Wounds and Injuries Commons^™

Modeling Musculoskeletal Combat Casualty Care: Nato Trauma System Performance In Large Scale Combat Operations, Mark P. Cote, Kaitlyn E. Holly, Roman J. Schoenfeld, Matthew R. Bryan, Malina O. Hatton, Mitchel B. Harris, Tracey P. Koehlmoos, Andrew J. Schoenfeld

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: It is unclear whether the current North Atlantic Treaty Organization (NATO) trauma system will be effective in the setting of Large-Scale Combat Operations (LSCO). We sought to model the efficacy of the NATO trauma system in the setting of LSCO. We also intended to model novel scenarios that could better adapt the current system to LSCO.

METHODS: We developed a discrete-event simulation model for patients with combat musculoskeletal injuries treated within the standard NATO system. The primary outcome of the model was survival. The model's health states were characterized as stable, hypovolemia, sepsis, shock, or death. The model simulated …

Clinical Outcomes Following Endoscopic Carpal Tunnel Release With The Arthrex Nanoscopic Release System-A Single Surgeon Experience, Sina Ramtin, Asif M. Ilyas

Department of Orthopaedic Surgery Faculty Papers

PURPOSE: Endoscopic carpal tunnel release (ECTR) is a minimally invasive alternative to open release, offering faster recovery and reduced postoperative discomfort. The Arthrex NanoScopic ECTR system, a novel single-use device using chip-on-tip digital imaging and designed for use under local anesthesia without arthroscopic equipment, may further streamline care and expand surgical access.

METHODS: A retrospective review was conducted of the first 50 consecutive ECTR procedures performed using the Arthrex NanoScopic system by a single hand fellowship-trained hand surgeon. All procedures were completed under wide-awake local anesthesia no tourniquet technique in an outpatient surgical center. Outcomes included operative times, adverse events, …

Identifying Critical Evidence Gaps In Wound Closure And Incision Management After Total Hip Arthroplasty: Delphi Panel Insights, Margaret Ainslie-Garcia, Lucas Anderson, Benjamin Bloch, Tim N Board, Antonia Chen, Samantha Craigie, Walter Danker, Najmuddin Gunja, James Harty, Victor Hernandez, Kate Lebedeva, Mitchell Ng, Daniel Hameed, Michael Mont, Ryan Nunley, Javad Parvizi, Sean Sequeira, Carsten Perka, Nicolas Piuzzi, Ola Rolfson, Joshua Rychlik, Emilio Romanini, Pablo Sanz-Ruiz, Rafael Sierra, Linda Suleiman, Eleftherios Tsiridis, Pascal-André Vendittoli, Helge Wangen, Luigi Zagra

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: In total hip arthroplasty (THA), proper management of surgical incisions is essential for optimal wound healing and patient outcomes. Despite advances in surgical techniques, significant challenges remain in preventing complications and infections. This study aimed to identify evidence gaps in THA wound care, including presurgical preparation, intraoperative practices, and postsurgical complications.

METHODS: Using a modified Delphi method, 20 expert orthopedic surgeons from Europe and North America participated in a 3-phase consensus process from April 1 to September 30, 2023. This included a preliminary questionnaire, a remote conference, and a final online survey. The panel reviewed literature and achieved agreement …

Incidence Of Heart Failure Following Carpal Tunnel Release Surgery, Harrison S. Fellheimer, Mahaa Ayub, Gabriel I. Onor, Lauren O'Mara, Eric Tecce, Pedro K. Beredjiklian

Department of Orthopaedic Surgery Faculty Papers

PURPOSE: Previous literature suggests a relationship between carpal tunnel syndrome (CTS) and heart failure (HF), indicating that patients with CTS are more likely to experience cardiomyopathy. Amyloid deposition leading to CTS may be prodromal for the development of amyloid cardiomyopathy. We hypothesized that patients undergoing surgery for CTS would have an increased risk of HF compared to those who did not undergo surgery.

METHODS: The TriNetX database was queried using the primary ICD-10 code for CTS to identify patients. Patients were included if they had surgical treatment for CTS, reported as endoscopic or open carpal tunnel release, or median nerve …

Epidemiological Trends Of Facial Fractures In The United States, Gabriel I. Onor, Ugochi T. Aguwa, Nicholas Barksdale, Isaiah X. Hughes, Molly Milano, Camila Cordero, Uche Nwagu, Oluwatomi Akingbola, Chibuzo J. Aguwa, Michael C. Okoronkwo

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Sustaining facial fractures may pose significant challenges to patients' health and quality of life. In the United States (U.S.), facial fractures account for 20 % of all sports-related injuries in pediatrics and many of these injuries are associated with traumatic brain injury. The objective of this study was to identify overall and sports-related incidence rates of facial fractures presenting to U.S. hospital emergency departments from 2014 to 2023 and define demographic risk factors for these injuries.

METHODS: The National Electronic Injury Surveillance System was queried to identify facial fractures from 2014 to 2023 as well as associated demographic data. …

Characteristics Of High-Risk Bipolar Bone Loss Lesions Using 3-Dimensional Imaging, Petar Golijanin, Justin Arner, Claire Ryan, Qais Zai, Liam Peebles, Annalise Peebles, Phob Ganokroj, Ryan Whalen, Stephanie Eble, Danielle Rider, Srdjan Ninković, Matthew Provencher

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: The concept of on-track versus off-track bone lesions in glenohumeral instability continues to evolve. Although much has been ascertained from an original biomechanical model, bony pathological changes, especially on 3-dimensional (3D) imaging, have not been fully evaluated.

PURPOSE: To compare the differences in on-track versus off-track lesions to characterize glenoid and humeral head bone defects using 3D modeling software.

STUDY DESIGN: Cross-sectional study; Level of evidence, 3.

METHODS:A consecutive cohort of 75 patients with recurrent anterior instability, with evidence of Hill-Sachs lesions (HSLs) and
glenoid bone loss (GBL) and a mean age of 27.1 years (range, 18-48 years), were …