Tips and tricks for utilizing this technique effectively, alongside early experiences, are presented.
In the treatment of peri-articular fractures, needle-based arthroscopy may provide a valuable addition and warrants further investigation.
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The potential of needle-based arthroscopy as a valuable adjunct in the treatment of peri-articular fractures necessitates further study. Classifying evidence as level IV.

Surgical intervention for displaced midshaft clavicle fractures (MCFs) is a subject of ongoing discussion among orthopedic surgeons, concerning both the appropriate timing and the absolute need for such procedures. This systematic review analyzes published research to compare functional outcomes, complication rates, nonunion occurrences, and reoperation rates between patients treated surgically for MCFs early versus late.
Search strategies were employed in the databases PubMed (Medline), CINAHL (EBSCO), Embase (Elsevier), Sport Discus (EBSCO), and the Cochrane Central Register of Controlled Trials (Wiley). The extraction of demographic and study outcome data for comparing early and delayed fixation studies took place after the initial screening and comprehensive full-text review process.
The review process yielded twenty-one studies suitable for inclusion in the study. genetics and genomics The early group contained 1158 patients; the delayed group, a significantly smaller number, comprised 44. The two groups exhibited comparable demographics, but a key difference lay in the proportion of males (816% in the initial group compared to 614% in the later group) and the substantial time lag before surgery for the group with delayed intervention, experiencing a lengthy 145 months compared to an average 46 days in the early group. The group initiating treatment earlier experienced better results in both disability of the arm, shoulder, and hand (36 vs. 130) and Constant-Murley scores (940 vs. 860). The delayed group experienced a greater proportion of initial surgeries resulting in complications (338% vs. 636%), nonunions (12% vs. 114%), and nonroutine reoperations (158% vs. 341%).
Early surgical treatment of MCFs is associated with better results, demonstrated by reduced nonunions, reoperations, and complications, and improved DASH and CM scores, when compared to delayed intervention. Although the number of delayed patients who achieved moderate outcomes is small, we propose a shared decision-making process as the optimal approach for treatment recommendations tailored to individual patients with MCFs.
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When treating MCFs, the outcomes associated with early surgery are superior to delayed surgery, specifically concerning nonunion, reoperation, complications, DASH scores, and CM scores. Infected fluid collections Nevertheless, considering the limited number of late-presenting patients who nonetheless experienced moderate results, we suggest a shared decision-making approach when recommending treatments for individual patients with MCFs. This assertion is corroborated by level II evidence.

The development of locking plate technology, roughly 25 years ago, has yielded substantial success in its subsequent applications. The original design's modification with newer materials and designs has not, as yet, translated into measurable improvements in patient care. An 18-year study at our institution investigated the consequences of utilizing first-generation locking plate (FGLP) and screw systems.
A retrospective analysis from 2001 to 2018 identified 76 patients who sustained 82 proximal tibia and distal femur fractures (both acute and non-union cases), treated with a first-generation titanium, uniaxial locking plate employing unicortical screws (commonly known as the LISS plate, produced by Synthes Paoli Pa). This cohort was juxtaposed against 198 patients with 203 similar fracture patterns, who were treated using second- and third-generation locking plates, otherwise known as Later Generation Locking Plates (LGLPs). To be included, participants needed at least a one-year follow-up period. A radiographic analysis, the Short Musculoskeletal Functional Assessment (SMFA), VAS pain scores, and knee range of motion were employed to evaluate outcomes at the final follow-up visit. IBM SPSS (Armonk, NY) was the tool used to calculate all descriptive statistics.
The 76 patients with a total of 82 fractures had a mean four-year follow-up period suitable for analysis. A first-generation locking plate was employed to fix 82 fractures in a group of 76 patients. The mean age at which injury occurred across all patients stood at 592 years, and 610% of them were female. A study on knee fractures treated with FGLP revealed a mean time to union of 53 months for acute cases and 61 months for cases initially categorized as non-unions. At the final follow-up, the mean standardized SMFA for all patients was 199, the mean knee range of motion was between 16 and 1119 degrees, and the average pain score, as measured by the VAS, was 27. No differences in outcomes were noted when comparing patients with equivalent fractures and nonunions treated with LGLPs versus a control group with similar characteristics.
Long-term follow-up of first-generation locking plates (FGLP) consistently reveals a high rate of union, a low incidence of complications, and satisfactory clinical and functional outcomes.
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Analysis of long-term outcomes for first-generation locking plates (FGLP) consistently demonstrates a high rate of bony union, a low rate of complications, and positive clinical and functional outcomes. The evidence classification is categorized as Level III.

Although prosthetic joint infections (PJIs) are uncommon, they represent a devastating complication resulting from total joint arthroplasty (TJA). When patients require surgery for PJI, their treatment options typically involve either a one-stage operation or the more standard two-stage procedure. Two-stage revisions, although more involved, pose a lower risk of reinfection than the less invasive DAIR procedure, which combines debridement, antibiotics, and implant retention. Irregular irrigation and debridement (I&D) procedures within these processes are likely partly responsible for this. Additionally, DAIR procedures are frequently preferred for their economical advantages and reduced operative durations, but no studies have examined operative time outcomes. A comparative analysis of reinfection rates with procedure time was undertaken in this study for DAIR procedures. This research project additionally planned to introduce and assess the Macbeth Protocol's efficacy in the I&D portion of the DAIR procedures.
Patient data for unilateral DAIR procedures on primary TJA PJI, carried out by arthroplasty surgeons from 2015 through 2022, were retrospectively analyzed to determine demographics, relevant medical history, BMI, joint details, microbiological findings, and follow-up data. In a further analysis, a single surgeon's DAIR procedures (for initial and subsequent total joint arthroplasty) were scrutinized, and the application of The Macbeth Protocol was observed.
The research team examined 71 patients, on average 6400 ± 1281 years of age, who had experienced unilateral DAIR procedures. The DAIR procedure demonstrated a statistically significant difference (p = 0.0034) in procedure time among patients with reinfections, with a mean time of 9372 minutes ± 1501 minutes, compared to 10587 minutes ± 2191 minutes in those without reinfections. The senior author, in treating 22 patients, performed 28 DAIR procedures, including 11 (393%) cases guided by The Macbeth Protocol. The application of this protocol exhibited no significant impact on the reinfection rate; the p-value was 0.364.
The study's findings indicate that a longer operative time in DAIR procedures for unilateral primary TJA PJIs correlated with a reduced incidence of reinfection. Included in this study is The Macbeth Protocol, which exhibited encouraging potential as an I&D technique, however, without meeting the standards for statistical significance. While operative time efficiency is important, arthroplasty surgeons should not jeopardize patient outcomes by compromising on reinfection rates.
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The study on DAIR procedures for unilateral primary TJA PJIs highlighted a correlation between the duration of operative time and a reduced rate of reinfection. Furthermore, this investigation presented The Macbeth Protocol, showcasing encouraging prospects as an I&D approach, even though it failed to achieve statistical significance. The imperative for arthroplasty surgeons is to prevent sacrificing patient outcomes, as demonstrated by reinfection rates, in pursuit of reduced operative time. A level of evidence of III was determined.

The Ruth Jackson Orthopaedic Society intends to aid women in orthopedic surgery, enabling progression and completion of orthopedic research and advancement in academic orthopedic surgery, by bestowing the Jacquelin Perry, MD Resident Research Grant and RJOS/Zimmer Biomet Clinical/Basic Science Research Grant. Chk inhibitor Investigations into the consequences of these grants are still pending. The research endeavors to pinpoint the proportion of scholarship/grant recipients who published their research, attained academic positions, and currently occupy leadership roles within the field of orthopedic surgery.
The winning research project titles were investigated in PubMed, Embase, and/or Web of Science to confirm publication status. Prior to the award year, the number of publications, post-award publications, the total publication count, and the H-index were determined for each recipient. An online investigation of each award recipient's employment and social media profiles, in conjunction with professional websites, was undertaken to determine their residency institution, fellowship involvement (number and specifics), orthopedics subspecialty, current employment status, and practice setting (academic or private).
Of the fifteen Jacquelin Perry, MD Resident Research Grant recipients, a remarkable 733% of the funded research projects have subsequently been published. Seventy-six point nine percent of award recipients currently work within academia, holding ties to a residency program, while a zero percent currently maintain leadership roles in orthopedic surgery. Eight winners of the RJOS/Zimmer Biomet Clinical/Basic Science Research Grant, representing 25% of the total, have publicized their research outcomes.