Bone-grafting procedures are common in orthopedic trauma surgeries. There are only few reports on the morbidity after proximal tibia harvesting. Here, we report an experience of complication after proximal tibia harvesting while treating subtrochanteric femoral osteomyelitis.

Purpose: Due to recent advances in internal fixation techniques, instrumentation and orthopedic implants there is an increasing number of humeral shaft fracture treated operatively. As a consequence, an increased number nonunion after operative fixation are being referred to our center. The aim of this study is to report the common error during osteosynthesis that may have led to nonunion and present a systematic analytical approach for the management of aseptic humeral shaft nonunion.Methods: In between January 2007 to December 2013, 20 patients with humeral shaft nonunion after operative procedure were treated according to our treatment algorithm. We could analysis x-rays of 12 patients from initial treatment to nonunion. In a subgroup of 12 patients the initial operative procedure were analyzed to determine the error that may have caused nonunion. The following questions were used to examine the cases: 1) Was the fracture biology preserved during the procedure? 2) Does the implant construct have enough stability to allow fracture healing?Results: In 19 out of 20 patients have showed radiographic evidence of union on follow up. One patient has to undergo reoperation because of the technical error with bone graft placement but eventually healed. There were 2 cases wherein the treatment algorithm was not followed. All patients had problems with mechanical stability, and in 13 patients had biologic problems. In the analysis of the initial operative fixation, only one of 12 patients had biologic problems.Conclusion: In our analysis, the common preventable error made during operative fixation of humeral shaft fracture is failure to provide adequate stability for bony union to occur. And with these cases we have demonstrated a systematic analytic management approach that may be used to prevent surgeons from reproducing the same fault and reduce the need for bone grafting. [ J Trauma Inj 2016; 29: 129-138 ]

Purpose:The purpose of this study was to analyze the equality between author key words used in the Journal of the Korean Orthopaedic Association and controlled vocabulary or medical subject headings (MeSH). Materials and Methods: A total of 1,058 English key words in 320 papers (average 3.3 words in a paper) from 2009 to 2012 were eligible for this study. We classified them according to matched, partially matched, and non-matched terms. The partially matched terms were further dissected into entry terms, qualifiers, anteriorly or posteriorly matched, abbreviations, and pleurals. After descriptive analysis, we assayed patterns of errors in using MeSH, and reviewed frequently used non-MeSH terms. Results: The rate of matched terms was 23.5% for an average of four years, and 34.8% for 2013, which is on the rise by year. The rate of partially matched terms was 34.8%, and that of non-matched terms was 41.7% for an average of four years. The most frequently used key words were Knee and Total knee arthroplasty (17 times), followed by Osteoarthritis (9), Femur, Hip, and Total hip arthroplasty (8). Conclusion: Use of proper keywords aligned with the international standards such as MeSH is important to be properly cited. The authors should pay attention and be educated on correct use of MeSH as key words.

BACKGROUND Mixed reality (MR) is a hybrid system that projects virtual elements into reality. MR technology has the advantage of providing immersive learning using various real-world tools. However, studies on educational programs using MR are scarce. OBJECTIVE This study aimed to investigate the educational effects of and satisfaction with an MR-based trauma decision-making simulator. METHODS A total 40 of trainees self-selected to participate in this experiment. All participants participated in the MR trauma simulator for approximately 30 minutes and conducted voluntary learning without any external help. Declarative knowledge, measured using 20 multiple-choice questions, was assessed before and after MR trauma training. To confirm the educational effect, test scores before and after MR trauma training were compared using a paired t-test. Student satisfaction after training was measured using a ten-item questionnaire rated on a five-point Likert scale. RESULTS A pretest-posttest comparison yielded a significant increase in declarative knowledge. The percentage of correct answers to multiple choice questions increased (from a mean of 42.3, SD 12.4 to 54.8, SD 13) after the MR-based trauma assessment and treatment training (P < 0.001). Of the participants, 79.45% were satisfied with the overall experience of using the MR simulator. CONCLUSIONS This study demonstrated a meaningful educational effect of the MR-based trauma training system even after a short training time.

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