Suture Button Repair for Lateral Ulnar Collateral Ligament in Terrible Triad Injuries: Surgical Technique.

Terrible triad injuries are typically treated surgically to restore elbow stability, as the radial head acts as a secondary stabilizer to valgus stress, while the coronoid provides stability against posterior elbow dislocations. The lateral ulnar collateral ligament (LUCL) is also commonly injured in terrible triad of the elbow injuries, and if not repaired, leads to posterolateral rotatory instability. Depending on the fracture pattern and size, the radial head fracture may be treated with open reduction internal fixation (ORIF), arthroplasty, or excision, whereas the coronoid fracture is most commonly treated with ORIF. If treated, these injuries are managed prior to LUCL fixation to avoid stressing the LUCL repair. We describe a technique for treatment of a LUCL injury with a suture button. When repairing the LUCL, a Kocher approach is used to visualize the LUCL footprint, which is then reattached to the insertion point on the lateral epicondyle using a suture button. The purpose of this study was to provide a step-by-step approach to using this surgical technique and an associated postoperative protocol.

Antecubital Burn Resulting From Antenna Coupling: A Case Report.

CASE: We present the case of a 54-year-old man who underwent elective hip disarticulation complicated by third-degree burn of the left antecubital fossa requiring skin graft. After careful review, it was determined that "antenna coupling" as a result of electrosurgery was the likely cause. We present an experiment demonstrating this phenomenon. CONCLUSION: Antenna coupling is a real but rare cause of intraoperative burns not previously described in the orthopaedic literature. Care should be taken to avoid coiling or running bovie or other electrosurgical device cords with other metallic cords or corded devices.

Instagram Use Among Orthopaedic Surgery Residency Programs.

INTRODUCTION: The COVID-19 pandemic created unprecedented challenges to residency recruitment. With in-person away rotations prohibited and interviews held virtually, orthopaedic residency programs turned to social media. Studies document the exponential growth of residency program Instagram accounts after March 2020, but few analyze the content of their posts. This study provides an updated assessment of such Instagram accounts including a detailed analysis of their content and a discussion of potentially concerning posts. METHODS: Orthopaedic surgery residency programs participating in the National Resident Matching Program and any Instagram accounts associated with these programs were identified. Instagram accounts were analyzed, and the 25 most recent posts and all highlighted stories for each account were coded for content based on a predetermined list of categories. Specific attention was given to content that may raise legal, ethical, or professionalism concerns. The primary outcome was the most common content code among posts. The secondary outcomes were the number of posts identified as potentially concerning and the types of concerns represented. RESULTS: Overall, 138 of 193 residency programs (72%) had an Instagram account at the time of cross-sectional analysis, 65% of which were created between April and December 2020. All accounts were public. Profiles had on average 1,156 ± 750 followers and 59 ± 75 posts. Of the 3,348 posts analyzed, the most common coded themes were resident introductions (33%), camaraderie (27%), and social life and hobbies (26%). There were 81 concerning posts from 52 separate accounts. Seventy-five of the concerning posts (93%) depicted residents scrubbed alone. CONCLUSION: Orthopaedic residency Instagram accounts are potential tools for residency recruitment and can depict a program's culture through posts over time. However, public accounts are open to scrutiny by other viewers, including patients and their families. Care must be taken to consider multiple perspectives of post content, so as to bolster, not damage, the residency program's reputation.