William Todd Obremskey

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Although hardware removal is commonly done, it should not be considered a routine procedure. The decision to remove hardware has significant economic implications, including the costs of the procedure as well as possible work time lost for postoperative recovery. The clinical indications for implant removal are not well established. There are few definitive(More)
OBJECTIVES To investigate negative pressure wound therapy (NPWT) to prevent wound dehiscence and infection after high-risk lower extremity trauma. DESIGN Prospective randomized multicenter clinical trial. SETTING Four Level I trauma centers. PATIENTS/PARTICIPANTS Blunt trauma patients with one of three high-risk fracture types (tibial plateau, pilon,(More)
BACKGROUND The American edition of The Journal of Bone and Joint Surgery (JBJS-A) has included a level-of-evidence rating for each of its clinical scientific papers published since January 2003. The purpose of this study was to assess the type and level of evidence found in nine different orthopaedic journals by applying this level-of-evidence rating(More)
BACKGROUND Trauma patients without intracranial hemorrhage or focal neurologic deficits are typically considered low risk for lasting neuropsychological and emotional deficits, and such sequela may be overlooked, especially in those with skull fractures and concussions. We undertook this study to determine the prevalence of and risk factors for persistent(More)
Inherent to understanding an orthopaedic study is a fundamental knowledge of the study's design principles and statistics. Statistics, in part, allow a researcher to sample a portion of the population and use probability to decide whether the findings from the sample are likely to apply to the whole population. Although statistical jargon can be confusing,(More)
BACKGROUND The impact of perioperative hyperglycemia in orthopaedic surgery is not well defined. We hypothesized that hyperglycemia is an independent risk factor for thirty-day surgical-site infection in orthopaedic trauma patients without a history of diabetes at hospital admission. METHODS Patients eighteen years of age or older with isolated(More)
This retrospective study investigated the effect of recombinant human bone morphogenetic protein-2 (rhBMP-2) mixed with cancellous allograft on fracture healing compared to iliac crest autograft in the treatment of long bone nonunion. Eighty-nine patients with 93 established long bone nonunions treated between January 2002 and June 2004 at a single academic(More)
OBJECTIVES To document the incidence of late pain and hardware removal after open reduction and internal fixation (ORIF) of ankle fractures. To test the hypothesis that late pain overlying the distal tibial and fibular hardware is associated with poorer functional outcomes. DESIGN Retrospective review. SETTING Level II trauma center. PATIENTS One(More)
Despite advances in resuscitation and surgical management of combat wounds, infection remains a concerning and potentially preventable complication of combat-related injuries. Interventions currently used to prevent these infections have not been either clearly defined or subjected to rigorous clinical trials. Current infection prevention measures and wound(More)
Institution(s): Vanderbilt Orthopedic Trauma, Medical Center East-South Tower, Suite 4200, Nashville, TN 37232–8774. Investigation performed at Vanderbilt Orthopedic Trauma, Nashville, Tennessee Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of(More)