Medicine and Health Sciences Commons^™

Missed Early Glenohumeral Septic Arthritis During Emergency Department Visit Owing To Low Virulence Streptococcus Mitis: A Case Report, Ashley A. Crum, Christopher A. Mcgrew, Matthew A. Tennison

UNM Orthopaedic Research Journal

Glenohumeral joint septic arthritis in a native joint is uncommon but can be debilitating if not treated early. Septic arthritis does not always present with the typical clinical findings, especially in immunocompromised patients. We report a rare case of glenohumeral septic arthritis from Streptococcus mitis infection in a diabetic woman that was initially missed on first presentation in the emergency department (ED). The exact cause of infection in this case remains unclear but is likely due to poor dentition and possible transient bacteremia in the setting of large rotator cuff tear in an immunocompromised patient (diabetes). The patient had a …

Posttraumatic Attenuation Of The Lisfranc Ligament In A 14-Year-Old Athlete: A Case Report, Paul J. Johnson, David M. Bennett

UNM Orthopaedic Research Journal

Lisfranc injuries in children are rare and range from mild midfoot sprains to severe traumatic fracture-dislocations. Management of sprains is nonoperative, whereas treatment of fracture-dislocations often requires internal fixation. We present a unique case of a midfoot sprain in a 14-year-old adolescent boy, with gradual increased instability at the joint owing to attenuation of the Lisfranc ligament. Closed reduction and percutaneous pinning resulted in successful treatment at 3 weeks postoperatively. Midfoot sprains may lead to further ligamentous attenuation and widening as seen on radiographs and thus should be monitored for signs of persistent pain and instability. Because midfoot instability contributes …

Capitate Stress Injuries Of Both Wrists In An Adolescent Female Gymnast: A Case Report, Brynne R.W Latterell, Deana M. Mercer, Shane P. Cass, Christopher A. Mcgrew

UNM Orthopaedic Research Journal

Gymnastic activities expose the wrist to a wide variety of overuse and acute stresses. Injuries to the distal radius are the most commonly reported gymnastic wrist condition; however, many other structures are at risk of injury from the sport’s high acute and overuse demands, including the carpal bones, most commonly the scaphoid. We describe a 17-year-old female, high-level gymnast in whom stress injuries to both capitate bones were ultimately diagnosed after initial symptoms of pain. This case demonstrated the need for prompt recognition, without which much chronic and debilitating injury would develop. For successful diagnosis, healthcare providers should carefully examine …

Carpal Tunnel Release During Pregnancy: Report Of Two Cases, Erica J. Gauger, Deana M. Mercer, Moheb S. Moneim

UNM Orthopaedic Research Journal

Symptoms of carpal tunnel syndrome are common occurrences during pregnancy, particularly in the third trimester. Most patients undergo successful nonoperative treatment shortly after birth or the cessation of breast feeding. However, symptoms noted earlier during pregnancy are more likely to be severe and persistent. We present the cases of two women who developed symptoms of severe carpal tunnel syndrome during the second trimester and did not improve with nonoperative measures. Both underwent carpal tunnel release during pregnancy, with excellent postoperative result. Obstetric providers and surgeons alike should consider surgical treatment for patients with carpal tunnel syndrome who do not improve …

A New Diagnosis Of Multiple Sclerosis In A 29-Year-Old Former Collegiate Basketball Player With Initial Symptoms Of Recurrent Bell’S Palsy: A Case Report, Eric R. Reynolds, Andrew D. Ashbaugh, Christopher A. Mcgrew

UNM Orthopaedic Research Journal

Multiple sclerosis (MS) is a demyelinating disorder of the central nervous system, characterized by immunemediated destruction of myelinated axons, which leads to notable physical disability. Although presence among active athletes is extremely low, it can cause considerable lifestyle changes for those athletes affected as they transition into life after competitive athletics. We describe a 29-year-old former collegiate women’s basketball player in whom MS was diagnosed during a visit for recurrent evaluation of Bell palsy. Subsequent neurology consult and magnetic resonance imaging led to the confirmation of the diagnosis of MS, and the patient began treatment for relapsing-remitting MS. During visits …

Sciatic Nerve Palsy After Operative Treatment Of Subtrochanteric Femur Fracture Resulting From Postoperative Hematoma: A Case Report, Tony G. Pedri, Gehron P. Treme

UNM Orthopaedic Research Journal

Treatment of subtrochanteric femur fractures can be difficult owing to high risk of complications. No cases of sciatic nerve palsy after hematoma following open reduction and intramedullary nailing of a subtrochanteric femur fracture have been reported. We describe a 28-yearold man who presented with a subtrochanteric fracture in the left femur after a motor-vehicle collision, in whom open reduction and intramedullary nailing led to an immediate postoperative hematoma and sciatic nerve palsy. Prompt diagnosis and early wound exploration resulted in complete resolution of the palsy at 1 month postoperatively. Our findings reinforce the importance of prompt diagnosis and treatment in …

Transhumeral Amputation For Treating Necrotizing Fasciitis Infection Of The Upper Extremity: Report Of Two Cases, Drew K. Newhoff, Amber L. Price, Christina Salas, Deana M. Mercer

UNM Orthopaedic Research Journal

Necrotizing fasciitis, an infection of the skin and subcutaneous tissue, can spread rapidly. Studies have emphasized the importance of prompt surgical intervention with aggressive debridement of diseased tissue; however, mortality rates are high despite immediate treatment. We describe two men, aged 44 years (case 1) and 74 years (case 2), presenting with necrotizing fasciitis who underwent aggressive surgical intervention, multiple debridements, and eventual transhumeral amputation of the upper extremity. In each case, the patients were discharged from the hospital to their homes on amoxicillin-clavulanate at postoperative days 15 (case 1) and 32 (case 2). Findings of laboratory studies had normalized. …

Lipoma Of The Tendon Sheath Causing Symptoms Of De Quervain’S Tenosynovitis: A Case Report, James Rose, Moheb S. Moneim

UNM Orthopaedic Research Journal

Deep lipomas arising from the extensor compartments of the wrist are extremely rare. Owing to infrequent presentation and mass effect on nearby structures, lipomas can be mistaken for other clinical entities. We describe a 70-year-old woman who presented to our clinic with symptoms initially suggestive of de Quervain’s tenosynovitis of the left wrist. However, findings of physical examinations and imaging techniques revealed a lipoma of the tendon sheath of the second dorsal compartment. The patient was successfully treated operatively, with excision and release of the first dorsal compartment. To help accurately diagnosis and treat lipomas of the wrist in deep-tissue …

Diagnosing An Acute Quadratus Plantae Tear In A 37-Year-Old Athlete: A Case Report, James P. Toldi, Shane P. Cass, Richard A. Miller, Christopher A. Mcgrew

UNM Orthopaedic Research Journal

Foot injuries occur frequently in distance runners and can notably impact training performance. Common diagnoses include plantar fasciitis, tendinopathies of the forefoot or midfoot, and stress fractures of the metatarsals. Occasionally, more obscure structures may be involved. We describe a 37-year-old male distance runner who presented with symptoms of heel pain and ecchymosis, suggesting an acute plantar fascia injury. However, findings of magnetic resonance imaging revealed a tear to the quadratus plantae (QP). The patient gradually returned to normal levels of physical activity, with complete resolution of symptoms by 4 months after the initial injury. Healthcare providers should be aware …

Unsuccessful Metatarsophalangeal Joint Replacement For Treating Arthritis Of The Great Toe: Report Of Three Cases, Jory Wasserburger, Paul J. Johnson, Katherine J. Gavin, Richard A. Miller

UNM Orthopaedic Research Journal

Metatarsophalangeal (MTP) joint fusion or replacement are commonly performed for treating advanced arthritis of the MTP joint of the great toe. However, results of MTP joint arthroplasty have shown no clear advantages compared to those of fusion. We present a 72-year old woman (case 1), 66-year-old woman (case 2), and 64-yearold man (case 3) who underwent unsuccessful MTP joint replacement of the great toe and presented to our clinic with pain at 15, 1, and 20 years postoperatively, respectively. Operative resection has been scheduled for case 1, whereas symptoms were managed nonoperatively in case 2. In case 3, operative removal …

Rare Tumors Adjacent To The Achilles Tendon: Report Of Two Cases, Jay J. Wojcik, Aditi S. Majumdar, Kathleen M. Madden, Richard A. Miller

UNM Orthopaedic Research Journal

Benign masses are not uncommon near the Achilles tendon of the ankle. However, the occurrence of angiomyomas or glomus tumors in the region has rarely been reported. We describe two patients, a 44-year-old woman and 44-yearold man, who presented with a tender mass posterior to the Achilles tendon. Excision led to successful removal of the lesion in both cases. Results of histological examinations revealed an angiomyoma and glomus tumor in the woman and man, respectively. Although rare, the presence of these tumors should be considered in the differential diagnosis of masses near the Achilles tendon.

Preparing Resident Physicians For Healthcare Reform, Michael M. Decker

UNM Orthopaedic Research Journal

No abstract provided.

Hosting The Perry Outreach Program And Medical Student Outreach Program In Albuquerque: Promoting Women Leaders In Engineering And Orthopaedic Surgery, Lauren Long, Sahar Freedman, Jodi Gomez, Deana M. Mercer, Christina Salas

UNM Orthopaedic Research Journal

No abstract provided.

The Albuquerque Community Sports Medicine Experience: Four Decades And Counting, Christopher A. Mcgrew, Thomas A. Decoster, Shane P. Cass, Richard Gerrells, Edward R. Sweetser

UNM Orthopaedic Research Journal

No abstract provided.

Novel Strategies For Time Efficiency In An Orthopaedic Clinic: A Satire, Christopher L. Shultz, Richard A. Miller

UNM Orthopaedic Research Journal

No abstract provided.

Taking An Orthopaedic Sabbatical: Mon Année En Lyon, Daniel C. Wascher

UNM Orthopaedic Research Journal

No abstract provided.

Total Ankle Replacement, Then And Now: A Review, Katherine J. Gavin

UNM Orthopaedic Research Journal

Total ankle replacement (TAR) for treating end-stage osteoarthritis of the ankle joint has been evolving since the early 1960s. Increased understanding of the biomechanics and kinematics of the foot and ankle, postoperative results of implant use, and advances in technology have led to improved implant designs and treatment outcomes. The current study reviews associated historical perspectives, kinematics, biomechanics, patient selection, imaging procedures, modern surgical techniques, postoperative complications, and comparison studies with arthrodesis to help evaluate TAR in successfully treating osteoarthritis of the ankle joint. Although arthrodesis remains the gold standard for treatment, findings of new studies have suggested that TAR …

Intradepartmental System Of Allocating Operating Room Block Time And Its Financial Impact At The University Of New Mexico Department Of Orthopaedics & Rehabilitation: A Preliminary Report, Dustin L. Richter, Gail Case, Nicholas White, Mary A. Jacintha, Robert C. Schenck Jr

UNM Orthopaedic Research Journal

Background: Within a hospital, the operating room (OR) is one of the most critical and expensive resources. Labor productivity is maximized by filling allocated surgical block time with as many hours of cases as possible. We have found that the intradepartmental block time release system at our institution has improved access to operating time, resulting in a substantial financial advantage within the department.

Methods: The annual charges and collections produced by the pick-up of intradepartmental released block time during the past 4 fiscal years (July 1-June 30) was assessed at both the main hospital and an outpatient surgical center.

Results: …

Remembrances: Orthopaedics Throughout The Years (1980s−Present), Richard A. Miller

UNM Orthopaedic Research Journal

No abstract provided.