Fractures of the proximal femur and acetabulum are frequently treated successfully with open reduction internal fixation procedures, but occasionally a patient might end up requiring a total hip arthroplasty. This can be for late posttraumatic arthritis of the hip, or perhaps cutout and failure of primary treatment. In certain cases, it is just better to do the arthroplasty at the initial presentation, especially in elderly patients with dome impaction or acetabular fractures with associated femoral head fractures. This issue of the Orthopedic Clinics of North America has two articles dealing with these difficult problems facing orthopedic surgeons who care for these patients. Dr Krause and colleagues have provided an excellent review on total hip arthroplasty after previous fracture surgery. Dr Buller and coauthors have also written an outstanding article entitled, “A Growing Problem: Acetabular Fractures in the Elderly and the Combined Hip Procedure.”
Wound management of open fractures, infections, and related problems in orthopedic trauma continues to be critical in both simple and complex fracture management cases. As we all know, nothing ruins a successful fracture reconstruction more than wound breakdown and infection. Dr Gage and colleagues have written an informative article on the uses of negative pressure wound therapy in orthopedic trauma. This continues to be a useful tool in our armamentarium, but many surgeons who only use it occasionally can likely learn a few tips to improve their understanding of when to use it, how to best use it, and when not to use it.
I trust that you will find the trauma section of this issue of the Orthopedic Clinics of North America useful to your practice.