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Hip hemiarthroplasty is a commonly performed orthopedic surgery, used to treat proximal femur fractures in the elderly population. Although hip hemiarthroplasty is frequently successful in addressing these injuries, complications can occur. Commonly seen complications include dislocation, periprosthetic fracture, acetabular erosion, and leg-length inequality. Less frequently seen complications include neurovascular injury and capsular interposition. This article presents a comprehensive review of the complications associated with the management of hip hemiarthroplasty. [ Orthopedics . 202x;4x(x):xx–xx.]

Dynamization of fracture fixation constructs provides early rigidity for primary bone healing and late motion for secondary healing. A review of laboratory, animal, and clinical studies investigating the impact, and optimal timing, of dynamization is limited by lack of standardization across studies. However, in animal models, dynamization improves histologic and biomechanical properties compared with statically rigid or flexible controls. In animals, dynamization at 3 to 4 weeks showed improved histologic results. In clinical studies, it showed faster, stronger, and stiffer bone healing. Clinical success dynamizing external fixators and intramedullary nails suggests a role for late dynamization in other fixation types, such as bridge plating. [ Orthopedics . 2020;43(3):e125–e133.]

This study examined the effect of weather and seasonality on hip fracture incidence in older adults residing in New York City. A total of 66,346 patients aged ≥65 years who sustained a fracture of the femoral neck or intertrochanteric region from 1985 to 1996 comprised the study population. Hip fractures were more likely to occur in the winter than in any of the other seasons (P

The accuracy of measuring angulation of stable proximal humerus fractures using the axillary lateral projection was investigated. A closing wedge osteotomy with apex anterior angulation was performed on two cadaveric humeri to simulate a stable surgical neck fracture. One specimen was fixed at 30° angulation and the other at 55°. Axillary radiographs were taken with each specimen articulating with the glenoid of a cadaveric scapula. The humerus was held in neutral rotation. Abduction was set at 30°, 60°, and 90°. In each position of abduction, an axillary lateral radiograph was taken in 30° forward flexion, neutral, and 30° extension to simulate various arm positions. A total of nine radiographs were taken for each specimen. The axillary view is not accurate for measurement of proximal humerus angulation at the arm positions commonly encountered in the trauma setting.

Computed tomography (CT) has been deemed a necessary part of management for Tillaux and triplane pediatric ankle fractures. However, no previously published study has attempted to quantify its usefulness in changing management. Six third-party, blinded orthopedic surgeons (F.A.L., E.N.K., D.M.P., K.J.K., D.S.F., K.A.E.) were randomly assigned to evaluate 24 pediatric Tillaux or triplane fractures with plain radiographs; after 6 months, they were again randomly assigned to evaluate the 24 radiographs plus CT scans, totaling 144 third-party, blinded evaluations. Intra- and interobserver agreements were assessed via correlation coefficient analysis. Evaluation of CT scans changed the original diagnosis of fracture type from Tillaux to triplane fracture in 7 (4.9%) of 144 evaluations. Inter- and intraobserver agreements regarding primary treatment plans did not significantly differ between radiographs and radiographs plus CT scans (0.5 vs 0.4, respectively; P >.05). The addition of CT did not significantly change the impression of the amount of displacement per case. By adding CT, more patients who were assigned nonoperative management were reassigned to operative treatment ( P =.033). Adding CT, although it may influence the decision to operate on Tillaux and triplane fractures, may not be as useful as previously thought.