ABSTRACT
Purpose: Hardware prominence is a concern in the fixation of olecranon osteotomies. Staple fixation has provided low-profile secure fixation in other areas of orthopedics. Without insetting, staples still have subcutaneous prominence. This study examines whether nitinol staples, when inset into bone via cortical notching, in an olecranon osteotomy can provide fixation strength sufficient for daily activities. Methods: Olecranon osteotomies were created in 8 cadaver arms and fixed with 2 nitinol staples. For inset and juxtacortical (noninset) staples, a micrometer measured the displacement between preplaced proximal and distal wires for 3 increasing loads: 0 N, 15 N, and 150 N. This measurement reflected the loss of osteotomy compression. We placed each arm in a pneumatic machine that flexed the elbow from 0° to 90° for 500 cycles at each load. We performed a 2-tailed t test (α value 0.05, ß value 0.2) to evaluate for differences in the loss of compression between inset and noninset nitinol staples. Results: We performed the displacement measurement procedure for both staple types at each of the 3 loads. At 0 N, the average displacement of inset was 0 mm and that of noninset was 0.02 mm. At 15 N, the average displacement of inset was 0.02 mm and that of noninset was 0.04 mm. At 150 N, the average displacement of inset was 0.05 mm and that of noninset was 0.09 mm. When comparing the displacement at the 3 force loads, there were no statistically significant differences between the staple types (P = .323). Conclusions: This study shows that inset staples do not considerably weaken osteotomy fixation with nitinol staples. Thus, nitinol staples may provide a low-profile, operatively-efficient fixation method compared with tension-band or screw-and-plate fixation methods for olecranon osteotomies. Future research can include comparing staples with plate constructs.Type of study/level of evidence: Therapeutic III.
ABSTRACT
BACKGROUND: Orthopaedics is the clinical discipline with the lowest percentage of female residents and faculty. Pediatric orthopaedics has a higher percentage of women than other orthopaedic subspecialties. It was the purpose of this study to examine bibliometric trends in the Journal of Pediatric Orthopaedics (JPO) with a specific focus on sex. METHODS: A bibliometeric analysis for the years 2015, 2005, 1995, 1985, 1981 was performed. The names of first and corresponding authors; corresponding author position; country of origin; number of institutions, countries, authors, printed pages, and references was tabulated. Author sex was identified for the first and corresponding authors using the "Baby Name Guesser" (www.gpeters.com/names/baby-names.php). A P<0.05 was considered significant. RESULTS: There were 746 publications; 68.7% were from North America. The average number of authors, corresponding author position, collaborating institutions, countries, and number of references increased, whereas the number of printed pages decreased. Asia had the greatest number of authors (4.4), with Australia/New Zealand the fewest (3.4). Sex was determined for 98.3% of the first authors and 98.5% of the corresponding authors. There was a significant increase in the number of female first authors over time (5.9% to 25.6%, P<10), especially in Europe and North America. There were significant increase in the number of female corresponding authors over time (5.8% to 17.6%, P=0.000009). There was a significant trend to have a greater percentage of both female first and corresponding authors over time (P=0.0005) with a reverse trend for both male first and corresponding authors (P<10). CONCLUSIONS: In this study, we noted that the number of female first and corresponding authors in Journal of Pediatric Orthopaedics has been steadily increasing. This should result in more female pediatric orthopaedic surgeons in academic faculty positions.
