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Orthopaedic injuries represent some of the most frequent conditions treated in emergency centers worldwide. Proper reduction techniques and evaluation of radiographic parameters are paramount in treating patients effectively. Orthopaedic providers at large tertiary centers may have several assistants available but are also burdened by notable patient loads and volumes. Frequently, fracture care may necessitate procedures performed by providers without the availability of skilled assistance, both in large tertiary academic centers and small independent emergency rooms with limited resources. As providers at a busy level 1 tertiary trauma center with only one primary orthopaedic resident responsible for the performance of most fracture reductions, we present both novel techniques and refined published approaches that allow the safe, efficient, and reliable reduction and stabilization of several different types of fracture dislocations with limited or no assistance, and only commonly found supplies., (Copyright © 2024 by the American Academy of Orthopaedic Surgeons.)

Essex-Lopresti injuries and terrible triad injuries of the elbow are rare injuries that typically result from high-energy trauma such as falling from a height or a motor vehicle collision. However, the combination of an Essex-Lopresti injury and terrible triad injury is unique and poses a significant challenge for treatment as these injuries are independently associated with poor functional outcomes if they are not acutely diagnosed. We describe a case of a 19-year-old who presented with an unusual variant of a terrible triad injury associated with an Essex-Lopresti injury. The patient had a distal radioulnar joint (DRUJ) and elbow dislocation, a radial head and coronoid process fracture, and a distal radius fracture. Almost a reverse Essex-Lopresti, this injury was successfully managed with open reduction and repair of the distal radius, radial head, and damaged ligaments in the elbow, along with an internal joint stabilizer (IJS)., Competing Interests: The authors have no conflict of interest to report., (Copyright © 2021 Luis M. Salazar et al.)

Introduction: External fixation is widely accepted as a provisional or sometimes definitive treatment for long-bone fractures. Indications include but are not limited to damage control surgery in poly-traumatized patients as well as provisional bridging to definite treatment with soft tissue at risk. As little is known about surgeon's habits in applying this treatment strategy, we performed a national survey., Methods: We utilized the member database of the German Trauma Society (DGU). The questionnaire encompassed 15 questions that addresses topics including participants' position, experience, workplace, and questions regarding specifics of external fixation application in different anatomical regions. Furthermore, we compared differences between trauma centre levels and surgeon-related factors., Results: The participants predominantly worked in level 1 trauma centres (42.7%) and were employed as attendings (54.7%). There was widespread consensus for planning and intra-operative radiographical control of external fixation. Surgeons appointed at a level I trauma centre preferred significantly more often supra-acetabular pin placement in external fixation of the pelvis rather than the utilization of iliac pins (75.8%, p = 0.0001). Moreover, they were more likely to favor a mini-open approach to insert humeral pins (42.4%, p = 0.003). Overall, blunt dissection and mini-open approaches seemed equally popular (38.2 and 34.1%). Department chairmen indicated more often than their colleagues to follow written pin-care protocols for minimization of infection (16.7%, p = 0.003)., Conclusion: Despite the fact that external fixation usage is widespread and well established among trauma surgeons in Germany, there are substantial differences in the method of application.