The Iowa orthopaedic journal
-
Treatment of Crowe IV developmental dysplasia of the hip (DDH) with total hip arthroplasty (THA) reconstructs the true acetabulum, which improves hip biomechanics and function. However, restoration of the native acetabulum may lead to limb lengthening and traction neuropraxia. The purpose of this study is to describe the short term results of a retrospectively reviewed series of patients with Crowe IV DDH treated with THA using a titanium mesh cup, cemented liner, and subtrochanteric femoral shortening osteotomy. ⋯ THA of Crowe IV DDH by reconstructing the acetabulum with bone graft, a titanium mesh cup, cemented liner, and subtrochanteric femoral shortening osteotomy demonstrated no osteolysis or subsidence and improved function with a low incidence of sciatic nerve palsy at short term follow up.Level of evidence: IV.
-
Recent estimates suggest an annual incidence of greater than 125,000 femoral neck fractures. Surgical treatment is indicated for the majority of these fractures, which are estimated to double by the year 2050. Most displaced femoral neck fractures in elderly patients are treated with arthroplasty secondary to high complication rates associated with internal fixation. ⋯ The Targon Femoral Neck Plate (Aesculap, Tuttlinger, Germany) has been used in Europe for the treatment of both displaced and nondisplaced femoral neck fractures by combining a side plate and multiple cancellous lag screws. Multiple studies have shown superior rates of both nonunion and osteonecrosis when compared to the SHS and multiple cancellous screws in both displaced and nondisplaced femoral neck fractures. This article details the design rationale, surgical technique and early postoperative results of a new hybrid implant used for the treatment of both displaced and nondisplaced femoral neck fractures.
-
The residency match is increasingly competitive. The interview is an essential component, yet little has been documented about the costs applicants incur during the interview process and it is unclear how they manage these expenses. ⋯ Senior medical students incur substantial costs to participate in residency interviews, often adding to already burdensome educational debt. We encourage residency programs, especially those in competitive specialty fields, to pursue cost reduction strategies. Additionally, medical schools should provide financial counseling to allow students to anticipate interview costs.