Background: Anterior cruciate ligament (ACL) injuries are relatively common among younger athletes, with significant physical, psychological, and financial consequences. Research has largely focused on female athletes by identifying specific risk factors for an ACL injury, including variation in pubertal growth timing. There is less known about risk factors in males, and little is known about the effects of pubertal development on ACL injury risk in men. Purpose/Hypothesis: The purpose of this study was to analyze the relationship between an indicator of pubertal growth timing (age at adult height) and biomechanical risk for ACL injuries in men. We hypothesized that earlier age at adult height is correlated with riskier landing biomechanics during a drop vertical jump (DVJ) in men. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 21 recreationally active male students (age range, 20-33 years) were included. Participants completed a questionnaire on age at adult height and limb dominance, and anthropometric measurements were taken. There were 6 DVJ tests performed, with participants landing on a force plate while digital cameras recorded kinematic data from retroreflective markers placed according to the Helen Hayes marker system. Primary outcomes were sagittal and frontal plane knee kinematics and kinetics during contact. Data were analyzed using Pearson product-moment correlation. Results: In both limbs, age at achieving adult height was significantly negatively correlated with knee flexion/extension angle at toe-off (dominant: r = –0.79, P < .01; nondominant: r = –0.74, P < .01) and with peak flexion (dominant: r = –0.63, P < .01; nondominant: r = –0.70, P < .01) and extension (dominant: r = –0.66, P < .01; nondominant: r = –0.56, P = .01) angles during contact. In the nondominant limb, age at adult height was significantly negatively correlated with varus/valgus angle at initial contact ( r = –0.43; P = .05) and toe-off ( r = –0.44; P = .04) and was positively correlated with peak varus moment during contact ( r = 0.42; P = .06). Age at adult height was also positively correlated with peak vertical ground-reaction force ( r = 0.58; P < .01). Conclusion: Later age at adult height was correlated with riskier landing profiles in this study. This suggests that males with later or longer pubertal growth may have increased mechanical risk for ACL injuries. A better understanding of the effects of pubertal growth on landing biomechanics can improve the early identification of male athletes at greater risk for injuries.

Kluyvera is a rare infection in the upper extremity. Originally identified as an opportunistic pathogen, the virulence of Kluyvera has been debated. An elderly male presented with multiple pressure sores after being found down for an unknown time period. A hand abscess bacterial culture grew Kluyvera species as part of a polymicrobial infection. Despite multiple debridements, antibiotics and wound care, his clinical course ultimately was unsatisfactory and eventually fatal.

Case: We discuss our reconstructive approach to avoid an above-knee amputation in a 33-year-old man presenting after lower extremity crush injury. We used a vascularized tibial bone flap and a foot fillet flap to restore length and joint functionality to the residual limb. The patient ambulates with good prosthetic fit on durable heel pad skin and 100° active knee motion. Conclusion: This pairing of intramedullary nail with vascularized bone flap and fillet flap to address soft-tissue coverage and retain limb length is a useful tool in traumatic lower extremity injury management, providing an alternative technique for tibial bone graft stabilization with robust, sensate tissue coverage.

Introduction In burn surgical care, wound coverage and the corresponding dressing are paired to maximize the ability to promote re-epithelization, minimize pain and patient discomfort, dressing change frequency and overall cost. This dressing, a copolymer material based on DL lactic acid, has been described as a reliable alternative dressing for partial thickness burns as well as skin graft donor sites with comparable wound-healing quality and duration. Our aim is to assess outcomes results of this copolymer dressing at our institution, as applied to partial thickness burn wounds and graft donor sites. Methods We performed a retrospective analysis of 55 adult patients admitted between January 1, 2020 to August 25, 2021 for the treatment of partial thickness burns that were managed with a poly-DL-lactide copolymer skin substitute at the burn wound and/or autograft donor site. Three study groups were established based on application site: wound only (group 1), donor site only (group 2), and both (group 3). We assessed operative times, infections rates, complications, length of stay, readmission rates, and mortality. Results Preliminary data of 40 patients shows clinically similar results for analgesic requirements, operative length, and hospital LOS between group 1 and group 3. Group 2 showed higher analgesic requirements, lower operative times, a lower LOS, and lower readmission rates. Group 3 shows higher pain levels and longer operative times, when compared with groups 1 and 2, but lower readmission rates than group 1. Conclusions The poly-DL-lactide copolymer skin substitute offers reliable wound coverage for a partial thickness burns while also reducing frequency of dressing changes and associated pain correlating to reduced length of hospital stay and wound healing interval.

Summary: A hands-on facial fracture simulation course can be an important adjunct teaching modality in resident education and training, enhancing both resident confidence and competence in treatment of facial fractures. In this study, 11 plastic surgery residents participated in a surgical wet laboratory and lecture focusing on operative management of facial fractures. Pre- and post-course questionnaires were administered as clinical knowledge assessments. Pre-course, 40% of participating residents reported feeling comfortable with facial fracture management (>5 of 10) and 50% of residents achieved competence on clinical assessment (scoring >50%). Following the simulation course, these same assessments were re-administered. Post-course, comfortability with fracture management increased to 100% among participating residents, and 90% of residents scored >50%, demonstrating improvement in clinical competency.

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