Prophylactic Intramedullary Rodding After Femoral Lengthening in Patients With Achondroplasia and Hypochondroplasia.

BACKGROUND: Femoral fracture after femoral lengthening in patients with achondroplasia and hypochondroplasia is a frequent complication, occurring in up to 30%. The purpose of this study is to demonstrate the effectiveness of prophylactic intramedullary rodding in preventing this complication. METHODS: Multicenter retrospective study involving 86 femoral lengthening procedures in 43 patients with achondroplasia or hypochondroplasia. Forty-two femora (21 patients) were prophylactically managed with intramedullary Rush rodding after external fixation removal (11 females and 10 males, mean age 14.6 years) compared with 44 femora (22 patients) without prophylactic intramedullary rodding (13 females and 9 males, mean age 15.2 years). The mean amount of lengthening in the rodding group was 13.3 cm (52.6%) with an External Fixation Index of 25.8 days/cm; in patients without rodding was 14.3 cm (61.5%) and 24.5 days/cm, respectively. RESULTS: Seven cases (15.9%) without rodding developed fractures. Four of them required surgical correction due to displacement or shortening. Only 1 patient (2.4%) had fracture of the femur after prophylactic rodding, and surgery was not required. The incidence of femur fracture was significantly lower in the prophylactic rodding group compared with the nonrodding group (2.4% vs. 15.9%, respectively; P =0.034). There were no cases of infection or avascular necrosis. CONCLUSIONS: Prophylactic intramedullary rodding is a safe and effective method for preventing femoral fractures after femoral lengthening in patients with achondroplasia or hypochondroplasia. LEVEL OF EVIDENCE: Level III-a retrospective comparative study.

Do black lives matter to employers? A combined field and natural experiment of racially disparate hiring practices in the wake of protests against police violence and racial oppression.

This study uses an experimental audit design, implemented both before and during the heightened unrest following the murder of George Floyd, to gauge the impact of Black Lives Matter and associated protests against police brutality and anti-Black racism on racially disparate hiring practices. We contrast treatment of fictitious Black and White job applicants in the labor market for service-related job openings, specifically applicants with prior experience as a police officer, firefighter, or code enforcement officer. Results reveal that the White advantage in employer call-backs and requests for an interview receded during the protests and unrest following the killing of George Floyd, even to the point of producing a Black advantage.

An audit experiment to investigate the "war on cops": a research note.

Objectives: This study examines whether former police officers are stigmatized in the labor market, particularly following social unrest from lethal police violence. Methods: We conduct an experimental audit study, both before and after heightened unrest from police violence. For service-related job openings, we compare the likelihood of getting an affirmative response from a prospective employer to a job application from a fictitious former police officer (the treatment condition) to the response to one of two control conditions: a former firefighter or a former code enforcement officer. Results: We do not find evidence that former police officers are discriminated against in the labor market. This finding holds in periods characterized by relatively little social unrest due to police violence as well as periods of heightened protest activity. Conclusions: At least with respect to the labor market for certain service-related professions, former police officers do not appear tainted by any stigma associated with their prior profession. Supplementary Information: The online version contains supplementary material available at 10.1007/s11292-021-09458-x.

Contrast between Spain and the Netherlands in the hidden obstacles to re-entry into the labour market due to a criminal record.

This article aims at analysing the differences between European countries in the obstacles ex-offenders face due to having a criminal record. First, a comparative analytical framework is introduced that takes into account all the different elements that can lead to exclusion from the labour market by the dissemination of criminal record information. This model brings together social norms (macro level), social actors (meso level) and individual choices (micro level) in the same framework. Secondly, this model is used to compare the different impact of having a criminal record in Spain and the Netherlands. This comparison highlights three important findings: (1) the difference between norms of transparency/privacy and inclusive/exclusive ideals, (2) the significant role of social control agents, such as probation agencies and the ex-offenders' social network, in shaping the opportunities that they have, and (3) self-exclusion seems to be a key mechanism for understanding unsuccessful re-entry into the labour market.

Orthopaedic disorders of pycnodysostosis: a report of five clinical cases.

PURPOSE: Pycnodysostosis is a rare autosomal recessive genetic disorder usually diagnosed at an early age. The few previously published case series have generally focused on maxillofacial manifestations and genetic considerations. The purpose of this study was to evaluate the clinical characteristics and differential diagnosis of pycnodysostosis focusing on its orthopaedic manifestations, which have been poorly described in the literature. METHODS: We evaluated clinical and radiographic characteristics of five patients with pycnodysostosis. RESULTS: Three male and two female patients were included in the study. One patient had consanguineous parents and two had a family history of pycnodysostosis. One patient was of normal height; four with short stature underwent growth hormone treatment. Most patients had bone fractures. All had typical cranial and orofacial manifestations, partial dysplasia of the terminal phalanges and increased bone density. Aplastic acromial ends and spondylolysis were not seen in any patient. Some patients had genu valgus, ankle valgus or sleep apnea; two required tympanic drains for serous otitis media. Two patients experienced nonunion. CONCLUSIONS: Short stature is a consistent feature of pycnodysostosis that can be treated with growth hormone. To our knowledge, serous otitis media, nonunion and other orthopaedic manifestations have not been previously described in pycnodysostosis patients. Intramedullary nailing osteosynthesis can be difficult in these patients because of skeletal sclerosis; therefore, other surgical options should be considered. Nonunion is common in this population. Pycnodysostosis is a poorly described disease, but clinicians should be aware of its potential manifestations in order to appropriately diagnose, manage and follow-up patients.