Category Archives: Traumatology

The STIC Intra-Compartmental Pressure Monitor System by C2Dx

by Rob Salter, Internal Product Specialist, C2Dx, Inc.

C2Dx is the exclusive manufacturer of the STIC Intra-Compartmental Pressure Monitor System previously supplied by Stryker. The company is led by a team of medical device industry veterans with years of experience providing superior products and service to customers around the globe. Our company is privately held and dedicated to providing world class products and service to healthcare professionals, while driving costs out of the healthcare continuum.

Compartment syndrome is one of the few true orthopedic emergencies and the consequences can be dire. A delay in diagnosis often leads to delayed treatment, causing irreversible muscle damage after 8 hours and irreversible nerve damage after 6 hours. The leading causes of malpractice claims filed against orthopaedic surgeons is missed compartment syndrome. These suits involve 87% delays in diagnosis and 37% delays in treatment, with 65% of total suits won by the plaintiff.

As described, time to diagnosis is one of the most prognostic factors, yet the ambiguity of the clinical signs may lead to delay. Many clinical exam findings are lagging indicators while pain out of proportion is the only leading indicator. Pain has low sensitivity, is considered subjective and on its own, inconclusive. Individual signs have only 13 – 54% sensitivity and 3+ signs are required for 98% sensitivity.

Recognized as the Gold Standard for over 30 years, the STIC Intra-Compartmental Pressure Monitor provides quick and continuous measurements, which adds valuable data to your clinical assessment for a prompt and more informed decision. Results show 94% sensitivity, 98% specificity, and 99% negative predictive value (Duckworth and McQueen, 2019).

Additional benefits of the STIC Monitor System include:

  • Sterile disposables for a simple, rapid set-up
  • Proven accuracy and reliability with strong clinical evidence
  • Hand-held with convenient pre-filled syringe for easy transport
  • Cost effective with a dedicated CPT reimbursement code

Click here to learn more about the STIC Intracompartmental Pressure Monitor System.

External Fixator to Volar Plate

by Alejandro Badia, MD

It was not too long ago that the standard of care for a distal radius fracture with displacement was the application of an external fixator. Like the brief internment in a penal colony, the patient was left to deal with this cumbersome device for several months. I highly doubt that many of the little old ladies who had this device applied appreciated its “minimally invasive” nature.

Over 10 years ago, I remember my partner and I applying the standard volar plate from the synthes set to ALL distal radius fractures, regardless of direction of  displacement. I think neither Mrs. Smith nor Mrs. Colles cared about their Frykman classification but likely appreciated the fact that a small palmar based plate on the wrist, as an outpatient under regional anesthesia, could allow them to get right back to their daily routine simply using a small splint or fiberglass cast as protection.

I remember just a few years later lecturing on this very topic in Ho Chi Minh City, or even Buenos Aires, and realizing that this had very quickly become the standard of care worldwide. It was gratifying to be part of a revolution that truly improved patient care of this ubiquitous fracture.

Alejandro Badia, MD

Badia Hand to Shoulder Center

Miami, FL, USA

How Urgent are Open Fractures?

Dahners photo

Dr. Laurence Dahners

by Laurence E. Dahners, M.D.

A relatively new factor to consider in the treatment of trauma victims with open fractures is the fact that the data do not support the concept that open fractures are “emergencies requiring surgical debridement within six hours.” Initial studies were in pediatric open fracture but recently papers regarding infection rates in adults have been published as well. None of these studies has shown a statistically significant difference in infection rates in fractures debrided in less than six hours as compared to those debrided between six and twenty-four hours. The “trends” (non statistical differences) lean toward higher infection rates in those debrided in the first six hours! It does make a huge difference how soon the antibiotics are started so this remains very important. It is difficult to rationalize why early debridement would not lower infection rates but I hypothesize that it may be easier to differentiate necrotic from viable tissue when the debridement is carried out after six hours. In any case I now perform debridement during the daylight hours.

Dr. Dahners is a Professor of Orthopaedic Surgery at the UNC School of Medicine in Chapel Hill, NC, USA.  His clinical focus is on trauma and his research interests are in ligament physiology, ligament healing, ligament growth and contracture, and bone healing and the biomechanics of internal fixation.  You can see his “Pearls of Orthopaedics” on OrthopaedicList.com.