-year period (2013 to 2022) using Current Procedural Terminology codes. All consecutive adult patients with ballistic proximal third femur fractures (femoral neck, intertrochanteric, subtrochanteric) managed with surgical fixation were identified. A comparison group of proximal femur fractures sustained by nonballistic mechanisms was collected from consecutive patients in a 3-year period (2020 to 2022), creating a 2:1 nonballistic-to-ballistic fracture ratio. Exclusion criteria consisted of younger than 18 years or older than 65 years, primary fixation of total/hemi hip arthroplasty, primary pathologic fractures, and fractures across existing prosthesis. The primary outcomes measured include concomitant genitourinary injury, computed tomographic angiography with abnormality, vascular injury requiring repair, soft-tissue reconstruction, thigh compartment syndrome, length of stay, fracture-related infection, revision surgery to promote bone healing, and implant failure.</p><p><strong>Results: </strong>A total of 411 patients were included with 137 (33%) sustaining ballistic proximal femur fractures. Most blunt fractures were closed (86.8%), whereas most ballistic fractures were Gustilo Anderson type 1 open fractures (81.7%). The individuals in the ballistic cohort were more likely to have vascular injury requiring surgical intervention (8.8% vs. 1.1%, P < 0.001), computed tomographic angiography with abnormality (10.9% vs. 1.1%, P < 0.001), compartment syndrome (7.3% vs. 0.7%, P < 0.001), concomitant GU injury (12.4% vs. 1.8%, P < 0.001), and deep vein thrombosis (5.1% vs. 1.5%, P = 0.048).</p><p><strong>Conclusion: </strong>Ballistic proximal femur fractures are associated with a higher risk of developing complications associated with trauma to nearby vascular structures and concomitant genitourinary structures. The rates of infection, revision surgery to promote bone healing, and implant failure were similar between the ballistic and nonballistic proximal femur fractures.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 7","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144664067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decline in Pediatric Anterior Cruciate Ligament Reconstructions Seen Over 20 Years in the American Board of Orthopaedic Surgeons Part II Oral Examination Database.","authors":"V Claire Clark, Meagan J Sabatino, Daniel R G Lind, Robert L Van Pelt, Curtis D Vandenberg, Jennifer J Beck, Andrew T Pennock, Aristides I Cruz, Theodore J Ganley, Kevin G Shea, Philip L Wilson, Henry B Ellis","doi":"10.5435/JAAOSGlobal-D-24-00287","DOIUrl":"10.5435/JAAOSGlobal-D-24-00287","url":null,"abstract":"<p><strong>Introduction: </strong>Although increased treatment of pediatric anterior cruciate ligament (ACL) injury is well-documented, surrounding trends remain unknown. We evaluated national trends over 21 years using data from pediatric ACL reconstructions (ACLR) submitted to the American Board of Orthopaedic Surgeons (ABOS) Part II Oral Examination and compared fellowship training, geographic variation, and case volume trends.</p><p><strong>Methods: </strong>The ABOS SCRIBE database was queried for ACLR in pediatric (<19) patients between 2000 and 2021. Data included geographic region, fellowship training, and patient demographics. ACLRs per capita was estimated using census data. Data were stratified by age and sex. Multiple linear regression assessed whether year, sex, and age/sex category predicted surgery number.</p><p><strong>Results: </strong>From 2000 to 2021, ABOS Part II candidates reported 12,124 pediatric ACLR. Nearly 2/3 were in patients 16 years or older. Most were in the Midwest (22.8%) and South (22.2%). Each region decreased in ACLR. Overall, pediatric ACLR decreased 31.3% and contributing surgeons decreased 40.4%. Female ACLR increased 39.5% from 2009 to 2014, with 11.9% more than male patients in 2014. After 2014, sex differences and total ACLR decreased. 81.3% were reported by surgeons with sports medicine training and 6.0% with dual sports medicine and pediatric orthopaedics fellowships. Dual training increased in 2009 and declined after 2013. Surgeries in male patients compared with female patients (B = -6.777, 95% confidence interval, -9.534 to -4.279) and male patients 16 to 18 years compared with male patients younger than 16 years (B = -4.935, 95% confidence interval, -6.596 to -3.273) decreased.</p><p><strong>Conclusion: </strong>Pediatric ACLR performed by ABOS Part II candidates decreased overall, but a concern for increased ACLR in female patients persists. More surgeries were done in the Midwest and South.</p><p><strong>Study design: </strong>Cross-sectional Study Level of Evidence: III.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Results of Aspiration, Erythrocyte Sedimentation Rate, and C-Reactive Protein in Patients With Known Prosthetic Joint Infection on Chronic Suppression.","authors":"Meredith Benson, Steven Denyer, Amy Wozniak, Daniel Schmitt, Nicholas Brown","doi":"10.5435/JAAOSGlobal-D-25-00139","DOIUrl":"10.5435/JAAOSGlobal-D-25-00139","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic antibiotic suppression (CAS) is regarded as a reasonable treatment option for persistent prosthetic joint infection in patients with multiple failed surgical eradication attempts or comorbidities that preclude surgical treatment. However, patient response to CAS has been highly variable. The purpose of this study is to determine if inflammatory marker values predict success with CAS and assess average inflammatory marker values to facilitate more accurate periprosthetic joint infection (PJI) diagnoses in patients suspected of having prosthetic joint infection who were already started on antibiotics.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted, identifying 46 patients on CAS. Inclusion based on culture-proven PJI and treatment with chronic suppressive antibiotics. Failure was defined as requirement of revision surgery or death related to PJI. Laboratory values (erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], polymorphonuclear neutrophilic [PMN] leukocyte, synovial white blood cell [WBC]) within 2 years following suppression initiation were collected. Wilcoxon rank-sum tests were used to compare laboratory values between those with success and failure.</p><p><strong>Results: </strong>This study analyzed 33 total knee and 16 total hip arthroplasties. The strongest predictor of failure with CAS within 2 years of treatment was elevated ESR (P < 0.05). Despite antibiotic treatment, 0 to 2 years following CAS initiation, 75% of patients had an elevated PMN% and 83.3% had elevated synovial WBC. CRP remained elevated in only 39.3% of patients, and ESR remained elevated in 66.7% of patients.</p><p><strong>Conclusion: </strong>The primary laboratory predictor of those who failed with CAS was elevated ESR. Second, elevated PMN% and synovial WBC were determined to be the strongest indicators of PJI in a patient who was treated with antibiotics before diagnosis, although CRP and ESR were more likely to normalize. This suggests that patients with strong clinical suspicion for PJI on antibiotics should be aspirated regardless of normalized ESR and CRP.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased Rates of Unplanned Return to the Operating Room in Socioeconomically Deprived Orthopaedic Trauma Patient Populations.","authors":"Kelsey S Hideshima, Julia Goupil, Max Haffner, Shannon Tse, Samuel K Simister, Rahul Bhale, Barton L Wise, Ellen Fitzpatrick, Gillian L Soles, Sean T Campbell, Augustine M Saiz, Mark A Lee","doi":"10.5435/JAAOSGlobal-D-25-00143","DOIUrl":"10.5435/JAAOSGlobal-D-25-00143","url":null,"abstract":"<p><strong>Introduction: </strong>Socioeconomic status has been correlated with clinical and functional outcomes in elective orthopaedic surgery; however, there has been limited application in orthopaedic trauma. The Area Deprivation Index (ADI) uses 17 different metrics to assess disadvantages at the neighborhood level by zip code. The purpose of this study was to examine the relationship between ADI and unplanned return to the operating room (UROR) in the orthopaedic trauma patient population.</p><p><strong>Methods: </strong>A retrospective review of adult orthopaedic trauma patients from 2014 to 2019 at a level 1 trauma center was done. Patient demographics, injury characteristics, and ADI were recorded. ADI was used to describe survival to UROR, and logistic regressions were used to identify factors that increased the odds of UROR.</p><p><strong>Results: </strong>In total, 1,031 patients were included in the study, with a UROR incidence of 14.3%. The average ADI score fell in the minimally deprived category (second quartile). Univariate analysis demonstrated a significant association between UROR and younger age (P < 0.001), higher Injury Severity Score (P < 0.001), ADI > 75 (P< 0.05), osteoporosis (P < 0.001), open fracture (P< 0.05), number of fractures (P < 0.05), and higher fracture complexity (P < 0.001). Multivariate analysis revealed that ADI > 75 (OR 3.486, P = 0.029), younger age (OR 0.982, P = 0.004), Injury Severity Score (OR 1.069, P < 0.001), and osteoporosis (OR 5.086, P < 0.001) was associated with UROR. Kaplan-Meier confirmed increased rates of UROR for the third and fourth ADI quartiles for all cases (P < 0.001) and when controlling for symptomatic implant (P < 0.001).</p><p><strong>Conclusion: </strong>Defined by ADI, patients from severely deprived communities undergoing orthopaedic trauma interventions were found to have a 3.5-fold increased rate of UROR. This study shows outcome disparities in the orthopaedic trauma population when using a comprehensive measure for socioeconomic status even after controlling for other contributing factors. Understanding and addressing the unique challenges facing socioeconomically deprived patient populations has the potential to markedly improve outcomes for orthopaedic trauma patients.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Analysis of Knee Osteoarthritis Treatment Information on Popular Social Media Platforms.","authors":"Manish Pathuri, Sai Reddy, Tanios Dagher, Emma Dwyer, Hayden Baker, Cody Lee, Rex Haydon, Jennifer Moriatis Wolf, Kelly Hynes, Jason Strelzow","doi":"10.5435/JAAOSGlobal-D-24-00335","DOIUrl":"10.5435/JAAOSGlobal-D-24-00335","url":null,"abstract":"<p><strong>Introduction: </strong>With the rise of social media as a source for health information, there is concern about the spread of unregulated, potentially misleading content. This study aimed to evaluate the quality of knee osteoarthritis (OA) treatment information on TikTok, YouTube, and Instagram platforms where patients often seek medical advice.</p><p><strong>Methods: </strong>TikTok videos, Instagram posts, and YouTube videos focusing on knee OA treatment and meeting specific engagement thresholds were identified using a standardized search. Six reviewers, including orthopaedic faculty and residents, assessed the content's accuracy and reliability using a 10-question Social Media Outreach Content Assessment & Review Tool (SOCART), adapted from the DISCERN instrument. Data were analyzed using analysis of variance, linear regression, and mixed methods.</p><p><strong>Results: </strong>The study reviewed 130 social media posts (YouTube: 30, TikTok: 50, Instagram: 50). YouTube had the highest median number of followers/subscribers, whereas TikTok had the most likes/day and comments/day. Most TikTok (66.7%) and Instagram (92.0%) content creators were from private practices, whereas YouTube creators were mainly affiliated with academic institutions (40.0%). YouTube scored the highest in SOCART assessments (32.86 ± 0.89/50), markedly outperforming Instagram (21.30 ± 0.69/50) and TikTok (20.34 ± 0.87/50; P < 0.001). Content from academic institutions scored higher than that from nonacademic sources (28.04 ± 1.05 vs. 21.77 ± 0.859, P = 0.014).</p><p><strong>Conclusion: </strong>YouTube's high ratings in all SOCART instrument categories suggest that it presents higher-quality information about knee OA treatments relative to Instagram and TikTok. However, YouTube content was still found to be inaccurate and unreliable, making it unsatisfactory for dissemination of important health information. In addition, despite having the lowest SOCART scores, TikTok received the most engagement. This study highlights two important findings: social media presents a risk for patient misinformation when seeking medical advice, and it creates opportunities for physicians to connect with patients using platforms with higher user engagement. Physicians and medical societies can use this information during educational content creation to inform platform choice and dissemination strategies.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Perioperative Fluid Resuscitation in Same-Day Total Joint Arthroplasty Discharge at a Level 1 Academic Center.","authors":"Brandon E Lung, Amanda Tedesco, Leo Issagholian, Megan R Donnelly, Aimee Zhang, Ryan DiGiovanni, William C McMaster, Russell N Stitzlein, Steven Yang","doi":"10.5435/JAAOSGlobal-D-24-00059","DOIUrl":"10.5435/JAAOSGlobal-D-24-00059","url":null,"abstract":"<p><strong>Introduction: </strong>Elderly patients are often dehydrated and are at risk of having prolonged recovery from surgery because of comorbidities and anesthesia. The aim of this study was to investigate the effects of perioperative fluid management on same-day discharge (SDS) rates, physical therapy performance, and complications in elective total joint arthroplasty (TJA).</p><p><strong>Methods: </strong>A retrospective review of 158 patients with primary TJA performed as first-start cases was conducted, consisting of 77 total knee and 81 total hip arthroplasty patients from 2021 to 2023. Intraoperative fluids and total perioperative fluids given on the date of surgery were compared between SDS and admitted patients.</p><p><strong>Results: </strong>Of the 158 TJA first-start cases, 13% of patients were discharged home on postoperative day 0, including 10% of TKA patients and 21% of THA patients. SDS patients were found to have a markedly higher total fluids/body mass index (BMI) ratio and mean intraoperative fluid administration by 400 mL compared with non-SDS patients. Patients who were hypotensive during therapy had a lower total fluids/BMI ratio.</p><p><strong>Conclusion: </strong>The total fluids/BMI ratio may be a useful tool to help guide appropriate intraoperative fluid administration based on varying BMI ranges. Intraoperative fluids during surgical intervention may be more beneficial in postoperative recovery compared with relying on oral replenishment.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Sagittal Correction of Symptomatic Sweeping Thoracolumbar Lordosis in an Adolescent With Congenital Kyphoscoliosis.","authors":"Adam Mansour, Allison Chowdhury, E Graham Englert, Allen Kadado","doi":"10.5435/JAAOSGlobal-D-24-00343","DOIUrl":"10.5435/JAAOSGlobal-D-24-00343","url":null,"abstract":"<p><p>A healthy 15-year-old male athlete presented with upper thoracic congenital kyphoscoliosis, causing notable pain and limiting participation in competitive sports. In addition to mid and low back pain related to sagittal profile, the patient also expressed concerns regarding shape of his back from the compensatory thoracolumbar lordosis relative to his desired physical activities. Imaging demonstrated an abnormal fusion segment from T4-T8 with hemivertebrae at T6 and T7. After failing conservative management, the patient underwent T2-L2 posterior spinal fusion with posterior column osteotomies, successfully restoring sagittal alignment and allowing a return to high-impact sports. Unfavorable symptoms associated with abnormal sagittal spinal alignment should be considered even in a stable, nonprogressive deformity. Sagittal correction with posterior spinal instrumented fusion can effectively restore sagittal posture and function in athletes with congenital kyphoscoliosis associated with a sweeping and symptomatic thoracolumbar lordosis, altering the natural history of the deformity and improving quality of life.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Characteristics, Injury Patterns, and Orthopaedic Injuries Between Electric Bicycle, Pedal Bicycle, Electric Scooters, and Motorcycle Accidents at a Level 1 Trauma Center.","authors":"Amanda Anderson, Maddison McLellan, Amanda Tedesco, Kylie Callan, Christina Grabar, Victor Joe, Jeffry Nahmias, James Learned","doi":"10.5435/JAAOSGlobal-D-25-00099","DOIUrl":"10.5435/JAAOSGlobal-D-25-00099","url":null,"abstract":"<p><strong>Background: </strong>Use of electric bikes (EBs) and electric scooters (ESs) has increased dramatically, and so are EB-related and ES-related orthopaedic injuries. There is limited research regarding the severity of EB injuries and whether they more closely resemble ES, motorcycle (MC), or pedal bicycle (PB) related injuries. The aim of this study was to characterize injury patterns associated with EB accidents and compare injury severity and details with those of PB, ES, and MC accidents.</p><p><strong>Methods: </strong>This was a retrospective review of trauma patients presenting to an academic, level one trauma center between 2019 and 2022 to compare EB, ES, PB, and MC trauma patients. Descriptive statistics were obtained to characterize demographic data. Two-sided Fisher exact tests were used to compare categorical data, and ANOVA was used to compare continuous variables between groups.</p><p><strong>Results: </strong>EB trauma patients were significantly more likely to experience traumatic brain injury (TBI), intracranial hemorrhage (ICH), or fractures of the head/face compared with MC (54.0% vs. 19.3%, P < 0.0001) and PB (54.0% vs. 33.5%, P = 0.0001) cohorts. EB trauma patients were more likely to lose consciousness than MC or PB trauma patients. Spine fractures (11.0%) were the most prevalent in the EB study population, followed by fractures of the acetabulum (6.0%) and clavicle/scapula/radius (5.0%). EB trauma patients were significantly more likely to be admitted to the intensive care unit (ICU) than MC trauma patients (25.0% vs. 16.0%, P = 0.0256) and were significantly more likely to present as critical trauma activations than PB trauma patients (14.0% vs. 6.0%, P = 0.0106).</p><p><strong>Conclusions: </strong>While the overall injury severity scores are similar to the modes of transport, there are differences in injury severity and patterns. EB accidents have a higher prevalence of TBIs, ICH, and facial fractures. EB trauma patients can result in high utilization of resources because many are critical trauma activations and have a higher rate of ICU stays. These data can help providers better understand injury patterns of EB accidents.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Confounding Association of Lower Limb Hypertrophy With Retarded Long Bone Growth in Mosaic Somatic Neurofibromatosis 1-A Genetic Review and Femoral Lengthening Treatment.","authors":"Edward Abraham, Nirav K Mungalpara, Apurva Choubey, John Alvarez","doi":"10.5435/JAAOSGlobal-D-25-00019","DOIUrl":"10.5435/JAAOSGlobal-D-25-00019","url":null,"abstract":"<p><p>This presentation describes a 15-year-old adolescent boy with neurofibromatosis type 1 with regional somatic mosaicism in the right half of his body. The unique clinical features are highlighted by generalized hemihypertrophy of the lower extremity in association with progressive growth retardation of long bones, which results in limb shortening. The patient successfully underwent limb lengthening. To our knowledge, this is the first neurofibromatosis type 1 article to report of a limb-lengthening procedure in a patient with two major and opposite growth phenomena on the same limb caused by a 36% gene deletion.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}