Semisupine Positioning for Proximal Humerus ORIF Using Arthroscopic Shoulder Distractor.

Advances in implant technology have improved the orthopaedic surgeon's ability to successfully treat proximal humerus fractures. However, obtaining and maintaining anatomic reduction throughout surgery remains difficult. Failure to do so can compromise surgical outcomes leading to poor clinical results. Here, we describe a novel surgical method using upper-extremity traction that allows control and positioning of the operative extremity. This technique facilitates achieving and maintaining fracture reduction and decreases operative time.

The Haitian Orthopaedic Residency Exchange Program.

After a devastating earthquake in Haiti in 2010, multiple South Carolinian orthopaedic teams, funded by the South Carolina Orthopedic Association (SCOA), developed an exchange program for Haitian residents. METHODS: SCOA teams have sequentially logged their patient experiences since 2015 for a total of six updates per year. These logs were reviewed in detail to evaluate clinical results in terms of case volumes, cases performed, follow-up obtained, and complications. RESULTS: Twenty-one orthopaedic attendings, 19 South Carolina orthopaedic residents, 22 Haitian orthopaedic residents, and 22 ancillary staff have rotated through Hospital Lumiere. The teams have seen over 2000 patients in the orthopaedic clinic and performed 554 surgeries, including 207 fractures (half of which being open), 24 nonunion and 7 malunion repairs, 15 lower extremity amputations, 27 hemiarthroplasties for femoral neck fractures, and 34 cases of chronic osteomyelitis. DISCUSSION: The SCOA Foundation has developed a coordinated service for the musculoskeletal needs of the Haitian people while collaboratively elevating the standard of orthopaedic training in Haiti. We report a collaborative model that other US residency programs can use to impart beneficial changes not only in their home program, but also in training programs abroad.

A prospective analysis of clinical detection of defective wrapping by operating room staff.

Surgical instrument trays are wrapped for sterilization, and these wraps are inspected by operating room personnel for defects before using the instruments. In this study, we intentionally damaged wraps, and these wraps were evaluated by operating room personnel. Examiners correctly identified a wrapper's sterile integrity with an overall 56.1% accuracy, with correct identification of 67.2% for defects between 2 and 5 cm. However, studies have shown bacterial contamination through defects as small as 1.1 mm. This study suggests that the current method for assessing sterility is inadequate.