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Kenneth J Koval: Influence Statistics

BACKGROUND: Delirium and pain are common following hip fracture. Untreated pain has been shown to increase the risk of delirium in older adults undergoing elective surgery. This study was performed to examine the relationship among pain, analgesics, and other factors on delirium in hip fracture patients.

METHODS: We conducted a prospective cohort study at four New York hospitals that enrolled 541 patients with hip fracture and without delirium. Delirium was identified prospectively by ...

BACKGROUND: The optimal choice for the stabilization of displaced femoral neck fractures remains controversial, with alternatives including arthroplasty and internal fixation. Our objective was to determine the effect of arthroplasty (hemiarthroplasty, bipolar arthroplasty, and total hip arthroplasty), compared with that of internal fixation, on rates of mortality, revision, pain, function, operating time, and wound infection in patients with a displaced femoral neck fracture.

METHODS: ...

OBJECTIVES: This study evaluated the use of a staged protocol involving temporary spanning external fixation and delayed formal definitive fixation in the management of high-energy proximal tibia fractures (OTA types 41) with regard to soft-tissue management, development of complications, and functional outcomes.

SETTING: Two level-one trauma centers and a tertiary care orthopaedic center.

PATIENTS: Fifty-three patients with 57 high-energy tibial plateau fractures.

METHODS: The authors ...

OBJECTIVE: Evaluate whether supplementary fibular fixation helped maintain axial alignment in distal metaphyseal tibia-fibula fractures treated by locked intramedullary nailing.

DESIGN: Retrospective chart and radiographic review.

SETTING: Three, level 1, trauma centers.

PATIENTS: Distal metaphyseal tibia-fibula fractures were separated into 2 groups based on the presence of adjunctive fibular plating. Group 1 consisted of fractures treated with small fragment plate fixation of the ...

BACKGROUND: Hip fractures occur in 280,000 North Americans each year. Although surgeons have reached consensus with regard to the treatment of undisplaced fractures of the hip, the surgical treatment of displaced fractures remains controversial. Identifying surgeons' preferences in techniques, and the rationale for their choices, may aid in focusing educational activities to the orthopaedic community as well as planning future clinical trials. Our objective was to clarify current opinion ...

OBJECTIVES: This study was performed to determine 1) the rate of ankle fractures in the elderly in the United States stratified by hospital referral region, and 2) whether the percentage of ankle fractures treated surgically is affected by factors, such as fracture location, hospital referral region, concentration of orthopaedists, presence of a teaching hospital in that region, patient age, race, gender, or the number and type of specific medical comorbidities.

DESIGN: A 20% sample of ...

We prospectively studied 367 patients who had a fracture of the hip, to determine the effect of an operative delay on postoperative complications and on the one-year mortality rate. All of the patients were at least sixty-five years old, cognitively intact, living at home, and able to walk before the fracture. An operative delay was defined as an interval of three calendar days or more between the time of admission to the hospital and the operation. The operation was performed within two ...

BACKGROUND: Distal radial fractures are common and confer a considerable financial burden on the health-care system; however, controversy surrounds the optimal treatment of these injuries. This study was performed to determine (1) the rate of distal radial fractures in the U.S. Medicare population stratified by hospital referral region and (2) whether the type of fracture treatment is affected by patient age, race, sex, comorbidity, or hospital referral region.

METHODS: A 20% sample of ...

BACKGROUND: Ankle fractures are among the most common injuries treated by orthopaedic surgeons. However, very few investigators have examined the functional recovery following ankle fracture surgery and, to our knowledge, none have analyzed factors that may predict functional recovery. In this study, we evaluated predictors of short-term functional outcome following surgical stabilization of ankle fractures.

METHODS: Over three years, 232 patients who sustained a fracture of the ankle ...

OBJECTIVES: To quantify the interval between injury and hospitalization in older hip fracture patients, to quantify the time from hospital arrival to surgical repair of hip fracture, and to describe factors contributing to extended intervals between injury, hospitalization, and surgical repair of hip fracture.

DESIGN: Prospective cohort study.

SETTING: Four hospitals in the New York City metropolitan area.

PARTICIPANTS: Consecutive patients aged 50 and older admitted with diagnosis of ...

OBJECTIVE: To determine the effectiveness of six-axis analysis deformity correction using the Taylor Spatial Frame for the treatment of posttraumatic tibial malunions and nonunions.

DESIGN: Retrospectively reviewed, consecutive series. Mean duration of follow-up was 3.2 years (range 2-4.2 years).

SETTING: Tertiary referral center for deformity correction.

PATIENTS/PARTICIPANTS: Eighteen patients were included in the study (11 malunions and 7 nonunions). All deformities were posttraumatic ...

OBJECTIVES: To determine the cost-effectiveness of open reduction internal fixation (ORIF) of displaced, midshaft clavicle fractures in adults.

DESIGN: Formal cost-effectiveness analysis based on a prospective, randomized, controlled trial.

SETTING: Eight hospitals in Canada (seven university-affiliated and one community hospital).

PATIENTS/PARTICIPANTS: One hundred thirty-two adults with acute, completely displaced, midshaft clavicle fractures.

INTERVENTION: Clavicle ORIF versus ...

BACKGROUND: Operative treatment of tibial fractures in children requires implants that do not violate open physes while maintaining tibial length and alignment. Both elastic stable intramedullary nails and external fixation can be utilized. We retrospectively reviewed our experience with these two techniques to determine if one is superior to the other.

METHODS: We retrospectively reviewed the operative records and trauma registries of three institutions within our hospital system and ...

OBJECTIVE: This study was performed to evaluate the results of operative treatment of ankle fractures in patients who required syndesmotic stabilization in addition to malleolar fracture fixation compared with patients who required malleolar fixation alone.

DESIGN: The authors conducted a retrospective review of prospectively collected data.

SETTING: Academic medical center.

PATIENTS: Between October 2000 and November 2006, 347 patients who underwent surgical repair of an unstable ankle ...

The radiographs of fifty fractures of the proximal part of the humerus were used to assess the interobserver reliability and intraobserver reproducibility of the Neer classification system. A trauma series consisting of scapular anteroposterior, scapular lateral, and axillary radiographs was available for each fracture. The radiographs were reviewed by an orthopaedic shoulder specialist, an orthopaedic traumatologist, a skeletal radiologist, and two orthopaedic residents, in their fifth ...