Faculty Bibliography

A hands-on facial fracture simulation course can be an important adjunct teaching modality in resident education and training, enhancing both resident confidence and competence in treatment of facial fractures. In this study, 11 plastic surgery residents participated in a surgical wet laboratory and lecture focusing on operative management of facial fractures. Pre- and post-course questionnaires were administered as clinical knowledge assessments. Pre-course, 40% of participating residents reported feeling comfortable with facial fracture management (>5 of 10) and 50% of residents achieved competence on clinical assessment (scoring >50%). Following the simulation course, these same assessments were re-administered. Post-course, comfortability with fracture management increased to 100% among participating residents, and 90% of residents scored >50%, demonstrating improvement in clinical competency.

BACKGROUND:Anterior cruciate ligament (ACL) injuries are relatively common among younger athletes, with significant physical, psychological, and financial consequences. Research has largely focused on female athletes by identifying specific risk factors for an ACL injury, including variation in pubertal growth timing. There is less known about risk factors in males, and little is known about the effects of pubertal development on ACL injury risk in men. PURPOSE/HYPOTHESIS/OBJECTIVE:The purpose of this study was to analyze the relationship between an indicator of pubertal growth timing (age at adult height) and biomechanical risk for ACL injuries in men. We hypothesized that earlier age at adult height is correlated with riskier landing biomechanics during a drop vertical jump (DVJ) in men. STUDY DESIGN/METHODS:Cross-sectional study; Level of evidence, 3. METHODS:A total of 21 recreationally active male students (age range, 20-33 years) were included. Participants completed a questionnaire on age at adult height and limb dominance, and anthropometric measurements were taken. There were 6 DVJ tests performed, with participants landing on a force plate while digital cameras recorded kinematic data from retroreflective markers placed according to the Helen Hayes marker system. Primary outcomes were sagittal and frontal plane knee kinematics and kinetics during contact. Data were analyzed using Pearson product-moment correlation. RESULTS:< .01). CONCLUSION/CONCLUSIONS:Later age at adult height was correlated with riskier landing profiles in this study. This suggests that males with later or longer pubertal growth may have increased mechanical risk for ACL injuries. A better understanding of the effects of pubertal growth on landing biomechanics can improve the early identification of male athletes at greater risk for injuries.

CASE:We discuss our reconstructive approach to avoid an above-knee amputation in a 33-year-old man presenting after lower extremity crush injury. We used a vascularized tibial bone flap and a foot fillet flap to restore length and joint functionality to the residual limb. The patient ambulates with good prosthetic fit on durable heel pad skin and 100° active knee motion. CONCLUSION:This pairing of intramedullary nail with vascularized bone flap and fillet flap to address soft-tissue coverage and retain limb length is a useful tool in traumatic lower extremity injury management, providing an alternative technique for tibial bone graft stabilization with robust, sensate tissue coverage.