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Peroneus tertius tendon tears are uncommon and patients typically recover with conservative management. The objec-tive of this case report is to highlight this usual injury and provide an alternative treatment option when conserva-tive management fails. A 24-year-old female professional ballet dancer presented with acute right lateral foot pain after hyperflexing over her pointe shoe. She completed a full course of physical therapy and non-steroidal anti-inflammatory drugs. However, upon returning to dance, she developed worsening pain and swelling over the lateral ankle. Magnetic resonance imaging revealed a complete peroneus tertius tear with retraction. She underwent surgi-cal debridement of this tendon and was able to return to dancing en pointe in 9 weeks.

Preoperative testing costs billions of dollars despite little evidence supporting its utility. learn more The purpose of this study was to determine the relationship between abnormal preoperative laboratory tests and postoperative complications following total joint arthroplasty.

The NSQIP database was used to identify 45,936 primary total hip arthroplasty (THA) and 76,041 pri-mary total knee arthroplasty (TKA) cases performed between 2006 and 2013. Complications within 30 days of surgery were collected and multivariable regression modeling was performed incorporating all significant laboratory values as well as demographics and preoperative comorbidities.

For THA patients, abnormal sodium (p = 0.016, OR = 1.89), white count (p = 0.043, OR = 1.73), and partial thromboplastin time (p = 0.028, OR = 1.43) were significantly associated with complications. For TKA patients, abnormal alkaline phosphatase (p = 0.04, OR = 2.12), creatinine (p = 0.003, OR = 1.56), and INR (p = 0.008, OR = 1.99) were significantly predictive of complications.

Of the 13 laboratory values, only six were significantly associated with complications. These findings may have implications for risk stratification in the inpatient setting.

Of the 13 laboratory values, only six were significantly associated with complications. These findings may have implications for risk stratification in the inpatient setting.

There has been controversy regarding whether headgear use in women’s lacrosse will affect the rate of head and musculoskeletal injuries. The purpose of this study was to investigate the effect of mandated headgear use on the rate of head and musculoskeletal injuries in high school women’s lacrosse.

This was a prospective cohort study of eight high school women’s lacrosse teams and their game op-ponents who were mandated to wear F3137 headgear for the 2017 and 2018 seasons. Athletic trainers documented all injuries that occurred as a result of participation on the lacrosse teams. Injury rates in the headgear cohort were compared to a retrospective (control) cohort from the High School Reporting Information Online injury data reports.

Over the study period, 17 total injuries were reported in the headgear cohort during 22,397 exposures for an injury rate of 0.76 injuries per 1,000 athlete-exposures. The headgear cohort demonstrated significant decreases in rates of in-game head and face injury (RR 0.141, 9.

Despite the recent trend toward outpatient orthopedic surgical procedures, there are patients who incur unanticipated conversions to inpatient status either immediately following ambulatory surgery or within days to weeks via presentation to the emergency department. The purpose of this study was to examine characteristics, co-morbidities, and causes of admissions in these populations in order to help identify factors for which strategies can be developed in order to minimize unanticipated admissions and medical costs.

Using a major academic medical center’s bill-ing department’s database, 95 outpatients were identified who were immediately converted into inpatient status and another 84 outpatients who were admitted within 30 days of surgery. The reasons for admission, length of procedure, length of admission, ASA score, comorbidities, and insur-ance type were assessed.

For the patients who were converted to inpa-tient status postoperatively, pain accounted for 57% of conversions. Hypertension was the mostoperative pain expectations. For patients admitted within 30 days of surgery, infection represented the majority of readmissions, and smoking was the most common comorbidity. While, some infections may be unavoidable, this stresses the importance of medical and social factor optimization prior to surgery. Addressing these factors leading to unanticipated admissions can have a profound effect on health care expenditures and patient outcomes.

Restoration of hindfoot alignment correlates with improved clinical and biomechanical outcomes after fracture care and reconstruction. Intraoperative assessment of alignment with fluoroscopy is challenging. This study was designed to determine the effect of rotation on the measurement of hindfoot alignment and to determine if any radiographic landmarks can be utilized to help surgeons identify appropriate rotation during intraoperative imaging.

Ten unmatched cadaveric limbs that had been disarticulated at mid-tibia were used and placed supine in a radiolucent jig. Fluoroscopic images were obtained with the C-arm positioned at 45°. Images were obtained in sequential rotational adjustments from 12° of internal rotation to 12° of external rotation. The location of the fibula relative to the base of the fifth metatarsal was measured on images and recorded as an interval percentage overlap (0% to 50%, 50% to 100%, and greater than 100%). Hindfoot alignment was recorded by measuring the angle between the tibial and calcaneal axis.

Varus and valgus hindfoot alignment demon-strated a linear relationship to leg rotation (r2 = 0.998, p < 0.001). In these uninjured cadaveric specimens, 8° to 15° of internal rotation relative to the medial border of the foot produced a normal valgus angle (0° to 5°). Using 50% to 100% overlap of the fibula over the fifth metatarsal base as a radiographic test was a reliable indicator of predicted measurement, with 89% sensitivity and 99% specificity.

The measurement of hindfoot alignment changes with foot rotation. Use of the fibula overlap of the fifth metatarsal base may be a helpful tool to judge appro-priate rotation intraoperatively.

The measurement of hindfoot alignment changes with foot rotation. Use of the fibula overlap of the fifth metatarsal base may be a helpful tool to judge appro-priate rotation intraoperatively.