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

{"title":"Athletic Identity Associations in Young Sports Medicine Patients.","authors":"Melissa A Christino, Ryan P Coene, Kathryn A Williams, Mary Daley, Kathryn E Ackerman, Andrea Stracciolini, Dennis E Kramer","doi":"10.5435/JAAOSGlobal-D-24-00195","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-24-00195","url":null,"abstract":"<p><strong>Introduction: </strong>Few studies have assessed athletic identity levels in young patients. This study examined athletic identity in adolescents and explored associations between athletic identity, patterns of sport participation, and coping skills.</p><p><strong>Methods: </strong>Patients aged 12 to 18 years who received sports medicine care completed a one-time, voluntary, anonymous survey. Surveys included demographics, sport participation information, Athletic Identity Measurement Scale (AIMS), and Athletic Coping Skills Inventory (ACSI). Statistical analysis included Fisher exact test, Student t test, Wilcoxon rank sum test, Kruskal-Wallis test, and Pearson correlation.</p><p><strong>Results: </strong>Three hundred thirty-four patients (mean ± SD age 15.0 ± 1.8 years, 64.7% girls) completed questionnaires. The mean AIMS and ACSI scores were 45.2 ± 11.5 and 50.2 ± 10.9, respectively. No notable differences were observed in AIMS scores between age groups or sexes. An increase in mean AIMS scores (higher athletic identity) was seen with greater weekly hours of sport participation (P < 0.001) and months per year of primary sport participation (P < 0.001). Multisport per season athletes had higher AIMS scores than single-sport athletes (48.2 ± 10.1 vs. 43.0 ± 11.9, P < 0.001). Team sport athletes reported higher athletic identities than individual sport athletes (47.0 ± 10.7, 41.4 ± 11.4, P < 0.001). Athletic Identity Measurement Scale scores positively correlated with ACSI scores (r = 0.31, P < 0.0001). Athletes with the highest athletic identity had markedly higher scores on ACSI subscales of Coachability, Concentration, Confidence and Achievement Motivation, Goal Setting and Mental Preparation, and Peaking Under Pressure than athletes with the least athletic identity. However, those with the highest athletic identities reported significantly lower scores on the ACSI Freedom From Worry subscale (P < 0.001).</p><p><strong>Discussion: </strong>Athletic identity did not differ among adolescents by age or sex. Athletic identity was higher in team sport athletes and those with increased sport participation volumes. While high athletic identity was associated with higher scores on favorable coping skill dimensions, these athletes may also worry more, potentially placing them at greater psychological risk after injury.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"8 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11407805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298062","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":"Assessing Healthcare Equity in Orthopaedic Surgery: An Analysis of Over 24,000 Surgical Cases.","authors":"Zachary R Visco, Ezan Chaudry, John S Hudson, Moe R Lim","doi":"10.5435/JAAOSGlobal-D-24-00240","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-24-00240","url":null,"abstract":"<p><strong>Introduction: </strong>Health disparities have been widely studied in the primary care and surgical settings. The purpose of this study was to examine surgical access disparities for orthopaedic surgical cases performed at a large academic health center by comparing the relationship between patient demographic factors and surgical wait time.</p><p><strong>Methods: </strong>A total of 24,778 orthopaedic surgical cases from 2018 to 2022 at a public, tertiary care, Level I trauma center were retrospectively analyzed to assess for surgical timing disparities based on patient-specific factors, including race, sex, language, and socioeconomic status.</p><p><strong>Results: </strong>Elective surgical cases were completed with an average surgical wait time of 28.11 ± 26.34 days. Urgent surgical cases were completed with an average surgical wait time of 1.23 ± 1.50 days. Patient race, sex, language, and socioeconomic status had no effect on surgical wait time for urgent case scheduling. Female patients had longer average wait times in elective cases, whereas race had a weak association with increased wait time. Two-factor interaction analysis showed no multifactorial effects of patient demographic factors on surgical wait time. Patient race and socioeconomic status were associated with increased distance from surgical sites, although increased distance did not correlate with increased surgical wait time.</p><p><strong>Conclusion: </strong>Patient demographic factors did not demonstrate clinically notable associations with surgical timing in this patient cohort, in contrast to previous studies demonstrating the effects of race and socioeconomic status on healthcare outcomes and access. Race and socioeconomic status did correlate with increased distance from surgical centers although distance from surgical sites did not correlate with surgical wait time. This contributes to previous literature on healthcare equity and indicates that surgical wait time may not contribute to the known healthcare inequalities seen in minority and marginalized patients.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"8 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11407820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298061","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":"Patient Factors Associated With Reimplantation After Girdlestone Resection Arthroplasty for Treatment of Periprosthetic Joint Infections of the Hip.","authors":"Jeffrey Okewunmi, Avanish Yendluri, John K Cordero, Nicole Zubizarreta, Darwin Chen, Calin S Moucha, Jashvant Poeran, Brett L Hayden","doi":"10.5435/JAAOSGlobal-D-24-00005","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-24-00005","url":null,"abstract":"<p><strong>Introduction: </strong>For patients unsuitable for prosthesis reimplantation or temporary spacer placement, Girdlestone resection arthroplasty (GRA) is a suitable option to eliminate infection. Using a large-scale database, this study aims to determine factors associated with reimplantation.</p><p><strong>Methods: </strong>This study included patients who underwent GRA and subsequent total hip arthroplasty (2012 to 2015 Medicare Limited Data Set with ≥5-year follow-up). A mixed-effects model measured associations between patient characteristics and reimplantation. Odds ratios (OR) with 95% confidence intervals (CI) were reported.</p><p><strong>Results: </strong>Among 2,772 GRA cases, 2,025 (73.1%) were reimplanted (median time to reimplantation 3.0 months). In multivariable analysis, patient factors associated with reduced odds of reimplantation were increased age (OR 0.96; CI, 0.94 to 0.97; P < 0.0001), Black race (OR, 0.58; CI, 0.37 to 0.90; P = 0.0149), obesity (OR, 0.74; CI, 0.58 to 0.94; P = 0.0150), and increased Deyo-Charlson comorbidities (1 comorbidity: OR, 0.78; CI, 0.61 to 0.99; P = 0.0453; two comorbidities: OR, 0.53; CI, 0.39 to 0.71; P < 0.0001; ≥3 comorbidities: OR, 0.69; CI, 0.49 to 0.95; P = 0.0244). Male (versus female) patients, however, had increased odds of reimplantation (OR, 1.64; CI, 1.32 to 2.02; P < 0.0001).</p><p><strong>Discussion: </strong>Age, race, and comorbidities influence the likelihood of reimplantation after GRA. Owing to variability in patients who undergo additional surgery, additional studies should be conducted to determine the rationale of patient selection.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"8 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298065","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":"Social Media Use by American Association of Hip and Knee Surgeons Members.","authors":"Hunter Culp, David Cieremans, Dustin Schuett","doi":"10.5435/JAAOSGlobal-D-24-00090","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-24-00090","url":null,"abstract":"<p><strong>Introduction: </strong>Social media offers physicians marketing opportunities previously unavailable. We sought to evaluate social media use and its correlation with public rankings among Association of Hip and Knee Surgeons members.</p><p><strong>Methods: </strong>A list of members and demographics was collected. Social media sites were reviewed for each surgeon, and a score was calculated based on active use. The US News and World Report (NWR) was used to determine rating and number of reviews. The Spearman correlation coefficient and independent samples t-test were used to measure correlation and compare means between the groups, respectively.</p><p><strong>Results: </strong>A total of 2436 members were analyzed. The average social media score was 4.14. The average US NWR score was 4.25. A strong correlation was observed between social media and US NWR scores (r = 0.74, P < 0.01) but not with the number of reviews (r = 0.40, P = 0.17). A strong association with US NWR rating (r = 0.74, P = 0.04) and a weak correlation with the total number of reviews (r = 0.61, P = 0.06) were found.</p><p><strong>Conclusions: </strong>Social media use is correlated with US NWR scores. Association of Hip and Knee Surgeons members may be underutilizing social media for the promotion of their practices. Future studies are needed to evaluate whether it affects patient volume and outcomes.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"8 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11398763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298066","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":"Transportation Barriers in Pediatric Orthopaedic Clinic Visits.","authors":"Maia H Hauschild, Tishya A L Wren, Michelle Chavez, Hanna Omar, Rachel Y Goldstein","doi":"10.5435/JAAOSGlobal-D-24-00231","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-24-00231","url":null,"abstract":"<p><strong>Objectives: </strong>To identify what transportation barriers pediatric patients face when traveling to a major metropolitan orthopaedic center, how these barriers affect care, and what changes can be made to address this issue.</p><p><strong>Study design: </strong>A cross-sectional transportation survey was administered to 107 caregivers of patients being seen in the orthopaedic clinic at a tertiary children's hospital in a large metropolitan area. Using logistic regression analysis, we compared socioeconomic characteristics, transportation methods, and scheduling practices among caregivers who reported missing at least one visit in the past and those who reported never missing a visit.</p><p><strong>Results: </strong>13% (14/108) of caregivers reported missing one or more past visits due to late arrival or transportation issues. Families that traveled more than 45 minutes to clinic (P = 0.04), waited more than one week to schedule a visit (P = 0.002), or reported difficulty scheduling a visit (P = 0.02) were significantly more likely to have a history of nonattendance. In addition, patients who were nonambulatory (P = 0.007), used a mobility device (P = 0.007), or were non-White (P < 0.05) were significantly more likely to have missed a visit.</p><p><strong>Conclusion: </strong>Travel time, difficult or delayed scheduling, and patient ambulatory status were all associated with missing orthopaedic clinic visits although other socioeconomic factors were not related. Interventions to improve orthopaedic clinic attendance should focus on promoting accessibility for patients with mobility limitations and encouraging simple and timely scheduling practices.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"8 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11387042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298069","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":"The Viability and Success of Noncemented Kinematic Total Knee Arthroplasty.","authors":"Sydney Flanagan, Thomas Stanila, Daniel Schmitt, Nicholas Brown","doi":"10.5435/JAAOSGlobal-D-24-00054","DOIUrl":"10.5435/JAAOSGlobal-D-24-00054","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of noncemented total knee arthroplasty (TKA) is increasing as personalized knee alignment strategies deviate from implanting components on a strict mechanical axis. This retrospective study evaluated the outcomes of 74 consecutive noncemented unrestricted kinematic TKA procedures.</p><p><strong>Methods: </strong>This study included 74 consecutive noncemented kinematic TKAs performed by one surgeon at a tertiary academic medical center from 2021 to 2023. The technique used was unrestricted femur-first caliper kinematic TKA. The outcomes included revision, pain scores, and radiographic measurements.</p><p><strong>Results: </strong>Of the 74 procedures performed, there were no revisions or readmissions for problems related to TKA. The mean follow-up was 17.6 months, with 74% of patients being followed up for more than 1 year postoperatively. On the day of surgery, postoperative measurements showed that the average tibial mechanical, distal femoral, and anatomic tibiofemoral angles were 3.3°, 7.7°, and 5.8°, respectively. 5 knees were observed initially with signs of radiolucency, which all resolved by the most recent appointment. None of the knees was radiographically loose. Of the patients, 65%, 19%, and 16% reported no pain, minimal pain, and some pain, respectively, at the 6-week follow-up visit. This improved to 78%, 19%, and 3% at the most recent follow-up.</p><p><strong>Conclusion: </strong>Combining kinematic alignment with noncemented fixation showed excellent clinical and radiographic outcomes with short-term survivorship. Although the use of both kinematic alignment and noncemented TKAs has been controversial, these early data suggest that noncemented kinematic TKA is safe and effective.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"8 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11383720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298068","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":"Socioeconomic Status and Time to Treatment in Patients With Traumatic Rotator Cuff Tears.","authors":"Caroline T Gutowski, Branden Wright, Vineeth Romiyo, Pietro Gentile, Krystal Hunter, Catherine J Fedorka","doi":"10.5435/JAAOSGlobal-D-24-00205","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-24-00205","url":null,"abstract":"<p><strong>Introduction: </strong>Socioeconomic status (SES) affects access to care for traumatic rotator cuff (RTC) tears. Delayed time to treatment (TTT) of traumatic RTC tears results in worse functional outcomes. We investigated disparities in TTT and hypothesized that individuals from areas of low SES would have longer time to surgical repair.</p><p><strong>Methods: </strong>Patients who underwent repair of a traumatic RTC tear were retrospectively reviewed. Median household income and Social Deprivation Index were used as a proxy for SES. The primary outcome was TTT. Patients were further stratified by preoperative forward flexion and number of tendons torn.</p><p><strong>Results: </strong>A total of 221 patients met inclusion criteria. No significant difference in TTT was observed between income classes (P = 0.222) or Social Deprivation Index quartiles (P = 0.785). Further stratification by preoperative forward flexion and number of tendons torn also yielded no significant difference in TTT.</p><p><strong>Discussion: </strong>Contrary to delays in orthopaedic care documented in literature, our study yielded no difference in TTT between varying levels of SES, even when stratified by the severity of injury. Thus, we reject our original hypothesis. Based on our findings, mechanisms in place at our institution may have mitigated some of these health disparities within our community.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"8 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298067","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":"A Scoring System for Predicting Nonunion After Intramedullary Nailing of Femoral Shaft Fractures.","authors":"Kent R Kraus, Joshua W Flores, James E Slaven, Ishani Sharma, Payton K Arnold, Brian H Mullis, Roman M Natoli","doi":"10.5435/JAAOSGlobal-D-24-00214","DOIUrl":"10.5435/JAAOSGlobal-D-24-00214","url":null,"abstract":"<p><strong>Introduction: </strong>Femoral shaft nonunion negatively affects patient quality of life. Although multiple risk factors have been identified for femoral shaft nonunion after intramedullary nail (IMN) fixation, there is no quantitative model for predicting nonunion.</p><p><strong>Study description: </strong>The study is a retrospective cohort study of patients with femoral shaft fractures treated at two level one trauma centers who were followed to fracture union or nonunion. Patient, injury, and surgical characteristics were analyzed to create a quantitative model for nonunion risk after intramedullary nailing.</p><p><strong>Methods: </strong>Eight hundred one patients aged 18 years and older with femoral shaft fractures treated with reamed, locked IMNs were identified. Risk factors including demographics, comorbidities, surgical variables, and injury-related characteristics were evaluated. Multivariate analysis was conducted, and several variables were included in a scoring system to predict nonunion risk.</p><p><strong>Results: </strong>The overall nonunion rate was 7.62% (61/801). Multivariate analysis showed significant association among pulmonary injury (odds ratio [OR] = 2.19, P = 0.022), open fracture (OR=2.36, P = 0.02), current smoking (OR=3.05, P < 0.001), postoperative infection (OR=12.1, P = 0.007), AO/OTA fracture pattern type A or B (OR=0.43, P = 0.014), and percent cortical contact obtained intraoperatively ≥25% (OR=0.41, P = 0.021) and nonunion. The scoring system created to quantitatively stratify nonunion risk showed that a score of 3 or more yielded an OR of 6.38 for nonunion (c-statistic = 0.693, P < 0.0001).</p><p><strong>Conclusions: </strong>Femoral shaft nonunion risk is quantifiable based on several independent injury, patient, and surgical factors. This scoring system is an additional tool for clinical decision making when caring for patients with femoral shaft fractures treated with IMNs.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"8 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141349","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":"Biportal Endoscopic Spine Surgery for Lumbar Laminectomy and Diskectomy: Postoperative Outcomes and Surgical Learning Curve, a Single US Surgeon's Experience.","authors":"Matthew Easthardt, Philip Zakko, Ali Jawad, Maximillian Lee, Daniel Park","doi":"10.5435/JAAOSGlobal-D-23-00161","DOIUrl":"10.5435/JAAOSGlobal-D-23-00161","url":null,"abstract":"<p><strong>Introduction: </strong>Biportal endoscopic spine surgery (BESS) has gained traction for lumbar laminectomy and diskectomy. To justify the transition to BESS, outcomes and the surgical learning curve should be known. This study evaluates rates of complications with BESS and how these rates change with increased surgeon experience.</p><p><strong>Methods: </strong>A single surgeon's consecutive patients who underwent BESS were evaluated. Patients older than 18 years who underwent BESS for lumbar laminectomy and diskectomy were included. Patients with previous spine surgery, multiple levels, or BESS for fusion were excluded. Demographics, length of surgery, intraoperative complications, postoperative complications, and revision surgery were recorded. The learning phase group and mastery phase group were based on a cumulative summation analysis based on surgical time.</p><p><strong>Results: </strong>A total of 63 patients, with 31 and 32 patients in the learning and mastery group, respectively, were included. Surgical time decreased from 87 to 52 minutes in the mastery phase. Conversion to open decreased from 3 to 0 cases (P = 0.1803), intraoperative complications decreased from 3 to 0 (P = 0.1803), postoperative complications decreased from 7 to 2 (P = 0.017), and rates of revision surgery decreased from 4 to 1 (P = 0.4233).</p><p><strong>Conclusion: </strong>This study suggests a learning curve of 31 cases for adequate performance of BESS for lumbar laminectomy and diskectomy.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"8 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11335333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005456","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":"Bone Bridge Transtibial Amputation by an Innovative Technique.","authors":"Yurii Oleksiiovych Bezsmertnyi, Viktor Ivanovych Shevchuk, Oleksandr Yuriyovych Bezsmertnyi, Oleksandr Yuriyovych Branitsky, Dmytro Vadymovych Bondarenko","doi":"10.5435/JAAOSGlobal-D-24-00063","DOIUrl":"10.5435/JAAOSGlobal-D-24-00063","url":null,"abstract":"<p><p>We present a case report of synostosis after transtibial amputation because of distraction regenerate formation after decortication of the lateral surfaces of the tibia and fibula, sequential compression, and distraction using the Ilizarov apparatus. Its advantage is that there is no need to shorten bone. The establishment of distal tibia-fibula synostosis (Ertl) in patients with transtibial amputation has been advocated to improve function and prosthetic wear. There are a variety of techniques to create a bone block. This case reports the successful use of an innovative technique to establish bone block. A patient with transtibial amputation underwent revision of residual limb by decorticating the lateral aspect of the distal tibia and the medial aspect of the distal fibula and acutely compressing the distal ends of the 2 bones with the Ilizarov apparatus. The distal fibula is then slowly and progressively distracted laterally, and the bone is formed in the space between the distal fibula and tibia, creating synostosis with an increased distal bone cross-sectional surface area for improved function and prosthetic wear. The follow-up period was 24 months. Within 3 months, synostosis was formed, which increased the area of the supporting surface and allowed temporary and then permanent prosthetics. After 24 months, synostosis did not differ from the structure of tibial stump bones.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"8 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11335330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005457","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}