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BackgroundMethodsResultsConclusionPrior research has shown a positive association of pseudoexfoliative glaucoma (PXG) in patients with non-melanoma skin cancer (NMSC), likely due to an increase in ultraviolet exposure associated with both. However, the role of NMSC as a genetic risk factor for PXG has not been examined. Thus, the goal of this study is to utilize Mendelian randomization with genome-wide association studies to evaluate for genetic causality while controlling for environmental confounders.We conducted a MR using the inverse variance weighted method (MR-IVW) as our primary analysis. Genomic data was sourced from GWASs for patients with NMSC (10,382 cases, 208,410 controls) and PXG (1,515 cases and 210,201 controls), originating from the FinnGen Biobank.Despite previous association of history of NMSC with occurrence of PXG, we found no evidence for a causal association between SNPs associated with NMSC and risk of PXG following MR analysis (MR-IVW, odds ratio (OR): 0.98, 95% CI: 0.85-1.14, P = 0.87).Here, we found no evidence for a causal association between SNPs associated with NMSC and the risk of PXG following a MR analysis. [ABSTRACT FROM AUTHOR]

Congenital pseudarthrosis of the clavicle remains remarkably rare, and the pathogenesis is unclear, but orthopaedic surgeons should be prepared to make this diagnosis and confident in the outcomes of open reduction and internal fixation with grafting. A 15-year-old female softball player presented with anterior shoulder pain during softball activities, with no precipitating trauma. She was diagnosed with congenital pseudarthrosis of the clavicle and initially treated conservatively. Following no improvement with physical therapy, home therapy, rest, and anti-inflammatory drugs, she was treated with open reduction and internal fixation of the clavicle with iliac crest autograft and demineralized bone matrix allograft., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons.)

Introduction: Atlas and axis fractures are the most severe cervical fractures which may result in complete paralysis or death. The purpose of the current study is to identify disparities regarding length of stay (LOS), mortality, and demographic factors in patients with the most serious cervical spine fractures utilizing a nationally representative database., Materials and Methods: The Nationwide Emergency Department Sample was utilized to provide a representative sample for patients with a primary diagnosis of C1 or C2 fracture presenting to emergency departments in years from October 2015 to December 2019. A multivariable logistic regression model was used to estimate LOS for different patient demographics, including gender, race, and age., Results: A weighted sample of 7,262,791 patients presented to emergency rooms in the United States between 2015 and 2019. The mean age at admission was 76 years old, 52.6% of patients were female, and 83.0% identified as white. Patients between 45 and 65 and patients over 65 were significantly more likely to have an increased LOS. Women were less likely to have an increased LOS than men. Patients identifying as Black were significantly more likely to have increased LOS over white patients. In addition, patients who had an increased LOS were more likely to die in the hospital than patients with a shorter LOS., Conclusion: This study provides patient characteristics that help providers determine patient risk factors for increased hospital LOS and in-hospital mortality for those suffering from C1 and C2 fractures. Clinicians should be made aware of these disparities to allow equitable delivery of care., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Craniovertebral Junction and Spine.)

Background: The aim of this study was to determine the incidence of missed compartment syndrome in tibia fractures treated with and without regional anesthesia., Methods: A retrospective chart review was performed of patients with operative tibial shaft or plateau fractures at a single level-one trauma hospital between January 2015 and April 2022 with a minimum of 3-month follow-up. Patients under 18 years of age, an ipsilateral knee dislocation, known neurologic injury at presentation, or prophylactic fasciotomy were excluded. We defined missed acute compartment syndrome (ACS) as a postinjury motor deficit still present at the 3-month postoperative appointment. For patients that received a peripheral nerve block, we recorded whether a continuous perineural catheter or one-time single-shot injection was performed, and the number of nerves blocked. Incidence rates for ACS were calculated with exact binomial 95% confidence intervals (CIs). Morphine milligram equivalents (MMEs) consumed 24 hours after surgery, use of nerve block, nerve block timing, and type of block were compared using Mann-Whitney and Kruskal-Wallis nonparametric tests. Statistical significance was defined as P < .05., Results: The incidence of compartment syndrome diagnosed and treated during index hospitalization was 2.2% (17/791, 95% CI, 1.3%-3.4%). The incidence of missed ACS was 0.9% (7/791, 95% CI, 0.4%-1.8%). The incidence of missed ACS was not different between those who received nerve block 0.7% (4/610, 95% CI, 0.2%-1.7%), and those who did not (1.7% (3/176, 95% CI, 0.4%-4.8%) P = .19). Within patients receiving a nerve block, all patients with missed ACS (n = 4) received a perineural catheter. Similar missed ACS rates were observed between tibial shaft and plateau fractures. Patients receiving a nerve block had lower MME compared to those who did not receive a nerve block (P < .001)., Conclusions: The results do not provide evidence that perioperative regional anesthesia increases the incidence of missed ACS in patients with operative tibial shaft or plateau injuries. but does decrease postoperative opioid requirements., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 International Anesthesia Research Society.)