OTA international : the open access journal of orthopaedic trauma最新文献

{"title":"The use of a laminar spreader for the reduction of extra-articular distal radius fractures: A technical trick.","authors":"Tarek A Taha","doi":"10.1097/OI9.0000000000000263","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000263","url":null,"abstract":"<p><p>Extra-articular distal radius fractures are often accompanied with shortening, loss of radial height, and radial displacement of the articular segment relative to the shaft of the radius, all seen in the coronal plane. Reduction can be somewhat challenging when reliance on traction and ligamentotaxis fails, especially in subacute or osteoporotic fractures. In this technical report, we describe a technique where application of a laminar spreader between the radius and the ulna in the metaphyseal region can easily reduce the fracture and help attain anatomic alignment in the coronal plane. An acute and a subacute fracture are shown for illustration of the technique.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 2","pages":"e263"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/91/4f/oi9-6-e263.PMC10503670.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10309155","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":"Early hip fracture surgery is safe for patients on direct oral anticoagulants.","authors":"Nicholas L Kolodychuk,&nbsp;Brian Godshaw,&nbsp;Michael Nammour,&nbsp;Hunter Starring,&nbsp;James Mautner","doi":"10.1097/OI9.0000000000000252","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000252","url":null,"abstract":"<p><strong>Objectives: </strong>To determine how preoperative direct oral anticoagulant (DOAC) use affects rates of blood transfusion, clinically important blood loss, and 30-day mortality in patients with hip fracture undergoing surgery within 48 hours of presentation to the emergency department.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Academic trauma center.</p><p><strong>Patients: </strong>A total of 535 patients with hip fracture who underwent open cephalomedullary nail fixation or arthroplasty either taking a direct oral anticoagulant or no form of chemical anticoagulant/antiplatelet agent before presentation (control).</p><p><strong>Main outcome measures: </strong>Demographics, time to surgery, type of surgery, blood transfusion requirement, clinically important blood loss, and 30-day mortality.</p><p><strong>Results: </strong>Forty-one patients (7.7%) were taking DOACs. DOAC patients were older (81.7 vs. 77 years, <i>P</i> = 0.02) and had higher BMI (26.9 vs. 24.2 kg/m², <i>P</i> = 0.01). Time from admission to surgery was similar between DOAC users (20.1 hours) and the control (18.7 hours, <i>P</i> > 0.4). There was no difference in receipt of blood transfusion (<i>P</i> = 0.4), major bleeding diagnosis (<i>P</i> = 0.2), acute blood loss anemia diagnosis (<i>P</i> = 0.5), and 30-day mortality (<i>P</i> = 1) between the DOAC and control group. This was true when stratifying by type of surgery as well.</p><p><strong>Conclusions: </strong>Our results suggest that early surgery may be safe in patients with hip fracture taking DOACs despite theoretical risk of increased bleeding. Because early surgery has previously been associated with decreased morbidity and mortality, we suggest that hip fracture surgery should not be delayed because a patient is taking direct oral anticoagulants.</p><p><strong>Level of evidence: </strong>Prognostic Level III.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 2","pages":"e252"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b7/6e/oi9-6-e252.PMC10079331.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10312620","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":"Illicit drug and alcohol use and measures of musculoskeletal function and mental health in orthopaedic trauma patients.","authors":"James Spratt,&nbsp;Zachary Adkins,&nbsp;Danny Warda,&nbsp;Michele Smith,&nbsp;Jennifer Bruggers,&nbsp;Paul Weiss,&nbsp;Stephen Becher","doi":"10.1097/OI9.0000000000000270","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000270","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study was to describe the relationship between positive toxicology screens and measures of preinjury mental health and physical function in an orthopaedic trauma population.</p><p><strong>Design: </strong>This was a cross-sectional study.</p><p><strong>Setting: </strong>Urban Level 1 trauma center.</p><p><strong>Patients: </strong>A total of 125 trauma patients gave written consent for this study.</p><p><strong>Main outcome measurements: </strong>Questionnaires such as, Patient Health Questionnaire-9, General Anxiety Disorder-7, PCL-5, and Short Musculoskeletal Function Assessment, were used to survey patients after surgical intervention.</p><p><strong>Results: </strong>Patient Health Questionnaire-9 (<i>P</i> = 0.05) and PCL-5 (<i>P</i> = 0.04) were not found to have significant differences between positive and negative toxicology screens. Both General Anxiety Disorder-7 (<i>P</i> = 0.004) and Short Musculoskeletal Function Assessment function (<i>P</i> = 0.006) were significantly higher in patients with positive toxicology screens.</p><p><strong>Conclusions: </strong>Positive toxicology seems to be associated with preinjury anxiety. Patient reported preinjury function was not adversely affected by the presence of illicit substances or alcohol, nor were levels of post-traumatic stress disorder and depression found to be higher in patients with positive toxicology screens.</p><p><strong>Level of evidence: </strong>Level IV Cross-Sectional Study.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 2","pages":"e270"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/66/50/oi9-6-e270.PMC10503674.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10311087","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":"Implications of COVID-19 on hip fracture care discharge locations during the early stages of the pandemic.","authors":"Sanjit R Konda,&nbsp;Garrett W Esper,&nbsp;Ariana T Meltzer-Bruhn,&nbsp;Abhishek Ganta,&nbsp;Philipp Leucht,&nbsp;Nirmal C Tejwani,&nbsp;Kenneth A Egol","doi":"10.1097/OI9.0000000000000277","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000277","url":null,"abstract":"<p><strong>Objectives: </strong>To document discharge locations for geriatric patients treated for a hip fracture before and during the COVID pandemic and subsequent changes in outcomes seen between each cohort.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Academic medical center.</p><p><strong>Patients/participants: </strong>Two matched cohorts of 100 patients with hip fracture treated pre-COVID (February-May 2019) and during COVID (February-May 2020).</p><p><strong>Intervention: </strong>Discharge location and COVID status on admission. Discharge locations were home (home independently or home with health services) versus facility [subacute nursing facility (SNF) or acute rehabilitation facility].</p><p><strong>Main outcome measurements: </strong>Readmissions, inpatient and 1-year mortality, and 1-year functional outcomes (EQ5D-3L).</p><p><strong>Results: </strong>In COVID+ patients, 93% (13/14) were discharged to a facility, 62% (8/13) of whom passed away within 1 year of discharge. Of COVID+ patients discharged to an SNF, 80% (8/10) died within 1 year. Patients discharged to an SNF in 2020 were 1.8x more likely to die within 1 year compared with 2019 (<i>P</i> = 0.029). COVID- patients discharged to an SNF in 2020 had a 3x increased 30-day mortality rate and 1.5x increased 1-year mortality rate compared with 2019. Patients discharged to an acute rehabilitation facility in 2020 had higher rates of 90-day readmission. There was no difference in functional outcomes.</p><p><strong>Conclusions: </strong>All patients, including COVID- patients, discharged to all discharge locations during the onset of the pandemic experienced a higher mortality rate as compared with prepandemic. This was most pronounced in patients discharged to a skilled nursing facility in 2020 during the early stages of the pandemic. If this trend continues, it suggests that during COVID waves, discharge planning should be conducted with the understanding that no options eliminate the increased risks associated with the pandemic.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 2","pages":"e277"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ab/01/oi9-6-e277.PMC10145965.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9448959","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":"Erectile dysfunction after acetabular fracture.","authors":"Iain S Elliott,&nbsp;Conor Kleweno,&nbsp;Julie Agel,&nbsp;Max Coale,&nbsp;Joseph T Patterson,&nbsp;Reza Firoozabadi,&nbsp;Michael Githens,&nbsp;Niels V Johnsen","doi":"10.1097/OI9.0000000000000276","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000276","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the rate of erectile dysfunction in male patients who have sustained an acetabular fracture with no previously identified urogenital injury.</p><p><strong>Design: </strong>Cross-sectional survey.</p><p><strong>Setting: </strong>Level 1 Trauma Center.</p><p><strong>Patients/participants: </strong>All male patients treated for acetabular fracture without urogenital injury.</p><p><strong>Intervention: </strong>The International Index of Erectile Function (IIEF), a validated patient-reported outcome measure for male sexual function, was administered to all patients.</p><p><strong>Main outcome measurements: </strong>Patients were asked to complete the International Index of Erectile Function score for both preinjury and current sexual function, and the erectile function (EF) domain was used to quantify the degree of erectile dysfunction. Fractures were classified according the OTA/AO classification schema, fracture classification, injury severity score, race, and treatment details, including surgical approach were collected from the database.</p><p><strong>Results: </strong>Ninety-two men with acetabular fractures without previously diagnosed urogenital injury responded to the survey at a minimum of 12 months and an average of 43 ± 21 months postinjury. The mean age was 53 ± 15 years. 39.8% of patients developed moderate-to-severe erectile dysfunction after injury. The mean EF domain score decreased 5.02 ± 1.73 points, which is greater than the minimum clinically important difference of 4. Increased injury severity score and associated fracture pattern were predictive of decreased EF score.</p><p><strong>Conclusion: </strong>Patients with acetabular fractures have an increased rate of erectile dysfunction at intermediate-term follow-up. The orthopaedic trauma surgeon treating these injuries should be aware of this as a potential associated injury, ask their patients about their function, and make appropriate referrals.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 2","pages":"e276"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d8/99/oi9-6-e276.PMC10194699.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9505542","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":"Pelvic ring injuries: recent advances in diagnosis and treatment.","authors":"Victor A de Ridder,&nbsp;Paul S Whiting,&nbsp;Zsolt J Balogh,&nbsp;Hassan R Mir,&nbsp;Blake J Schultz,&nbsp;Milton Chip Routt","doi":"10.1097/OI9.0000000000000261","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000261","url":null,"abstract":"<p><p>Pelvic ring injuries typically occur from high-energy trauma and are often associated with multisystem injuries. Prompt diagnosis of pelvic ring injuries is essential, and timely initial management is critical in the early resuscitation of polytraumatized patients. Definitive management of pelvic ring injuries continues to be a topic of much debate in the trauma community. Recent studies continue to inform our understanding of static and dynamic pelvic ring stability. Furthermore, literature investigating radiographic and clinical outcomes after nonoperative and operative management will help guide trauma surgeons select the most appropriate treatment of patients with these injuries.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 3 Suppl","pages":"e261"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3a/a8/oi9-6-e261.PMC10392441.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9987105","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":"Sagittal deformity of Garden type I and II geriatric femoral neck fractures is frequently misclassified by lateral radiographs.","authors":"Madeline S Tiee,&nbsp;Andrew G Golz,&nbsp;Andrew Kim,&nbsp;Joseph B Cohen,&nbsp;Hobie D Summers,&nbsp;Anup J Alexander,&nbsp;William D Lack","doi":"10.1097/OI9.0000000000000273","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000273","url":null,"abstract":"<p><p>The objective of this study was to determine the validity and inter-rater reliability of radiographic assessment of sagittal deformity of femoral neck fractures.</p><p><strong>Design: </strong>This is a retrospective cohort study.</p><p><strong>Setting: </strong>Level 1 trauma center.</p><p><strong>Patients/participants: </strong>Thirty-one patients 65 years or older who sustained low-energy, Garden type I/II femoral neck fractures imaged with biplanar radiographs and either computed tomography or magnetic resonance imaging were included.</p><p><strong>Main outcome measurements: </strong>Preoperative sagittal tilt was measured on lateral radiographs and compared with the tilt identified on advanced imaging. Fractures were defined as \"high-risk\" if posterior tilt was ≥20 degrees or anterior tilt was >10 degrees.</p><p><strong>Results: </strong>Of 31 Garden type I/II femoral neck fractures, advanced imaging identified 10 high-risk fractures including 8 (25.8%) with posterior tilt ≥20 degrees and 2 (6.5%) with anterior tilt >10 degrees. Overall, there was no significant difference between sagittal tilt measured using lateral radiographs and advanced imaging (<i>P</i> = 0.84), and the 3 raters had good agreement between their measurements of sagittal tilt on lateral radiographs (interclass correlation coefficient 0.79, 95% confidence interval [0.65, 0.88], <i>P</i> < 0.01). However, for high-risk fractures, radiographic measurements from lateral radiographs alone resulted in greater variability and underestimation of tilt by 5.2 degrees (95% confidence interval [-18.68, 8.28]) when compared with computed tomography/magnetic resonance imaging. Owing to this underestimation of sagittal tilt, the raters misclassified high-risk fractures as \"low-risk\" in most cases (averaging 6.3 of 10, 63%, range 6 - 7) when using lateral radiographs while low-risk fractures were rarely misclassified as high-risk (averaging 1.7 of 21, 7.9%, range 1 - 3, <i>P</i> = 0.01).</p><p><strong>Conclusions: </strong>Lateral radiographs frequently lead surgeons to misclassify high-risk sagittal tilt of low-energy femoral neck fractures as low-risk. Further research is necessary to improve the assessment of sagittal plane deformity for these injuries.</p><p><strong>Level of evidence: </strong>Level IV diagnostic study.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 2","pages":"e273"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f6/e7/oi9-6-e273.PMC10113109.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9386262","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":"Are Canadian orthopaedic surgeons and American orthopaedic surgeons on par? A Canadian practice survey of orthopaedic traumatologists.","authors":"Stephen Doxey,&nbsp;Arthur J Only,&nbsp;Michael Milshteyn,&nbsp;Brian P Cunningham,&nbsp;Lisa K Cannada","doi":"10.1097/OI9.0000000000000272","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000272","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to obtain information on Canadian orthopaedic trauma surgeon practices and salary demographics. It was hypothesized that most of the practicing surgeons recognize specific practice aspects (compensation, call schedule, operating room availability, and provided support staff) as key factors in employment opportunity evaluation.</p><p><strong>Design: </strong>Cross-sectional survey study.</p><p><strong>Setting: </strong>Orthopaedic Trauma Association (OTA) practice surveys.</p><p><strong>Participants: </strong>All active Canadian members of the OTA were eligible to participate.</p><p><strong>Main outcome measurement: </strong>A 50-question survey was sent through email to OTA members assessing physician, practice, and compensation metrics of Canadian orthopaedic traumatologists.</p><p><strong>Results: </strong>Fifty-two of 113 Canadian OTA members participated giving a response rate of 46%. All surgeons worked in an academic practice, either for a university (83%) or community hospital (17%). Only 2% of surgeons have changed jobs in the last 5 years, and over 73% of surgeons maintain the same place of employment during their careers. Most had an available dedicated orthopaedic trauma operating room (73%). The majority indicated having residents (71%) and fellows (63%) as support staff. Many reported completing 300-500 cases per year (42%), which decreased during COVID-19 for 50% of surgeons. The most common reported compensation was between $400,000 and $600,000 US dollars (25%) with many working 4-6 call shifts a month (48%) and 51-70 hours a week (48%).</p><p><strong>Conclusion: </strong>This study demonstrated the varying practice and physician economic variables currently in Canada. The identification and continued surveillance of these employment variables will allow for transparency in job market evaluation by applicants.</p><p><strong>Level of evidence: </strong>Level V.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 2","pages":"e272"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/19/88/oi9-6-e272.PMC10069860.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9256542","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":"Orthopaedic Trauma Association Global Outreach Task Force Proceedings.","authors":"Emily Benson","doi":"10.1097/OI9.0000000000000269","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000269","url":null,"abstract":"<p><strong>Introduction: </strong>In 2020, the Orthopaedic Trauma Association (OTA) adopted an updated strategic plan emphasizing global outreach. A task force was appointed to better understand the current global orthopaedic trauma educational demand and how the organization may better partner with our global colleagues. This article provides a description of the process and the results of the findings.</p><p><strong>Methods: </strong>First, the current international demographics of the OTA membership were reviewed. Then, 2 surveys were distributed. The first was sent to all current members of the OTA to determine how important the members believe that global orthopaedics should be to the organization's mission. The second survey was sent out to our international orthopaedic trauma colleagues. The results of both surveys were reviewed, analyzed, and summarized in an executive summary report which was presented to the OTA Board of Directors earlier this year.</p><p><strong>Results: </strong>The responses from the membership survey indicated a keen interest in the development of global outreach within our organization. The global outreach survey received 72 responses from 28 different countries, mostly lower and lower-middle income countries. This included many countries in Asia and Africa who had no prior relationship with the OTA. Most respondents were already using online educational materials and expressed a desire for more high-quality online offerings as well as regional resource-specific orthopaedic trauma courses.</p><p><strong>Conclusion: </strong>The overwhelming majority of member respondents believe that global orthopaedics is highly important and central to our mission. Similarly, a majority of the international respondents believed that global orthopaedics is necessary and worthwhile. They expressed a need for more educational opportunities and collaboration, particularly in the areas of online offerings as well as regional, resource-specific courses.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 2","pages":"e269"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9c/3c/oi9-6-e269.PMC10503673.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10309154","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":"Management of aseptic nonunions and severe bone defects: let us get this thing healed!","authors":"Aaron Nauth,&nbsp;Brett D Crist,&nbsp;Saam Morshed,&nbsp;J Tracy Watson,&nbsp;Hans-Christoph Pape","doi":"10.1097/OI9.0000000000000258","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000258","url":null,"abstract":"<p><p>Effective nonunion and bone defect management requires consideration of multiple potential contributing factors including biomechanics, biology, metabolic, and patient factors. This article reviews these factors as well as several potential nonunion or bone defect treatments including bone grafts, bone graft substitutes, the induced membrane technique, and distraction osteogenesis. A summary of these concepts and guidelines for an overall approach to management are also provided.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 3 Suppl","pages":"e258"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4d/ce/oi9-6-e258.PMC10392436.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10289977","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}