Today’s Top Story

Study Compares Open Fracture Management in Younger Versus Older Patients

A retrospective study published online in Injury evaluated similarities and differences between managing older and younger patients with open lower limb fractures. A total of 33 pediatric (age < 16 years) patients and 99 older (age > 65 years) patients with severe open lower limb fractures were included in the analysis and followed for at least nine months. The median age in the pediatric cohort was 12 years, and most patients (76 percent) had open tibial fractures, while 12 percent had ankle fracture dislocation. Most injuries were high-energy and managed with external fixators and free flap coverage. Median hospital stay was 12 days, and median time to union was 114 days. In the older cohort, the mean age was 76 years. Low-energy fragility fractures were more common than high-energy injuries, which required free flaps. Median hospital stay and time to union were 13 days and 150 days, respectively.

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Other News

Study Associates High Activity Levels and Mental Distress with Knee Issues in Young Patients

A study published online in BMC Musculoskeletal Disorders identified risk factors for knee problems in younger patients. A total of 314 staff and students from a single university aged 18 to 39 years completed a questionnaire pertaining to the presence of knee problems. Researchers used the International Physical Activity Questionnaire to collect activity data. Just under a third (31.8 percent) of patients reported knee problems, with pain being the most common dominant symptom. The only independent risk factors for knee problems were high levels of physical activity and mental distress.

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Study: Caudal Epidural Anesthesia to Lumbar Plexus Blockade in Pediatric Hip Surgery Patients

A retrospective study published online in the Journal of Pain Research found that analgesia, including caudal epidural anesthesia (CEA), may be advantageous compared to lumbar plexus blockade (LPB) in young hip surgery patients. The study included 61 patients, of whom 29 received an LBP and 32 received CEA. Intraoperative opioid use was similar between the groups: 0.7 mg/kg of oral morphine equivalents (OMEs) in the LBP group versus 0.6 in the CEA group. During the first 48 hours after surgery, opioid use was higher in the LBP group (4 mg/kg of OME) than the CEA group (2 mg/kg of OME). Median 24-hour postoperative pain scores were five in the LBP cohort and three in the CEA group.

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Study Assesses Outcomes in Early Versus Late Rib Fracture Stabilization in Patients with Respiratory Failure

Early surgical stabilization in patients with severe rib fracture and respiratory failure could be associated with reduced medical costs, shorter mechanical ventilation duration, and shorter intensive care unit (ICU) visits and hospital length of stay (LOS), according to a retrospective study published online in PLOS ONE. Severe rib fracture patients with respiratory failure were stratified based on time to surgical stabilization: early (within three days of injury, n = 16) and late (more than three days after injury, n = 17). Median duration of mechanical ventilation was significantly shorter in the early group than the late group (36 hours versus 90 hours), as were ICU visits (123 hours versus 230 hours) and hospital LOS (12 days versus 18 days). The early group also had lower national health insurance costs (median $6,617 U.S. dollars versus $10,017 U.S. dollars).

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EHR Data Use on the Rise in Hospitals

Hospitals are using electronic health record (EHR) data at an increasing rate and for a variety of measures, according to a report from The Office of the National Coordinator for Health Information Technology. In 2017, the most commonly reported use of EHR data was to support quality improvement (82 percent), followed by monitoring patient safety (81 percent) and measuring organization performance (77 percent).

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May AAOS Now Is Now Available Online

AAOS members will soon receive the print edition of the May issue of AAOS Now, but the electronic edition is already available on the AAOS Now website and on iOS and Android devices through the AAOS Access app. This month’s issue includes a vision of the Academy’s future from AAOS President Kristy L. Weber, MD; the impact of medical tourism on the healthcare system; and more.

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Cast Your Ballot! AAOS 2020 Nominating Committee, 2019 Resolutions and Bylaws Amendments

Active, emeritus, and inactive Fellows: Electronic balloting is now open to elect five members for the 2020 AAOS Nominating Committee and to determine action on two AAOS resolutions and three AAOS bylaws amendments. Balloting is quick, secure, and confidential. For the resolutions and bylaws amendments, at least 5 percent of the total Fellowship must cast ballots for the voting to be valid. Ballots must be cast by June 12. An AAOS member ID is required to vote.

Learn more and cast your ballot…(member login required)


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