Digital Commons Network^™

Training Set Augmentation And Biology-Aware Harmonization Improve Radiomic Models For Lung Cancer Prediction In Indeterminate Nodules, Claire Huchthausen, Menglin Shi, Gabriel De Sousa, James Larner, Einsley Janowski, Jonathan Colen, Krishni Wijesooriya

Data Science Faculty Publications

CT radiomics-based machine learning has potential to predict lung cancer in pulmonary nodules (PNs) earlier than standard-of-care methods. Low malignancy rates in early-development PNs and variable image acquisition hinder development of radiomic models for diagnosing these PNs. To address these challenges, we augmented training using later-development PNs and harmonized for acquisition effects. We examine early-development benign and malignant PNs (n = 106) below the sensitivity of standard-of-care diagnosis. Classifiers predicting malignancy performed near chance when trained on ComBat-harmonized radiomic features from only early-development PNs. We then augmented training with later-development benign and malignant PNs (n = 225). We evaluated whether …

Real-Space Imaging Of The Electron-Pair Density Hole In Molecular Auger-Meitner Decay, Mats Simmermacher, Nathan Goff, Andres Moreno Carrascosa, Elke Fasshauer, Thomas Northey, Lingyu Ma, Haiwang Yong, Brian Stankus, Asami Odate, Xuan Xu, Wenping Du, Kyle Acheson, Joseph C. Cooper, Daniel Ratner, Mengning Liang, Ruaridh Forbes, Michael P. Minitti, Adam Kirrander, Peter M. Weber

Physics Faculty Publications

Electrons in matter can rearrange extremely quickly under external perturbations, underpinning subsequent structural and chemical transformations. Coulomb interactions between neighbouring electrons often shape this response, giving rise to correlated motion and strongly affecting the distribution of electrons in the system. Here we show that non-resonant hard X-ray scattering can directly access changes in the radial electron-pair density during the rapid rearrangement of core and valence electrons. We do this by studying sulfur hexafluoride molecules undergoing Auger–Meitner decay. We exploit a second-order interaction between the X-ray photons and the molecules to trigger and probe the decay dynamics with a single pulse, …

Candidate Interaction Partners Of Calpain-5 Suggest Clues To Its Involvement In Neovascular Inflammatory Vitreoretinopathy, Jozsef Gal, Vimala Bondada, Rachel Crasta, Dorothy E. Croall, Calvin P. Vary, James W. Geddes

Spinal Cord and Brain Injury Research Center Faculty Publications

Although calpain-5/CAPN5 is widely expressed in mammals, little is known regarding its functions. Pathogenic mutations of CAPN5 are causal for a devastating autoimmune eye disease, neovascular inflammatory vitreoretinopathy (NIV). To provide insight into both the physiological and pathological roles of CAPN5, it is essential to identify candidate interaction partners and possible substrates. Human SH-SY5Y neuroblastoma cells, transfected with full-length catalytically dead (Cys81Ala) CAPN5-3×FLAG, were used for anti-FLAG co-immunoprecipitation (co-IP) and quantitative proteomics using Sequential Window Acquisition of all THeoretical mass spectra (SWATH-MS). Fifty-one proteins were enriched at least four-fold, p < 0.01, relative to cells transfected with an empty FLAG vector. A high proportion (24/51) of candidate CAPN5 interaction partners are associated with protein quality control, including components of the chaperonin, chaperone, and ubiquitin–proteasome systems. Additional candidate interactors include tubulins, kinases, phosphatases, G proteins, and mitochondrial proteins. CAPN5 interactions for 14 of the candidate proteins were confirmed by co-IP and immunoblotting. Of these 14 proteins, 11 exhibited in vitro calcium-induced proteolysis following co-IP with WT CAPN5-3×FLAG. Impaired calcium-induced proteolysis of co-IP proteins was observed for the pathogenic CAPN5 variants R243L and R289W. Further studies are needed to validate the association of candidate CAPN5 interactors with proteins and complexes suggested by the SWATH-MS and co-IP results, and the possible role of CAPN5 within such complexes. The possible involvement of CAPN5 in protein quality control is relevant to NIV, as defects in protein quality control have been implicated in inherited retinal disorders. Proteomic data are available via ProteomeXchange with identifier PXD068008.

Exploring The Impact Of Age On Traumatic Brain Injury Cause And Recovery In Arkansas: A Retrospective Review, Abby Jones, Steven Wheeler, Jessica Danley

2026 Honors Symposium

Traumatic brain injuries (TBIs) remain a major public health concern, and increasing evidence goes to show the significance of the effect of age in quality of care, diagnosis, and recovery outcomes. In rural states, such as Arkansas, where research has shown a lack of resources and higher fatality rates among TBI patients, healthcare professionals can become better informed and equipped as a result of research efforts to uncover the effects of age on cause and recovery for inpatient TBI individuals in the early stages (Daugherty et al., 2022). Current research and prior evidence suggests that older individuals are more likely …

Clinical Test Cases For Commissioning, Qa, And Benchmarking Of Model-Based Dose Calculation Algorithms In 1⁹2ir Hdr Gynecologic Tandem And Ring Brachytherapy, Vasiliki Peppa, Maude Robitaille, Fatemeh Akbari, Shirin Enger, Rowan Thomson, Firas Mourtada, Gabriel Fonseca

Department of Radiation Oncology Faculty Papers

PURPOSE: To develop clinically relevant test cases for commissioning Model-Based Dose Calculation Algorithms (MBDCAs) for ¹⁹²Ir High Dose Rate (HDR) gynecologic brachytherapy following the workflow proposed by the TG-186 report and the WGDCAB report 372.

ACQUISITION AND VALIDATION METHODS: Two cervical cancer intracavitary HDR brachytherapy models were developed based on a real patient, using either uniformly structured regions or realistic segmentation. The patient's computed tomography (CT) images were processed, converted to a series of digital imaging and communications in medicine (DICOM) CT images, and imported into two treatment planning systems (TPSs), the Oncentra Brachy and BrachyVision. The original segmentation …

Establishing An Advanced Practice Provider-Led Transient Ischemic Attack Clinic: A Quality Improvement Initiative, Brittany A. Young

DNP Projects

Background: Due to lack of subspecialized neurological care in many rural community settings, care in tertiary hospitals is in demand. Insufficient care pathways can lead to lack of bed and provider availability. Advanced Practice Provider Transient Ischemic Attack clinics have been shown to be safe alternatives to hospital admission, for patients who meet criteria. This study targeted practice change at a 1000 bed tertiary academic hospital.

Methods: The quasi-experimental study sample inclusion criteria included Transient Ischemic Attack patients presenting to the emergency department with an ABCD2 < 4, complete symptom resolution, and no new cardiac changes on monitoring. A pre and post survey with educational PowerPoint intervention was provided to all emergency department and Neurology providers and nurses. A Transient Ischemic Attack clinic was established with a corresponding order set to be utilized for streamlined outpatient work up.

Results: During the pilot period, 29 admissions were deferred with 69% …

Advancing Cns Tumor Management: Novel Modalities In Surgery, Radiation, And Chemotherapy, Armin David Tavakkoli

Dartmouth College Ph.D Dissertations

Most tumors affecting the brain and spine are managed through a combination of surgical resection, radiation, and chemotherapy; however, operative morbidity from invasive surgery, the narrow therapeutic window of conventional radiotherapy, and poor blood-brain barrier penetration of systemic agents are critical barriers that hinder long term tumor control. This thesis presents three complementary strategies to advance brain and spine tumor therapy. First, we investigate laser interstitial thermal therapy (LITT) in the treatment of spinal tumors with metastatic epidural spinal cord compression, replacing “separation surgery” with a minimally invasive, image-guided approach that maximizes tumor ablation while preserving neurologic function. Second, we …

Prevalence And Characteristics For Mental Health Disorder Before And After Childhood Cancer Diagnosis—A Statewide Population-Based Study Among Medicaid Beneficiaries, Feitong Lei, Laurie E. Mclouth, Eric B. Durbin, Thomas T. Tucker, John L. Villano, Bin Huang

Internal Medicine Faculty Publications

Introduction: Pediatric cancer patients suffer mental health deficits. Patients who are vulnerable with respect to socioeconomic or other sociodemographic factors may be at heightened risk for worse mental health outcomes during cancer for many reasons including entering treatment with an existing mental health disorder. The purpose of this study was to describe the prevalence and trajectory of mental health before and after a childhood cancer diagnosis in a socio-demographically at-risk sample.

Methods: Data from the Kentucky Cancer Registry was utilized to identify patients aged 19 or under with a first primary childhood cancer diagnosis during 2001–2017. Linking KCR data with …

Patient Safety: Paramedic To Nurse Patient Handover Quality And Its Influence On Clinical Deterioration In The Emergency Department, Madison P. Penick

Nursing | Senior Theses

Background: Quality patient handoff from Emergency Medical Services to the Emergency Department is a crucial transition of care that directly impacts patient safety, medical intervention, and patient outcomes. If concise, effective communication is not achieved, critical details can be left out resulting in medical errors, delayed intervention times, and lack of identification of clinical deterioration.

Aim: This study aims to understand how paramedic to nurse handoff quality impacts a nurse’s early identification of clinical deterioration.

Proposal:

Methodology: A quasi-experimental study of mixed-method research.

Recruitment strategy: A fire department in Marin County, CA and ED nurses from the base trauma center …

Reducing Respiratory Viral Testing In A Pediatric Emergency Department: A Quality Improvement Initiative, Anna Suessman

North Texas GME Research Forum 2026

Background: Respiratory viral testing in pediatric emergency departments (EDs) is frequently performed despite limited impact on clinical management for many low-risk presentations. Unnecessary testing increases cost and operational burden may delay patient throughput and can provide false reassurance to caregivers. Additionally, pediatric emergency department nurses agreed with overburden and impact to throughput based on overuse of viral testing (qualitative nursing survey conducted on September 4, 2024 showed >98% felt testing was unnecessary). We hypothesized that reducing testing through standardized team education and discharge processes would not negatively affect patient experience. This initiative aimed to decrease unnecessary respiratory viral testing during …

Association Of Glp-1 Receptor Agonist Use With Postoperative Outcomes After Rotator Cuff Repair In Patients With Diabetes: A Propensity Score–Matched Analysis, Mckenna W. Box, Troy B. Puga, Hans Drawbert, Aysu Erdemir, John T. Riehl

North Texas GME Research Forum 2026

Background Diabetes impairs tendon healing after rotator cuff repair (RCR), with early postoperative poor glycemic control linked to a higher failure risk in studies. GLP-1 receptor agonists (GLP-1RAs) are increasingly used for glycemic control. Preclinical studies indicate that GLP-1RA may benefit rotator cuff healing through anti-inflammatory mechanisms as well. However, real-world data on the effects of GLP-1RAs on RCR outcomes remain incompletely understood.

Methods We conducted a retrospective cohort study using an institutional dataset (01/01/2016 to 09/30/2024) of adults aged 18-74 years with type 2 diabetes who underwent RCR. GLP-1RA exposure was established by home medication lists. Patients with autoimmune …

A Lethal Connection Uncovered: Direct Endoscopic Evidence Of A Primary Aortoenteric Fistula, Joel Mathews, Trina Lewis, Munazzah Kaleem, Long Hoang

North Texas GME Research Forum 2026

BACKGROUND: Primary Aortoenteric Fistulas (PAEFs) are a rare condition that occurs when the native aorta develops an abnormal connection with the gastrointestinal lumen. PAEFs tend to develop within the duodenum, specifically the distal region of the third part of the duodenum, which is retroperitoneal and is anterior to the aorta. Duodenal PAEFs can be difficult to diagnose and are often lethal, given their non-specific presenting symptoms and rapid progression to hemorrhagic shock.

CASE PRESENTATION: This case focuses on a 70-year-old male with a history of T4N2 colon adenocarcinoma with hemicolectomy, active smoking, and abdominal aortic aneurysm (AAA) who was transferred …

Procedural-Based Contemporary Management Of Bell's Palsy Long-Term Sequelae: A Narrative Review, Robert M. Frederick, Rhorie Kerr, Eric Dobratz, William Dougherty

Department of Otolaryngology (ENT) Faculty Publications

Objective

To describe the long-term sequelae of Bell's palsy and summarize available treatment options, including recent advances, so that general otolaryngologists and other practitioners are aware of the clinical findings and available interventions.

Data Sources

PubMed.

Review Methods

A literature search was performed on December 18, 2024, via PubMed using keywords such as "synkinesis," "selective myectomy," "selective neurectomy," "botulinum toxin," "intervention" in the context of "Bell's palsy" with preference for articles published within the last 5 to 10 years but inclusion of select older articles that provided necessary context for the current topic. Articles included in the review were written …

Machine Learning Classification Of Prostate Cancer Genomic Sequences Using K-Mer And Sequence-Derived Features, Kuldeep Rawat, Hirendra Nath Banerjee, Jamie Noble, Saa Naudia Deloatch, Satyendra Banerjee, Sachin Shetty, Soumya Banerjee

VMASC Publications

Prostate cancer disproportionately impacts African American men, who experience significantly higher mortality rates and earlier disease onset than other populations. Current diagnostic approaches, including prostate-specific antigen testing and biopsy, lack sufficient specificity and sensitivity, underscoring the need for accurate, molecular-level classification tools. This paper presents a machine learning framework for binary classification of genomic DNA sequences as cancerous or healthy. A dataset of 1684 FASTA-formatted sequences obtained from the National Library of Medicine - GenBank was analyzed, with 1662 sequences retained after quality control filtering. Feature engineering yielded 67 attributes, including GC content, Shannon entropy, sequence length, and trinucleotide k-mer …

Modern Potentiostat Architectures For Electrochemical Sensing: Design, Integration, And Future Directions, Reagan Aviha, Gymama Slaughter

Center for Bioelectronics Publications

Potentiostats are essential to electrochemical sensing, enabling precise control of electrode potentials and measurement of current responses. As demand grows for portable, wearable, and point-of-care systems, potentiostat design has evolved from benchtop instruments to compact, low-power, and wirelessly connected platforms. This review provides a comprehensive, system-level perspective on modern potentiostat architectures, covering operational principles, analog front-end design, signal generation and acquisition, communication protocols, and software integration. Unlike prior reviews that treat these aspects independently, this work integrates electrochemical theory with electronic design and data communication frameworks. Key components, including operational amplifiers, transimpedance amplifiers, DAC/ADC subsystems, and microcontroller-based control, are examined …

Initiation, Timing, And Duration Of Prone Positioning In Icu Ards Patients: An Integrative Research Review (Irr), Amanda Everard Thomas

Covenant Nurses Week 2026

No abstract provided.

Leveraging Virtual Reality And Haptics To Teach Surgical Skills: A Usability Study On Retropubic Midurethral Slings, Lauren Siff, Ginger S. Watson, Jerome Dixon, Moshe Feldman, Franklin Bost, Philippe J. Giabbanelli

VMASC Publications

Traditional methods to learn soft-tissue surgical procedures rely on cadaver labs or patient-based learning, which are costly and geographically limited, and raise ethical questions. Virtual reality (VR) with haptic feedback offers a scalable alternative, but most current platforms emphasize bone-based rather than soft-tissue procedures learned by feel. We developed a VR+haptic simulation for preoperative training of retropubic midurethral sling (MUS) surgery. This study examines the usability of this platform with thirteen expert urogynecologic surgeons and subsequently makes improvements (e.g., in haptics) to evaluate the platform with twelve trainees based on the NASA Task Load Index for workload and a UTAUT-informed …

An Anti-Adhesive Compound Modulating The Production Of Staphylococcus Aureus Cell Wall-Anchored Proteins, Allison C. Leonard, Ruina Bao, Cindy Menjivar, Megan J. Myers, Telmo O. Paiva, Zhiyong Zheng, Kirsten A. Berry, Kenneth W. Bayles, Ronald S. Flannagan, Yves F. Dufrêne, Jeffrey L. Bose, David E. Heinrichs, Georgina Cox

Journal Articles: Pathology and Microbiology

As one of the leading global causes of death associated with antimicrobial resistance, Staphylococcus aureus frequently colonizes the human nasal cavity and adheres to keratinized skin, establishing reservoirs that drive subsequent infections and emphasize the need for new decolonization strategies. Using a high-throughput, whole-cell screening platform, here we identify geranylgeranoic acid (GGA), a naturally occurring polyunsaturated, branched-chain fatty acid, as having dual activity against methicillin-resistant S. aureus (MRSA). At elevated concentrations, GGA exhibits microbicidal effects, whereas at sub‑microbicidal doses, it effectively inhibits MRSA adhesion to keratin, fibronectin, fibrinogen, and immunoglobulins. GGA possesses anti-adhesive activity against a panel of multidrug-resistant S. …

Distal Adding-On As A Complication Of Posterior Spinal Fusion In Adolescent Idiopathic Scoliosis: A Scoping Review Of Contemporary Evidence, Hussein Hashem, Hassan Abou Adma, Joseph Hayek, Ali Rezazadeh Shirazi, Karim Gaber, Waleed Kishta

Western Journal of Orthopaedics

Distal adding-on (DAO) is a complication of spinal fusion characterized by postoperative deformity progression distal to the fusion construct. DAO after posterior spinal fusion for adolescent idiopathic scoliosis (AIS) is variably defined and inconsistently managed. This scoping review synthesizes evidence on DAO detection, management, and outcomes. A PRISMA-ScR–guided search identified relevant studies. Thirty-one studies (2,998 patients; median follow-up, 30 months) met inclusion criteria. Reported DAO incidence ranged from 3.5% to 62.5%, reflecting heterogeneity in definitions, patient factors, surgical constructs, and follow-up duration. Revision surgery was infrequent and typically delayed. When performed, it was most often prompted by progressive coronal decompensation …

Increased Mortality And Reduced Survival In Nonagenarians With Hip Fractures: Implications For Geriatric Care, Roman Austin, Julio Avila, Audrey Wassef, Kate Parker, Katherine Gavin

Western Journal of Orthopaedics

Background: Hip fractures in nonagenarians (patients aged ≥ 90 years) are becoming increasingly common as the population ages, yet outcomes in this group remain poorly characterized. This study compared in-hospital mortality and survivorship at three months, six months, and one year after hip fracture surgery in nonagenarians with a younger elderly cohort aged 65 years to 89 years. Secondary outcomes included fracture characteristics, surgical management, and discharge disposition. Methods: A retrospective chart review was conducted on patients who underwent hip fracture surgery at a single Level I Trauma Center from August 2019 to December 2021. Patients were grouped into nonagenarians …

Benign Painful Soft Tissue Tumors Of The Digits: A Contemporary Review, Nethmi Withanage, Athikur Rahman, Lawrence Hurst, Samantha Muhlrad

Stony Brook Orthopaedic and Musculoskeletal Journal

Purpose: Benign painful tumors of the digit are commonly encountered in hand surgery yet frequently pose diagnostic challenges due to overlapping clinical presentations. This review synthesizes current evidence on eight benign soft tissue tumors and cystic lesions that commonly cause digital pain: glomus tumor, giant cell tumor of the tendon sheath (GCTTS), digital mucous cyst, digital ganglion cyst, epidermoid inclusion cyst, pyogenic granuloma, nerve sheath tumors, and angioleiomyoma.

Methods: A comprehensive review of PubMed/MEDLINE was performed, supplemented by hand surgery textbooks and online educational resources. Case series, retrospective cohort studies, and review articles were included.

Results: Each tumor exhibits a …

Albuminuria Screening Among Egyptian Patients With Cardiovascular Diseases, Regardless Of Their Diabetic Condition, Amira Fawzy Soliman, Khaled Shelbaya, Wael Abdelatief Mohamed Elhakeem, Osama Louis, Basheer Hafez, Wael Ali, Tarek M.Abdelaziz Elkholy, Baher Emil Ibrahim, Mahmoud M Abdou, Bassem Zarif

Journal of Medicine in Scientific Research

Even in the absence of overt kidney disease, albuminuria is increasingly recognized as a marker of systemic endothelial dysfunction and heightened cardiovascular risk. This prospective cohort study aimed to evaluate whether baseline urinary albumin-tocreatinine ratio (UACR) predicts subsequent incident cardiovascular outcomes among Egyptian adults with cardiovascular disease, regardless of diabetic status.

A Comparison Of Haemodialysis And Renal Transplantation On Male Sexual Function And Hormonal Abnormalities, Hala Ibrahim Mohamed, Ahmad Mohamad Abbas Elseasi

Journal of Medicine in Scientific Research

Background Sexual dysfunction and hormonal imbalance are common in males with end-stage renal disease (ESRD), particularly among those on chronic hemodialysis. Kidney transplantation may restore endocrine homeostasis and improve sexual function. This study aimed to compare the effects of hemodialysis and renal transplantation on male sexual function and related hormonal profiles. Methods This cross-sectional study was conducted on 40 married men (≥18 years) with ESRD at National Institute of Urology and Nephrology from October 2024 to October 2025. Participants were divided into two groups: Group I (hemodialysis) and Group II (renal transplantation). Clinical evaluation, laboratory tests, and hormonal assays (Folliclestimulating …

The Impact And Prevalence Of Pain In Adolescents And Children Living With Type-One Diabetes Mellitus, Randa Mohamed Darwish, Ayat Ibrahim Ghanem, Lamis Safwat Mubarak

Journal of Medicine in Scientific Research

Background: Pain is frequent but often underrated and even overlooked in adolescents and children living with type-one diabetes mellitus and can negatively impact their quality of life(QoL) and their cooperation within the management plan. Objective: To discern the common types , severity and prevalence of pain in pediatrics living with type-one-diabetes;compared to the group of diabetes-free control, and to probe associations with glycemic control, fatigue, and (QoL). Methods: This cross-sectional study incorporated 102 adolescents and children withtype -one- diabetesmellitus; and 99 age- and sex-matched healthy peers aged 8- 16 years. Pain intensity was evaluated using the (body-pain) domain in the …

The Postoperative Analgesic Effect Of Lumbar Erector Spinae Plane Block Versus Pericapsular Nerve Group Block In Patients Undergoing Hip Surgeries, Islam M. El-Desoky, Mohamed Elshafey, Amal Ismail Abdelrahman

Journal of Medicine in Scientific Research

Background: Hip surgery requires effective pain control for proper recovery and decreasing the length of hospital stay. Aims: We aimed to assess the analgesic effect of Erector spinae plane block (ESPB) and pericapsular nerve group (PENG) blocks in pain control after hip operations. Methods: This randomized clinical trial included 69 ASA I–II patients scheduled for hip surgery were randomly allocated into three groups: PENG block, ESPB, and control groups (23 each). The primary outcome was postoperative pain assessed via the Numeric Rating Scale (NRS) at rest and during movement. Secondary outcomes included intraoperative and 48-hour morphine consumption, time to first …

Role Of New-Onset Qt Prolongation In Ecg In Critically Ill Septic Patients As A Prognostic Tool: An Observational Prospective Cohort Icu Study, Talal Ibrahim Mostafa Hagag, Salwa M.A. Dahesh

Journal of Medicine in Scientific Research

Background QT interval prolongation is a common finding among critically ill patients and could be a marker of autonomic nervous dysregulation, instability of metabolism, and/or septic cardiomyopathy. Nevertheless, its prognostic role among septic ICU populations remains unclarified. The current aim of this study was to explore its potential role regarding short-term mortality. Methods In this cohort study, 119 septic adults were included in the study within 24 hours of ICU admission. Demographics, clinical variables, lab values, and QTc intervals were measured within 2 hours of ICU admission following exclusion for clinically significant electrolyte imbalances and use of QT-prolonging medications. QTc …

Front Matter, Arianna Medina

Western Journal of Orthopaedics

No abstract provided.

21st Century Perspective On The Changing Pattern Of Nerve Injuries From Gunshot Wounds In The U.S., Thomas A. Decoster

Western Journal of Orthopaedics

Gunshot wounds (GSWs) with nerve injuries in the 21st century differ significantly from those reported in the 20th century. The vast majority are now low-velocity civilian injuries, in contrast to high-velocity military injuries previously reported. The rate of nerve injury in civilian GSWs is approximately 5%, compared with the 30% reported in military cohorts. However, the most common pattern of nerve injury in the current civilian population is neurotmesis and partial neurotmesis, in contrast to the majority axonotmesis of the military cohorts. In the 20th century, treatment generally consisted of watchful waiting for signs of spontaneous recovery over three months …

Full Issue, Arianna Medina

Western Journal of Orthopaedics

No abstract provided.

Insertion Of An Internal Joint Stabilizer Through A Posterolateral Approach For The Management Of Complex Elbow Instability, Miguel A. Pirela-Cruz, Nikalus Skipp, Ana Love, Deana Mercer, Jazzlyn Gonzalez

Western Journal of Orthopaedics

Background: Complex elbow fracture-dislocations represent a substantial surgical challenge. Achieving adequate stability while permitting early postoperative motion is essential to prevent stiffness. The internal joint stabilizer (IJS) has emerged as an alternative to hinged external fixation, providing internal dynamic stabilization with improved patient tolerance and reduced risk of soft-tissue complications. Although the IJS is commonly inserted through a lateral approach, injuries involving multiple anatomical structures may necessitate broader exposure. Purpose: To describe the surgical technique for IJS insertion through a posterolateral approach (PLA) for complex elbow injuries involving multiple anatomical structures. Methods: The PLA provides extensile exposure to the posterior, …