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Abstract Background The sacroiliac joints (SIJ) are specialized articulations in the pelvis that allow load transfer between the upper and lower body. Traumatic pelvic disruption often requires surgical fixation of at least one of these joints. Subsequent SIJ pain is associated with asymmetries in joint laxity or stiffness. This pilot study examines SIJ stiffness in patients with intact sacroiliac screw fixation after posterior pelvic ring injuries. This information will prove valuable to informing surgeons about technique efficacy in SIJ injury stabilization. Questions/purposes This pilot study examined SIJ stiffness in patients with intact sacroiliac screw fixation to: (1) establish vibration energy color Doppler imaging (VECDI) SIJ intra-rater reliability; (2) measure SIJ stiffness in subjects following surgical fixation using VECDI; (3) compare stiffness data between post-surgical and healthy control subjects; (4) evaluate the relationship between stiffness data and pain and disability scores. Methods 13 reliability and 19 experimental subjects were tested using VECDI. Subjects were placed into a side-lying position on top of a shaker apparatus that transmitted vibration energy to the pelvic ring while color Doppler images were taken from the bilateral posterior SIJ. One investigator performed SIJ measurements on healthy subjects to establish reliability and then evaluated post SIJ fixation stiffness in experimental subjects at four-weeks (T1) and eight-weeks (T2). Visual analog scales were used to collect subjective pain scores at each time point. Results Healthy subject VECDI values suggested good intra-rater reliability (ICC = 0.819; CI 95% = 0.405–0.945). No significant differences in SIJ stiffness (ΔTU) were observed between healthy and experimental subjects at both time points (p > .05). Pearson correlation coefficients highlighted relationships between current pain at T1 and T2 (p = .004, r = .879), and Oswestry Disability Index (ODI) values at T1 and T2 (p = .003, r = .890). Conclusions Asymmetric laxity through the SIJ can be associated with pain resulting from either trauma or inherent physiologic variations. Prior to this study, the mainstay of evaluation was subjective indexes, such as the ODI. Here we propose VECDI as a potentially objective tool in SIJ assessment. Following surgical fixation necessitated by trauma, fixation using SI screws demonstrated similar stiffness values through the SIJ at four- and eight-weeks post-operatively when compared to healthy controls. Direct inferences regarding VECDI’s exact sensitivity to SIJ dysfunction cannot be concluded from our investigation due to small sample sizes. Future investigations should include a larger sample size to enhance our understanding of stiffness measurements obtained using VECDI, validate the technique, and determine the time-course of healing from SIJ surgical stabilization.

Abstract Background ChatGPT has gained widespread attention for its ability to understand and provide human-like responses to inputs. However, few works have focused on its use in Orthopedics. This study assessed ChatGPT’s performance on the Orthopedic In-Service Training Exam (OITE) and evaluated its decision-making process to determine whether adoption as a resource in the field is practical. Methods ChatGPT’s performance on three OITE exams was evaluated through inputting multiple choice questions. Questions were classified by their orthopedic subject area. Yearly, OITE technical reports were used to gauge scores against resident physicians. ChatGPT’s rationales were compared with testmaker explanations using six different groups denoting answer accuracy and logic consistency. Variables were analyzed using contingency table construction and Chi-squared analyses. Results Of 635 questions, 360 were useable as inputs (56.7%). ChatGPT-3.5 scored 55.8%, 47.7%, and 54% for the years 2020, 2021, and 2022, respectively. Of 190 correct outputs, 179 provided a consistent logic (94.2%). Of 170 incorrect outputs, 133 provided an inconsistent logic (78.2%). Significant associations were found between test topic and correct answer (p = 0.011), and type of logic used and tested topic (p =

Introduction. Olecranon fractures are common injuries that require surgical intervention for optimal outcomes. Various fixation methods have been described in the literature, including the use of intramedullary proximal ulna screws in combination with tension band augmentation. Limited research has compared this hybrid technique to other established methods of fixation. This study compared complication and reoperation rates between multiple groups. Methods. A retrospective review was conducted on patients with olecranon fractures who underwent internal fixation at a level 1 trauma center between January 1st, 2013, and April 22nd, 2023. Data was collected using CPT codes, and patients were categorized into five groups based on the method of fixation received: no implant, tension band only, locking olecranon plate, intramedullary screw and tension band hybrid, and others. Variables such as patient demographics, Mayo fracture classification, open vs. closed injury, implant type, reoperation rates, and postoperative complications were recorded. Results. A total of 217 patients were included in the study. No difference was found with implant choice and reoperation rate (p=0.461). There was a significant difference found with reoperation and fracture type (p=0.027) and open fracture (p=0.002). Conclusion. The primary findings of this study indicate no significant difference in implant choice and reoperation rates among the various fixation methods used for olecranon fractures. These findings suggest that the hybrid fixation technique, utilizing intramedullary proximal ulna screws in combination with tension band augmentation, is a viable and comparable treatment option when evaluated against other well-documented methods of fixation. This study also reiterates that severity of initial injury is often the most important factor related to poorer outcomes. Further discussion and analysis of the data will provide a comprehensive understanding of implications and recommendations for olecranon fracture fixation.