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The current literature suggests that well-selected patients >60 years of age undergoing surgical treatment for a type II odontoid fracture have a decreased risk of short-term and long-term mortality without an increase in the risk of complications.

Background The COVID‐19 pandemic profoundly impacted breast cancer treatment in 2020. Guidelines initially halted elective procedures, subsequently encouraging less invasive surgeries and restricting breast reconstruction options. We examined the effects of COVID‐19 on oncologic breast surgery and reconstruction rates during the first year of the pandemic. Methods Using the National Surgical Quality Improvement Program, we performed an observational examination of female surgical breast cancer patients from 2017 to 2020. We analyzed annual rates of lumpectomy, mastectomy (unilateral/contralateral prophylactic/bilateral prophylactic), and breast reconstruction (alloplastic/autologous) and compared 2019 and 2020 reconstruction cohorts to evaluate the effect of COVID‐19. Results From 2017 to 2020, 175 949 patients underwent lumpectomy or mastectomy with or without reconstruction. From 2019 to 2020, patient volume declined by 10.7%, unilateral mastectomy rates increased (70.5% to 71.9%, p = 0.003), and contralateral prophylactic mastectomy rates decreased. While overall reconstruction rates were unchanged, tissue expander reconstruction increased (64.0% to 68.4%, p < 0.001) and direct‐to‐implant and autologous reconstruction decreased. Outpatient alloplastic reconstruction increased (65.7% to 73.8%, p < 0.0001), and length of hospital stay decreased for all reconstruction patients ( p < 0.0001). Conclusions In 2020, there was a nearly 11% decline in breast cancer surgeries, comparable mastectomy and reconstruction rates, increased use of outpatient alloplastic reconstruction, and significantly reduced in‐hospital time across all reconstruction types.

Background: Breast-implant–associated anaplastic large cell lymphoma (BIA-ALCL) is associated with prolonged exposure to textured implants. Current studies describing textured implant use are limited to single center/surgeon experiences. Using the Tracking Operations and Outcomes for Plastic Surgeons database, the study aims to characterize national trends in rates of smooth versus textured implant utilization. The hypothesis is that rates of textured implant use have decreased in the most recent time period. Methods: Tracking Operations and Outcomes for Plastic Surgeons was queried from 2007 to 2019 for CPT codes involving breast implant use in augmentation and reconstruction. The rate of smooth and textured implant utilization was calculated for each year per procedure type. Generalized additive models with a smoothing function and Pearson chi-square tests were used to assess the trends. Results: Textured implant use peaked in 2016, being utilized in 17.83% of cosmetic and 40.88% of reconstructive procedures. Textured implants were more commonly used for reconstructive compared with cosmetic cases for 2007–2009, 2011, and 2013–2019 (P < 0.02). Both cosmetic and reconstructive cases had nonlinear trends in textured implant use over the study period, with textured rates decreasing from 2017 to 2019 (P < 0.001). In 2019, textured implants were used in 2.15% of cosmetic and 7.58% of reconstructive cases. Conclusions: This is the first national study describing trends in textured versus smooth breast implant use in the United States. Textured implant utilization peaked in 2016. Based on a median time horizon of 10 years before development of BIA-ALCL, the peak number of cases can be anticipated in 2026 or thereafter.