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  1. Article ; Online: Symptomatic Ischial Stress Fractures in Elite Athletes Treated With Percutaneous Screws: A Report of 2 Cases.

    Schultz, Blake J / Mansour, Alfred / Eastman, Jonathan A / Routt, Milton Chip

    JBJS case connector

    2022  Volume 12, Issue 4

    Abstract: Cases: Two high-level athletes with symptomatic gluteal pain with explosive movements that had failed nonoperative management were eventually diagnosed with ischial stress fractures. These were treated with percutaneous posterior column screws. Both ... ...

    Abstract Cases: Two high-level athletes with symptomatic gluteal pain with explosive movements that had failed nonoperative management were eventually diagnosed with ischial stress fractures. These were treated with percutaneous posterior column screws. Both patients healed their fractures and made full return to sport.
    Conclusion: Ischial stress fractures should be considered in the differential for athletes with persistent gluteal pain. Percutaneous fixation is a minimally invasive and effective method of treating symptomatic ischial stress fractures that have failed nonoperative treatment.
    MeSH term(s) Humans ; Fractures, Stress/surgery ; Fracture Fixation, Internal ; Spinal Fractures/surgery ; Athletes ; Sciatica ; Bone Screws
    Language English
    Publishing date 2022-12-15
    Publishing country United States
    Document type Case Reports ; Journal Article
    ISSN 2160-3251
    ISSN (online) 2160-3251
    DOI e22.00481
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Clamp Assisted Reduction of the Transverse Acetabular Fracture With Anterior Column Screw Fixation and Posterior Plating: A Technical Trick and Case Series.

    Mitchell, Phillip M / Shaath, M Kareem / Routt, Milton Chip

    Journal of orthopaedic trauma

    2021  Volume 35, Issue 12, Page(s) e521–e524

    Abstract: Summary: Displaced transverse acetabular fractures are unstable injuries that frequently require repair. Although multiple approaches, techniques, and fixation constructs have been described to treat this pattern, achieving an anatomical reduction and ... ...

    Abstract Summary: Displaced transverse acetabular fractures are unstable injuries that frequently require repair. Although multiple approaches, techniques, and fixation constructs have been described to treat this pattern, achieving an anatomical reduction and applying fixation to maintain this until union remains the goal of treatment. We present a surgical technique for transverse or transverse/posterior wall acetabular fractures repaired using a clamp-assisted reduction through the sciatic notch, followed by anterior column screw fixation and subsequent posterior column plating through a Kocher-Langenbeck exposure. We review a case series of 55 patients treated with this technique and evaluate reduction quality using postoperative computed tomogram scans to assess for any residual step-off.
    MeSH term(s) Acetabulum/diagnostic imaging ; Acetabulum/injuries ; Acetabulum/surgery ; Bone Screws ; Fracture Fixation, Internal ; Fractures, Bone/diagnostic imaging ; Fractures, Bone/surgery ; Hip Fractures ; Humans ; Spinal Fractures ; Treatment Outcome
    Language English
    Publishing date 2021-10-08
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 639099-7
    ISSN 1531-2291 ; 0890-5339
    ISSN (online) 1531-2291
    ISSN 0890-5339
    DOI 10.1097/BOT.0000000000002116
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2234: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Pelvic ring injuries: recent advances in diagnosis and treatment.

    de Ridder, Victor A / Whiting, Paul S / Balogh, Zsolt J / Mir, Hassan R / Schultz, Blake J / Routt, Milton Chip

    OTA international : the open access journal of orthopaedic trauma

    2023  Volume 6, Issue 3 Suppl, Page(s) e261

    Abstract: Pelvic ring injuries typically occur from high-energy trauma and are often associated with multisystem injuries. Prompt diagnosis of pelvic ring injuries is essential, and timely initial management is critical in the early resuscitation of ... ...

    Abstract Pelvic ring injuries typically occur from high-energy trauma and are often associated with multisystem injuries. Prompt diagnosis of pelvic ring injuries is essential, and timely initial management is critical in the early resuscitation of polytraumatized patients. Definitive management of pelvic ring injuries continues to be a topic of much debate in the trauma community. Recent studies continue to inform our understanding of static and dynamic pelvic ring stability. Furthermore, literature investigating radiographic and clinical outcomes after nonoperative and operative management will help guide trauma surgeons select the most appropriate treatment of patients with these injuries.
    Language English
    Publishing date 2023-06-16
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2574-2167
    ISSN (online) 2574-2167
    DOI 10.1097/OI9.0000000000000261
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Multidimensional Pelvic Fluoroscopy: A New and Novel Technique for Assessing Safety and Accuracy of Percutaneous Iliosacral Screw Fixation.

    Shaw, James / Gary, Joshua / Ambrose, Catherine / Routt, Milton Chip

    Journal of orthopaedic trauma

    2020  Volume 34, Issue 11, Page(s) 572–577

    Abstract: Objectives: Multidimensional fluoroscopy is new imaging technology that generates intraoperative cross sectional imaging. Can this technology be used to assess accuracy and safety of percutaneously placed iliosacral screws intraoperatively?: Design: ... ...

    Abstract Objectives: Multidimensional fluoroscopy is new imaging technology that generates intraoperative cross sectional imaging. Can this technology be used to assess accuracy and safety of percutaneously placed iliosacral screws intraoperatively?
    Design: Retrospective study.
    Setting: Level 1 academic trauma center.
    Patients/participants: Fifty-two consecutive patients during a 7-month period with unstable posterior pelvic ring disruptions.
    Intervention: All patients were treated with percutaneous iliosacral and/or transsacral screw fixation by a single experienced surgeon. Traditional triplanar fluoroscopy was performed during guidepin insertion. Intraoperative multidimensional fluoroscopy was used for all patients after iliosacral screw fixation.
    Main outcome measurements: Intraoperative multidimensional fluoroscopy and postoperative computed tomography (CT) scans for each patient were retrospectively reviewed by the treating surgeon and another trauma surgeon. Screw position in relation to the sacral neuroforamen was assessed using multidimensional fluoroscopy and compared to postoperative CT scan. Screws were classified as extraforaminal, juxtaforaminal, or intraforaminal.
    Results: No screws were intraforaminally seen on intraoperative multidimensional fluoroscopy or postoperative CT scan. All iliosacral and transsacral screws were considered safe. Intraobserver and interobserver variability existed between reviewers when grading screws as extraforaminal versus juxtaforaminal. This was not clinically significant because both agreed that extraforaminal and juxtaforaminal screw positions are safe. Multidimensional fluoroscopy was used in 3 patients to assess guidepin placement before definitive screw fixation. Two patients underwent a change of fixation after reviewing multidimensional fluoroscopy. No postoperative neurological examination changes occurred.
    Conclusions: Multidimensional fluoroscopy is a novel imaging technology that can safely be used intraoperatively to accurately determine iliosacral and transsacral screw placement.
    Levels of evidence: Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.
    MeSH term(s) Bone Screws ; Fluoroscopy ; Fracture Fixation, Internal ; Fractures, Bone/diagnostic imaging ; Fractures, Bone/surgery ; Humans ; Ilium/diagnostic imaging ; Ilium/surgery ; Pelvic Bones/diagnostic imaging ; Pelvic Bones/surgery ; Retrospective Studies ; Sacrum/diagnostic imaging ; Sacrum/surgery
    Language English
    Publishing date 2020-09-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639099-7
    ISSN 1531-2291 ; 0890-5339
    ISSN (online) 1531-2291
    ISSN 0890-5339
    DOI 10.1097/BOT.0000000000001796
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2234: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  5. Article ; Online: Risk Factors for Conversion to Total Hip Arthroplasty After Acetabular Fractures Involving the Posterior Wall.

    Firoozabadi, Reza / Hamilton, Benjamin / Toogood, Paul / Routt, Milton Chip / Shearer, Dave

    Journal of orthopaedic trauma

    2018  Volume 32, Issue 12, Page(s) 607–611

    Abstract: Objectives: Identify risk factors for early conversion to total hip arthroplasty (THA) in an effort to aid in counseling patients and selecting the optimal treatment for patients who sustain a fracture involving the posterior wall of the acetabulum.: ... ...

    Abstract Objectives: Identify risk factors for early conversion to total hip arthroplasty (THA) in an effort to aid in counseling patients and selecting the optimal treatment for patients who sustain a fracture involving the posterior wall of the acetabulum.
    Design: Retrospective cohort analysis.
    Setting: Level I trauma center.
    Patients: Patients with acetabular fractures involving the posterior wall managed with open reduction internal fixation at least 4 years out from surgery.
    Intervention: Preoperative and postoperative computed tomography scans were reviewed for injury characteristics and reduction quality. Participants were contacted by telephone to document reoperations and functional outcomes including the SF-8 and modified Merle d'Aubigne Hip Scale.
    Main outcome measure: Conversion to THA.
    Results: The overall rate of conversion to THA was 5% at 2 years, 14% at 5 years, and 17% at 9 years. Presence of 5 specific radiographic features was associated with a 50% rate of conversion to THA in contrast to 11% if 4 or less features were present. Among cases with less than 1 mm of diastasis/step-off on postoperative computed tomography scan, there were no THA conversions, 10% conversion for 1-4 mm, and 54% if 4 mm or more of malreduction. There was no difference in SF-8 or modified Merle d'Aubigne scores comparing patients who underwent THA and those who did not.
    Conclusions: Acetabular fractures with posterior wall involvement are associated with a significantly higher rate of conversion to THA if reduction is not near-anatomic. A combination of clinical/radiographic findings is associated with poorer reductions and higher rate of conversion to THA.
    Level of evidence: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
    MeSH term(s) Acetabulum/injuries ; Adult ; Aged ; Arthroplasty, Replacement, Hip/methods ; Cohort Studies ; Databases, Factual ; Female ; Follow-Up Studies ; Fracture Fixation, Internal/adverse effects ; Fracture Fixation, Internal/methods ; Fracture Healing/physiology ; Fractures, Bone/diagnostic imaging ; Fractures, Bone/surgery ; Humans ; Injury Severity Score ; Male ; Middle Aged ; Postoperative Complications/diagnostic imaging ; Postoperative Complications/surgery ; Range of Motion, Articular/physiology ; Reoperation/methods ; Retrospective Studies ; Risk Assessment ; Time Factors ; Trauma Centers ; Treatment Outcome
    Language English
    Publishing date 2018-10-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639099-7
    ISSN 1531-2291 ; 0890-5339
    ISSN (online) 1531-2291
    ISSN 0890-5339
    DOI 10.1097/BOT.0000000000001327
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2234: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  6. Article ; Online: Determining Stability in Posterior Wall Acetabular Fractures.

    Firoozabadi, Reza / Spitler, Clay / Schlepp, Calvin / Hamilton, Benjamin / Agel, Julie / Routt, Milton Chip / Tornetta, Paul

    Journal of orthopaedic trauma

    2015  Volume 29, Issue 10, Page(s) 465–469

    Abstract: Objectives: To determine if the radiographic parameters of femoral head coverage by the intact posterior wall, acetabular version, and location of the fracture or a history of dislocation were determinates of hip stability in patients with posterior ... ...

    Abstract Objectives: To determine if the radiographic parameters of femoral head coverage by the intact posterior wall, acetabular version, and location of the fracture or a history of dislocation were determinates of hip stability in patients with posterior wall acetabular fractures.
    Design: Retrospective review.
    Setting: Level I trauma hospital.
    Patients: One hundred eighty-five consecutive patients with isolated unilateral posterior wall (OTA 62-A1) acetabular fractures.
    Intervention: Patients underwent dynamic stress fluoroscopic examination under general anesthesia to determine hip stability.
    Main outcome measurements: A number of radiographic measurements were performed, and an examination under anesthesia served as a standard to compare stable versus unstable hips.
    Results: Examination under anesthesia (EUA) determined 116 hips to be stable and 22 hips as unstable. Moed and Keith method of wall size measurements and cranial exit point of fracture was statistically different between stable and unstable hips. Twenty-three percent of the unstable hips had wall sizes less than 20%. Average cranial exit point of fracture from dome was 5.0 mm in the unstable group and 9.5 mm in the stable group, and fractures that extend into the dome demonstrate a statistically significant increase in hip instability.
    Conclusions: Determination of hip stability can be challenging in patients with posterior wall acetabular fractures. Our data suggest that the location of the exit point of the fracture in relation to the dome of the acetabulum is a radiographic marker that can be used to aid physician in determining stability, and wall sizes less than 20% is not a reliable indicator of stability.
    Level of evidence: Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.
    MeSH term(s) Acetabulum/diagnostic imaging ; Acetabulum/injuries ; Adult ; Aged ; Aged, 80 and over ; Female ; Fractures, Bone/complications ; Fractures, Bone/diagnostic imaging ; Hip Joint/diagnostic imaging ; Humans ; Joint Instability/diagnostic imaging ; Joint Instability/etiology ; Male ; Middle Aged ; Radiographic Image Interpretation, Computer-Assisted/methods ; Reproducibility of Results ; Sensitivity and Specificity ; Young Adult
    Language English
    Publishing date 2015-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639099-7
    ISSN 1531-2291 ; 0890-5339
    ISSN (online) 1531-2291
    ISSN 0890-5339
    DOI 10.1097/BOT.0000000000000354
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2234: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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