Based on the current literature, the authors recommend the following patient characteristics not receive antibiotics: clean hygienic patients, without autoimmune disease, and those not taking steroid medication. Surgical characteristics that would render prophylaxis unnecessary include those without hardware, those without reasonable risk of hematoma formation, or those performed at an ambulatory surgery center as opposed to a large hospital. However, the decision should be made on a case-by-case basis weighing the evidence presented.
TTR is an uncommon injury. Risks factors for rupture include renal disease and anabolic steroid use. Lateral elbow radiographs should be scrutinized for the DKS in patients with extension weakness. Outcomes are excellent following repair, and rates of rerupture are low.
The annual SOMOS meeting is a productive academic event, producing quality presentations resulting in a high manuscript publication rate in every orthopaedic surgery subspecialty. This is the first series to demonstrate overall productivity of a general orthopaedic surgery scientific meeting as well as the subspecialty-specific impact factors of published investigations.
Background: There is a high prevalence of combined shoulder instability in military patients. Short-term outcomes after 270° labral repair are promising; however, there is a paucity of longer term outcome data in this high-demand group of patients. Purpose: To report the midterm outcomes of active-duty military patients treated with 270° labral repair for combined shoulder instability. Study Design: Case series; Level of evidence, 4. Methods: All consecutive patients between January 2011 and January 2019 who underwent 270° labral repair by the senior surgeon with complete outcome scores were identified. All patients had experienced a shoulder dislocation after a traumatic event and had magnetic resonance imaging and intraoperative findings consistent with combined-type instability. A total of 52 patients met the inclusion criteria for the study, and all were active-duty servicemembers at the time of surgery. Results: The mean follow-up was 78.21 months (range, 24-117 months). There was a statistically significant increase in the mean American Shoulder and Elbow Surgeons score (from 44.92 to 89.31; P < .0001), Single Assessment Numeric Evaluation score (from 52.32 to 93.17; P < .0001), and Rowe instability score (from 46.63 to 91.35; P < .0001) from preoperatively to postoperatively. Mean pain decreased significantly as measured by the visual analog scale for pain (from 8.04 to 1.44; P < .0001). Range of motion in forward flexion (from 155.29° to 155.96°; P = .6793), external rotation (from 67.50° to 65.29°; P = .0623), and internal rotation (from T9.58 to T9.56; P = .9650) did not change significantly postoperatively. Outcomes did not differ significantly for patients who underwent surgery on their dominant shoulder versus those who underwent surgery on their nondominant shoulder, nor did outcomes vary with the type of anchor utilized (biocomposite vs all-suture). The overall rate of return to active duty was 92.31%. Conclusion: Midterm outcomes in this population of active-duty patients undergoing 270° labral repair for combined shoulder instability demonstrated a statistically and clinically significant improvement in patient-reported outcome scores, a significant decrease in pain, and an overall rate of return to active duty of 92.31%.
For all indications, the scaphoid staple has a high union rate and a low complication rate. In the authors' experience, the procedure is fast, not technically challenging, and may be considered for primary fracture, delayed union, nonunion, and avascular necrosis of the scaphoid.
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