Citations

Abstract A bony Bankart fracture is a common injury pattern in anterior shoulder instability. The fracture fragment size varies and the larger the fragment the more likely recurrent instability will occur. When a large bony Bankart fracture is present, surgical fixation is preferred. Both open and arthroscopic approaches exist with multiple fixation techniques including anterior‐to‐posterior screw fixation, suture anchor bridge fixation, and suture button fixation. Arthroscopic screw fixation is difficult, as the angle necessary to be parallel to the glenoid surface requires a far medial start point and places the nerve at risk. The use of a variable‐pitch, headless compression screw placed from posterior to anterior avoids these risks. We describe an arthroscopic technique for glenoid fixation using a posterior‐to‐anterior, cannulated, variable‐pitch headless compression screw for the treatment of an anterior BBF. Technique Video video See video under supplementary data.

The COVID-19 pandemic caused tremendous disruption to the U.S. healthcare system and nearly crippled some hospitals during large patient surges. Limited ICU beds across the country further exacerbated these challenges. Telemedicine, specifically tele-critical care (TCC), can expand a hospital’s clinical capabilities through remote expertise and increase capacity by offloading some monitoring to remote teams. Unfortunately, the rapid deployment of telemedicine, especially TCC, is constrained by multiple barriers. In the summer of 2020, to support the National Emergency Tele-Critical Care Network (NETCCN) deployment, more than 50 national leaders in applying telemedicine technologies to critical care assembled to provide their opinions about barriers to NETCCN implementation and strategies to overcome them. Through consensus, these experts developed white papers that formed the basis of this article. Herein, the authors share their experience and propose multiple solutions to barriers presented by laws, local policies and cultures, and individual perspectives according to a minimum, better, best paradigm for TCC delivery in the setting of a national disaster. Cross-state licensure and local privileging of virtual experts were identified as the most significant barriers to rapid deployment of services, whereas refining the model of TCC to achieve the best outcomes and defining the best financial model is the most significant for long-term success. Ultimately, we conclude that a rapidly deployable national telemedicine response system is achievable.