Background: Anterior cruciate ligament (ACL) injuries are relatively common among younger athletes, with significant physical, psychological, and financial consequences. Research has largely focused on female athletes by identifying specific risk factors for an ACL injury, including variation in pubertal growth timing. There is less known about risk factors in males, and little is known about the effects of pubertal development on ACL injury risk in men. Purpose/Hypothesis: The purpose of this study was to analyze the relationship between an indicator of pubertal growth timing (age at adult height) and biomechanical risk for ACL injuries in men. We hypothesized that earlier age at adult height is correlated with riskier landing biomechanics during a drop vertical jump (DVJ) in men. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 21 recreationally active male students (age range, 20-33 years) were included. Participants completed a questionnaire on age at adult height and limb dominance, and anthropometric measurements were taken. There were 6 DVJ tests performed, with participants landing on a force plate while digital cameras recorded kinematic data from retroreflective markers placed according to the Helen Hayes marker system. Primary outcomes were sagittal and frontal plane knee kinematics and kinetics during contact. Data were analyzed using Pearson product-moment correlation. Results: In both limbs, age at achieving adult height was significantly negatively correlated with knee flexion/extension angle at toe-off (dominant: r = –0.79, P < .01; nondominant: r = –0.74, P < .01) and with peak flexion (dominant: r = –0.63, P < .01; nondominant: r = –0.70, P < .01) and extension (dominant: r = –0.66, P < .01; nondominant: r = –0.56, P = .01) angles during contact. In the nondominant limb, age at adult height was significantly negatively correlated with varus/valgus angle at initial contact ( r = –0.43; P = .05) and toe-off ( r = –0.44; P = .04) and was positively correlated with peak varus moment during contact ( r = 0.42; P = .06). Age at adult height was also positively correlated with peak vertical ground-reaction force ( r = 0.58; P < .01). Conclusion: Later age at adult height was correlated with riskier landing profiles in this study. This suggests that males with later or longer pubertal growth may have increased mechanical risk for ACL injuries. A better understanding of the effects of pubertal growth on landing biomechanics can improve the early identification of male athletes at greater risk for injuries.

Background: To review the available literature on Darrach and Sauvé-Kapandji (SK) procedures and perform a systematic review to identify differences in clinical outcomes. We hypothesized that SK would have a higher complication rate without significant clinical benefit. Methods: A literature search was conducted using PubMed, EMBASE, Cochrane Library, and SCOPUS (from inception to January 2020) to identify studies evaluating outcomes of Darrach and SK procedures. Primary outcome measures included the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, range of motion, grip strength, complications, and overall satisfaction. Results: A total of 103 articles were identified and screened, and of these, 44 full-text articles were used for data extraction and qualitative analysis. Outcomes were similar for QuickDASH scores, grip strength, and range of motion, as was overall satisfaction. Specifically, satisfaction rates for stabilized SK and Darrach procedures in patients without rheumatoid arthritis were comparable at 70.2% and 72.6%, respectively. Average QuickDASH scores were similar (21 for Darrach and 29 for SK). Mechanical symptoms due to stump instability occur with either procedure but were higher with the Darrach procedure (12.5% compared with 6.8%). The SK had more surgery-related complications such as nonunions (2.3%), symptomatic hardware, and reoperations (6.8% compared with 3.2%). Conclusions: Both Darrach and SK procedures provide comparable satisfaction rates regardless of the underlying pathology. Improvement in range of motion, strength, and overall function is similar for both procedures; however, the reoperation rate is higher with SK.

The goal of this study was to compare information available on the Internet about the treatment of distal radius fractures with the guidelines established by the American Academy of Orthopaedic Surgeons (AAOS) in a qualitative observational study. A scoring system was used to compare the top 20 websites, excluding advertisements, from Google, Bing, and Yahoo with the AAOS guidelines. In addition, the results of the advertising content and the social media content were discussed. Of the 32 unique websites included in the study, 22 (68.75%) suggested operative fixation for fractures with unacceptable postreduction alignment (radial shortening >3 mm, dorsal tilt >10°, or intra-articular displacement or step-off >2 mm) as opposed to cast fixation. Of the 32 sites, 26 (81.25%) were unable to recommend for or against any 1 specific operative method for fixation of distal radius fractures. Only 2 of 32 (6.25%) sites mentioned age-specific recommendations, and 6 of 32 (18.75%) mentioned accurate activity protocols. Because the AAOS cannot recommend for or against immobilization of the elbow in patients treated with cast immobilization, it is reasonable that 7 of 32 (21.88%) sites discussed these options. The websites common to all 3 search engines also scored very well, with 84.89% of their recommendations being consistent with the AAOS recommendations. Most websites contain appropriate recommendations for the treatment of distal radius fractures. However, there is a significant amount of misinformation as well. The available information may be difficult for patients to interpret and may affect their expectations about care. [ Orthopedics . 2020;43(2):e79–e86.]

The most commonly diagnosed malignancy in the United States is non-melanoma skin cancer (NMSC) with &gt; 2 million new cases of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) predicted for 2010. The economic burden and increasing incidence in younger populations, especially women, reinforces the value of skin cancer prevention. Health education and prior attempts at skin cancer chemoprevention have had limited success. A strong link between epithelial carcinogenesis and elevated polyamines, together with a series of phase I and II trials, led to a NCI-sponsored phase III double-blind, placebo-controlled skin cancer chemoprevention trial of α-difluoromethylornithine (DFMO) (500 mg/m2/day) for 4–5 years in 291 subjects with a history of NMSC. Subjects receiving DFMO developed significantly fewer BCC s than placebo subjects with an event rate of 0.28 BCC/person/year versus 0.40 BCC/person/year, (P = 0.03; Total BCCs: DFMO 163, placebo 243). DFMO appeared to have minimal effects on SCC incidence (DFMO 0.15 SCC/person/year, placebo 0.19, p=0.56; Total SCCs: DFMO 95, placebo 115). Subjects tolerated DFMO well, and the only significant observed toxicity was increased audiometric hearing loss. A key issue in the clinical viability of a chemoprevention agent after acute effectiveness and/or tolerance is the latent effectiveness and/or toxicity of the agent. Such effects attributable to DFMO have not been assessed. Earlier chemoprevention research has observed positive and negative latent effects with chemopreventive agents. Use of tamoxifen (5 years) for breast cancer prevention provided continued or greater protection for up to 10 years after drug stoppage. On the contrary, early work with retinoids in oral cancer prevention implied a rebound effect with subjects developing more neoplasms upon discontinuation. Also, the recent linkage between isotretinoin and inflammatory bowel disease is a concerning example of toxicity experienced years after use of a chronically administered agent. The continued interest in DFMO as a chemopreventive agent provided cause to update the clinical data and overall health status of the 291 subjects from the phase III skin cancer prevention study of DFMO to understand the sustainability of the observed DFMO effects. After institutional review board approval, we reviewed medical records of 243 subjects who received care at UW Health. Individual records were manually reviewed, and a pending comparative review of data mining by Natural Language Processing will also be completed. Both reviews focused on the skin cancer events by histology, other neoplasia (invasive and non-invasive), significant other diagnoses, and survival. The rate of skin cancer recurrence from end of study drug to the time of last medical contact (the primary endpoint) was compared between subjects randomized to DFMO or placebo using a two-sample test for primary analysis. As a secondary analysis, the rate of skin cancer recurrence from randomization to the time of last medical contact was also compared. In an exploratory analysis, the primary endpoint was analyzed using Poisson regression models to account for the baseline patient/disease characteristics at the time of randomization such as sex and age of patients and pre-study skin cancer history. Data from the 243 subjects totaling over 2,300 person years is undergoing further validation and preliminary data analysis, and will be available shortly. Citation Information: Cancer Prev Res 2011;4(10 Suppl):A52.