Plating vs. External Fixation for Open Tibia Fractures

Terry Stanton

In presenting his study on the value of damage-control plating, Manish K. Sethi, MD, first framed the economic impetus for evaluating an alternative to external fixation in temporizing open tibia fractures prior to intramedullary (IM) nailing. Noting that Medicare is bundling payments for selected services such as major joint arthroscopy, he said the federal government “intends to expand this system across all of orthopaedics.”

Is TAA Effective in Patients with Stiff Ankles?

Jennie McKee

“Ankle arthritis is unlike arthritis in other joints,” said James W. Brodsky, MD. “In the ankle, the loss of motion may not be proportional to the severity of the arthritis, nor is there necessarily contracture or extreme loss of motion.” But stiffness can, indeed, pose a problem for a significant number of people with ankle arthritis.

Antibiotic Use Influences Infection Rates in Open Fractures of the Hand

Maureen Leahy

Open fractures can be difficult to heal and have a high risk of infection. The overall infection rate for open fractures of the hand, however, is relatively low and most infections can be treated successfully with antibiotics alone, according to study data presented at the American Society for Surgery of the Hand annual meeting. Moreover, although the use of antibiotics influences infection rates in these fractures, the timing of débridement does not.

Shared Decision Making in Orthopaedics

Alexandra E. Page, MD; Ben Moulton, JD, MPH

The process of shared decision making (SDM) helps physicians and patients move beyond passive informed consent to more collaborative, patient-centered experiences. By offering a balanced review of conservative and invasive treatment options, including the option of observation only, SDM provides patients an opportunity to express their personal values and goals in the context of health decisions.

The Fellowship Match: An Update

Lisa K. Cannada, MD

Remember the “good old days”? When PGY-2 residents started looking for fellowships before they had even been exposed to the range of orthopaedic specialties available? When residents interviewing for a fellowship were faced with the ultimatum “Choose now or lose it”? What was good about that? Today’s fellowship match is an organized process for all orthopaedic specialties.

Lumps, Bumps, and What to Do with Them

JAAOS article examines “Diagnosis and Management of Soft-tissue Masses” Nearly every orthopaedist—as well as other providers of musculoskeletal care—has encountered patients who have soft-tissue masses of the extremities. The November issue of the Journal of the AAOS (JAAOS) takes a look at how orthopaedic surgeons and others can properly diagnose and manage these lumps and bumps.

The Missing Link in Safety and Quality

Dwight W. Burney, MD

Recent reports in the orthopaedic and medical literature have cast orthopaedics in an unfavorable light. Consider the following examples: A review of Medicare Patient Safety Monitoring System data showed no decrease in adverse events for patients who required surgery between 2005 and 2009; a significant portion of this study population was orthopaedic patients.

Through the Looking Glass: Google Glass and the Future of Hand Surgery

Paul A. Sibley, DO; David W. Martineau, MD

Paul A. Sibley, DO, and David W. Martineau, MD The medical technology boom has exploded in recent years. A prime example is the use of Google Glass (Mountain View, Calif.). Glass is a smart, “wearable technology” currently being used and developed in the field of hand surgery with revolutionary potential. Worn like traditional glasses, Glass is likened to a smartphone on your head (Fig. 1). It has an optical head-mounted display that is akin to watching a 25-inch screen at 8 feet.