Level IV prognostic.

BACKGROUND: Gunshot wounds to the upper extremity in pediatric patients are an uncommon injury, but their impact on the patient can be severe. They can be accompanied by nerve damage, bone fracture, or tendon rupture. The most common cause of these pediatric gun injuries is unintentional firearm discharge. The most common type of firearm involved overall is a powdered weapon; however, non-powder weapons are a significant contributor to pediatric firearm injury. The purpose of this study is to describe the characteristics and treatment outcomes of pediatric GSW in a level one trauma center on the US-Mexican border. METHODS: Retrospective case series. RESULTS: Ten patients met our inclusion criteria for the study. The most frequent mechanism of injury was due to violence (60%), and the most frequent type of firearm involved was a powdered weapon (80%). Males were more affected than females (70%). Six patients experienced bone fracture, three patients experienced nerve damage, and one patient experienced tendon damage. No patients had lasting physical deficits as the result of their injury. CONCLUSION: Most of the pediatric GSW (60%) were due to violence. However, a significant percentage was due to accidental injury (40%). Addressing powder and non-powder weapon safety is warranted to reduce firearm injury in the pediatric population. Good outcomes can be expected in most pediatric GSW.

Objectives: The purpose was to investigate the association between Hirsch index (H-index) and academic rank among orthopaedic trauma surgeons affiliated with Orthopaedic Trauma Association (OTA) and Accreditation Council for Graduate Medical Education (ACGME) fellowship programs with academic appointments. Additional variables investigated included total number of publications and training program affiliation. Design: Database review. Participants: Orthopaedic trauma surgery faculty members at OTA and ACGME orthopaedic trauma surgery fellowship. Main outcome measurement: H-index, total number of publications, academic rank, and fellowship training pedigree. Results: The H-indices of 273 orthopaedic traumatologists from 57 fellowship programs were organized and calculated. There are strong correlations among total number of publications, citations, and H-index. Overall, there is a strong association with number of publications, number of citations, and H-index with higher academic rank. Overall, H-index was a stronger predictor of academic rank than total number of publications and citations. Appointment to the same program as an individual’s fellowship training program and orthopaedic subspeciality fellowship outside of traumatology were not associated with academic rank. Level of Evidence: IV, case series Key words: trauma, fellowship, academic rank, H-index

Objectives: Describe basic differences in sutures and the overall impact on cost efficacy. Design: Review. Intervention: Suture choice. Main Outcome measurements: Cost. Results and Conclusions: It is important for a surgeon to consider the advantages of various sutures and needles to ensure proper primary approximation, prevent infection or dehiscence, and close in a time-efficient manner. Modern-day sutures can be divided into three main categories: natural vs synthetic, monofilament vs multifilament, and non-absorbable vs absorbable. A newer monofilament barbed suture has been given increasing attention, as it reduces procedural times and ultimately operative costs. Level of Evidence: IV, Review Keywords: suture, barbed, cost, orthopaedic surgery, orthopedic surgery, cost analysis (J Ortho Business 2022; Volume 2, Issue 2:pages 13-18)