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The sliding hip screw device (SHSD) is a commonly used implant to treat extracapsular neck of femur fractures. The most common described mode of failure is femoral head screw cut out. Mechanical failure is rare and when it occurs normally involves the plate rather that the sliding hip screw. Failure of the sliding hip screw itself is the most uncommon mode of failure and few cases have been reported in the literature. The mode of mechanical failure is usually multiple-cycle, low stress fatigue failure rather than low-cycle, high stress failure as a result of nonunion of the fracture. This case demonstrates a low cycle, high stress failure of the SHS and some of the potential causes for this are discussed.

The goal of this study was to assess whether patients receive their antibiotic prophylaxis as prescribed. We also investigated what doses and durations of antibiotics are typically ordered, which patients actually receive antibiotics and factors causing the ordered antibiotic regimen to be altered.We performed a retrospective review of 205 patient charts and sent a national survey to all surgeon members of the Canadian Orthopaedic Trauma Society (COTS) about antibiotic prophylaxis in the setting of surgical treatment for closed fractures.In all, 93% (179 of 193) of patients received an appropriate preoperative dose of antibiotics, whereas less than 32% (58 of 181) of patients received their postoperative antibiotics as ordered. The most commonly stated reason for patients not receiving their postoperative antibiotics as ordered was patients being discharged before completing 3 postoperative doses. There was a 70% (39 of 56) response rate to the survey sent to COTS surgeons. A single dose of a first-generation cephalosporin preoperatively followed by 3 doses postoperatively is the most common practice among orthopedic trauma surgeons across Canada, but several surgeons give only preoperative prophylaxis.Adherence to multidose postoperative antibiotic regimens is poor. Meta-analyses have failed to demonstrate the superiority of multidose regimens over single-dose prophylaxis. Single-dose preoperative antibiotic prophylaxis may be a reasonable choice for most orthopedic trauma patients with closed fractures.

Bridging external fixation is used more frequently than non-bridging fixation in the management of unstable distal radius fractures, despite evidence from randomized controlled trials of better outcome with the latter technique. This study was designed to investigate the generalizability of the technique of non-bridging external fixation, and to define the indications for the use of each technique and their complications.641 patients with unstable displaced fractures of the distal radius were treated with bridging or non-bridging external fixation. Non-bridging external fixation was used where there was space for pins in the distal fragment. 52 patients were lost to follow-up, leaving 588 patients available for study. Complete data from radiographic measurements after fracture healing were available for 546 patients. 59 % of fractures were treated with the non-bridging technique.Fractures treated with bridging external fixation had a 6 times increased risk of dorsal malunion (p0.001) and a 2.5 times increased risk of radial shortening (p0.001) after adjusting for confounding factors (95% CI for odds ratio: 3-13 and 1.5-4, respectively) compared to non-bridging techniques. Minor pin tract infections were more common in the non-bridging group.Non-bridging external fixation of the distal radius is a generalizable technique, and reduces the risk of dorsal malunion compared with bridging external fixation. Major complication rates are low and the technique is applicable to most unstable fractures of the distal radius. We recommend that non-bridging external fixation be used where there is space for the pins in the distal fragment.

The article reviews the book “Managerial Achievement: Action Strategies,” by Dalton E. McFarland.

Peer evaluation research was reviewed from the three major perspectives of validity studies, methodology, and situational factors. Most of the research programs were conducted in the course of developing procedures for evaluating training groups (e.g., in Officer Candidate School, U.S. Military Academy, and Ranger course). Substantial concurrent and predictive validity generally was found, with correlation coefficients in the .30 to .50 range. Different evaluation methods (rating, ranking, nominations, and combinations of these techniques) did not differ substantially in either reliability or validity. Evaluation methods did, however, differ in acceptability and feasibility. Situational factors have documented or potential effect on the evaluation process that developers and users of peer evaluations should be aware of. Although many issues surrounding peer evaluations remain unresolved, evidence suggests that these issues can be resolved, and that they do not detract from the conclusion that peer evaluations are a powerful tool in discriminating complex human behavior.

Previous research on leadership effectiveness has often used criteria of one type and from one source. In this research, data on leadership effectiveness were collected with a variety of measures from different sources (leaders, peers, subordinates). Findings were analyzed for statistical convergence and by a multitrait-multimethod intercorrelation matrix. A satisfying degree of convergence but relatively little divergence appeared, and 47% of the variance was not accounted for by either one. Apparently, many measurement techniques or sources of data are essentially interchangeable. One cannot safely interpret results across different studies, however, because of the large amount of variance that remains unaccounted for by either convergent or divergent validity. The report is written for psychologists.

The investigation of leadership processes normally requires the identification of various system outcomes which are potentially related, either directly or indirectly, to the exercise of leadership. Indeed, without such a specification of system outcomes, it is impossible to speak about leadership effectiveness. In previous research, leadership measures have often focused solely on the personal traits, attitude structure, or the behavioral repertoire of the formal leader. These measures have not always been related, either concurrently or predictively, to other important concepts such as individual and unit performance, subordinate job satisfaction, and work group morale. The present paper presents the development of several measures of these concepts which may be useful in the investigation of leadership effectiveness. (Author)

The primary criterion for selection of recipients of Army ROTC scholarships in an applicant's rank on an order-of-merit list based on his Whole Man Score (WMS). The WMS is a linear combination of variables believed useful as predictors of criteria such as academic success, aptitude for military science, leadership potential, and predisposition toward a military career. Four predictors are used: (1) high school class standing score; (2) Scholastic Aptitude Test (SAT) or American College Test (ACT) score; (3) extracurricular, athletic, and leadership activity score; and (4) personal interview score. The predictors are assigned arbitrary weights of 3:3:3:1, respectively (TRADOC circular 145-5, 1975). This paper documents the psychometric rationale underlying the method of computing the high school class standing portion of the WMS. The method involves adjusting for class size by converting class rank to percentile rank. Percentile rank is then transformed to a normalized standard score by introducing an a priori distributional assumption. Several alternative methods for estimating missing class standing scores are compared.

Leadership style and group effectiveness have been shown to be related to individual beliefs concerning the attribution of control of events. The individual believes that events are controlled either externally or by internal, personal forces. The research reported here involves measurement of the basic belief patterns and the investigation of the relationships with leadership style and group effectiveness. Survey instruments, including the Rotter Internal-External (I-E) scale, the Mach IV Machiavellian scale, Budner's Intolerance of Ambiguity scale, Fiedler's Least-Preferred Co-worker scale, and the Military Leadership Behavior Scale, were administered to 275 Special Forces Reserves during their 2-week active duty training period. Analysis of the results showed the factor structure of the Rotter I-E scale to be similar to the original, supporting the common idea of internal-external locus of behavioral control and, further, that locus of control beliefs are multidimensional. The concept of the I-E scale is sound and moderately useful in understanding reward expectations of soldiers and improving effectiveness of military units.

A 32-item Least-Preferred Coworker (LPC) scale was administered to 260 Army reservists participating in a field training exercise. The LPC scale yielded a 5-factor structure similar to a commonly recurring factor structure reported in the literature on peer ratings and implicit personality theory. Correlations between LPC factor scores and various performance criteria were examined for formal leaders, highest endorsed members, and nonendorsed members. Results suggest that the LPC dimensions are differentially predictive as a function of the criterion involved and the role of the individual in the team. Results were discussed in terms of item relevance and various psychometric properties of the LPC scale. The discovery of this particular 5-factor structure may represent a major step toward resolving the enigmatic quality of LPC by tying it to existing literature not dealing specifically with the LPC scale. There may be relationships between leader behavior and specific LPC dimensions.