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Letter From The Chief Of The Division Of Physical Therapy, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Treatment Of Tears Of The Superior Labrum Anterior And Posterior: A Review, Luke W. Buthuis

UNM Orthopaedic Research Journal

Tears to the superior labrum anterior and posterior (SLAP) are common injuries of the shoulder, and patients with these types of lesions are treated regularly by both general and sports-specialized orthopaedic surgeons. The causes, diagnosis, and effective treatment of these wounds have been examined extensively in the past several decades, owing partially to the development of arthroscopic techniques. Because clinical understanding has thus undergone frequent and notable changes, no standard method exists for current treatment. To help identify effective techniques for treating isolated SLAP tears, I reviewed the anatomy of the labrum and associated range of motion and stability of …

Causes, Evaluation, And Treatment Of Instability Of The Patellofemoral Joint Of The Knee: A Review, Michael J. Hopson

UNM Orthopaedic Research Journal

Instability of the patellofemoral (PF) joint of the knee is typically caused by chronic atraumatic injuries and inciting traumatic events. Anatomically, bony and softtissue structures surrounding the PF joint and extensor mechanism contribute to overall stability of the area, which results in efficient kinematic function at the PF articulation. Furthermore, physiological, genetic, anatomical, and demographical factors may affect the development and progression of PF joint instability. Treatment techniques have varied owing to individual factors that may have influence on pathological features of the injury. Nonoperative treatment has predominantly focused on strengthening of the quadriceps and vastus medialis by coordinated, closed …

Splinting Method For Preventing Thermal Injuries In Patients With Malleolar Fractures Of The Ankle After Operative Treatment Performed Under Regional Anesthesia, Alex Telis, Katherine J. Gavin, Heather M. Menzer, E Brooke Baker, Richard A. Miller

UNM Orthopaedic Research Journal

After performing open reduction and internal fixation (ORIF) for treating malleolar fractures of the ankle, surgeons typically use plaster splints during postoperative recovery of patients. Use of regional anesthesia during ORIF has been noted as a risk factor for burns in patients using plaster splints, possibly owing to inability to feel pain after undergoing regional block. We describe a successful postoperative splinting technique used for preventing thermal injuries in this patient population. We reviewed medical records of patients between 2011 and 2013 at our institution with malleolar ankle fractures who had underwent ORIF under general anesthesia, peripheral nerve block, or …

Predicting Vancouver Types B1 And B2 Periprosthetic Fractures Of The Femur, David M. Bennett, Logan R. Koehler, David J. Margolis, Matthew J. Radelet, Zhenqiang Lu, Tony G. Pedri, Michael M. Decker, Michael D. Miller

UNM Orthopaedic Research Journal

Background: Periprosthetic fractures of the femur after primary total hip arthroplasty (THA) can be complex and difficult injuries to treat. Because of the increased prevalence of THA, an overall increase is anticipated in the incidence of this complication. Vancouver types B1 and B2 periprosthetic femur fractures (defined as fractures around or just below the stem, with well-fixed and loose femoral stems, respectively) are particularly challenging to accurately classify and thereby treat owing to the difficulty in interpreting stability of stems on initial radiographs. To determine whether the method of stem fixation (ie, cement or press fit) may be a predictor …

Psychosocial And Demographic Factors Influencing Pain Scores Of Patients With Knee Osteoarthritis, Lauren A. Eberly, Dustin L. Richter, George D. Comerci, Deana M. Mercer, Gary W. Mlady, Daniel C. Wascher, Robert C. Schenck Jr

UNM Orthopaedic Research Journal

Background: Noted levels of pain in patients with diagnosed osteoarthritis (OA) of the knee are commonly assessed by using a numeric scoring system. However, the results of pain levels in patients with knee OA may be influenced by factors other than the patient’s actual physical discomfort or disease severity, including demographic and psychosocial variables. We retrospectively examined 355 patients with knee OA who had reported associated pain levels using a 0- to 10-point rating scale.

Methods: Data obtained from the medical records of patients were Kellgren-Lawrence (KL) grade, demographic characteristics, body mass index (BMI), concomitant disorders, drug use, alcohol use, …

Estimation Of Simulated Blood Loss By Orthopaedic Residents Before And After Brief Training, Jeffrey T. Jobe, Erika L. Garbrecht, Heather M. Menzer, Richard A. Miller

UNM Orthopaedic Research Journal

Background: Accurate estimation of blood loss (EBL) may be helpful for patient safety during certain operative procedures; however, medical students and residents are rarely instructed in EBL. In a series of two tests, we attempted to reveal any significant improvement in accuracy of EBL after a brief training session.

Methods: Fourteen orthopaedic residents were recruited. Participants estimated the amounts of simulated blood before and after a training session that involved a visual of 110 cm3 of the spilled fluid. Three volumes of 50, 237, and 531 cm3 of simulated blood were spilled on a lap sponge, blanket, and trash bag, …

Comparison Of Blood Loss Between Short-Stem And Conventional Femoral Implants In Total Hip Arthroplasty, Sean Kuehn, Drew K. Newhoff, Dukens Labaze, Aditi S. Majumdar, Rick J. Gehlert

UNM Orthopaedic Research Journal

Background: Although the postoperative results of total hip arthroplasty (THA) are generally successful, the standard technique and implant design have many proposed modifications. The purpose of the current study was to determine if using short-stem femoral implants minimized the intraoperative blood loss during THA when compared with conventional THA.

Methods: The medical records of patients who underwent THA using short-stem and conventional femoral implants between 2009 and 2013 were reviewed. Patients with previous surgical procedures for treating the acetabulum or proximal femur and patients without reported hematocrit levels were excluded; subsequently, a total of 53 patients for each group (short-stem …

Investigating Potential Role Of Surgeons In Sternal Wire Failure By Biomechanical Tests, Christina Salas, Rachel N. Tufaro, C Etta Tabe, Kwasi Addae-Mensah, W Daniel Tanberg, Christopher Buksa, Jessica A. Avila, Jorge A. Wernly

UNM Orthopaedic Research Journal

Background: Stainless steel wires are commonly used to close the sternum after cardiac-related operative procedures. However, complications have been reported associated with fracture of wires and subsequent migration into the chest cavity. The objective of this study was to biomechanically evaluate the role of surgeons in contributing to wire failure. We hypothesized that surgeons may impose damage to the sternal wire, which may be exacerbated by postoperative wire degradation and patient movement.

Methods: A biomimetic sternal model and custom test fixture simulated a median sternotomy. The sternum was closed by a fellowship-trained cardiothoracic surgeon using figure-of-eight and simple closure techniques. …

Design Of A Robotic Apparatus For Simulated Motion Of The Human Hand, Kenneth J. Smith, Sean R. Coss, Deana M. Mercer, Christina Salas, David I. Grow

UNM Orthopaedic Research Journal

Background: The hand is complex, in that any small disturbance to the flexor tendons, extensor tendons, and intrinsic muscles can result in dysfunction of the entire structure. We designed a robotic device to consistently load a native thumb carpometacarpal (CMC) joint in assessing the effects of ligamentous damage on stability of the thumb CMC joint.

Methods: The device consisted of a mechanical plate in which to fixate a cadaveric hand, a tendon-suture routing system, a bracket to couple multiple suture lines to a cable to maintain equal force among sutures and tendons, and the finger-thumb force measurement devices. To apply …

Postoperative Complications In Patients With Trapeziometacarpal Joint Osteoarthritis Treated With Carpometacarpal Arthroplasty: Report Of Two Cases, Jessica A. Avila, Taylor H. Parnall, Ericka L. Charley, Lauren N. Mercer, Elizabeth A. Mikola, Deana M. Mercer

UNM Orthopaedic Research Journal

Osteoarthritis of the carpometacarpal (CMC) joint, specifically, of the thumb trapeziometacarpal (TMC) joint, is a common condition in older women. Complications associated with surgical treatment range from transient tendinitis to wrist instability. We present two patients in whom complications developed after undergoing CMC arthroplasty. In one patient, rupture of the flexor carpi radialis (FCR) was noted postoperatively after using a combination of ligament reconstruction and tendon interposition with complete trapeziectomy. The second patient presented with a flexor pollicis longus (FPL) tendon that was tethered with sutures, in which surgical release of the entrapped FPL tendon led to successful treatment. In …

Postoperative Deep Vein Thrombosis And Pulmonary Embolism After Ankle Fusion In A Patient With Hemophilia A: A Case Report, Christopher P. Bankhead, Michael J. Hopson, Richard A. Miller

UNM Orthopaedic Research Journal

Deep vein thrombosis (DVT) and subsequent pulmonary embolism (PE) are uncommon postoperative complications of operative procedures for treating injuries of the foot and ankle. Because the disorder of hemophilia A prevents blood clotting and increases bleeding, patients with this condition have been even less likely to develop DVT and PE. We present a 36-year-old man with hemophilia A in whom operative ankle fusion for treating hemophilic arthropathy of the left ankle led to DVT and PE. After decreasing dosage of antihemophilic medication and administering enoxaparin, the symptoms improved and the patient was discharged from the hospital on postoperative day 5. …

Simultaneous Dislocation Of Both Interphalangeal Joints In The Same Digit Of A 56-Year-Old Woman With Workers’ Compensation: A Case Report, Danika Z. Boomer, Kristin M. Loker, Deana M. Mercer

UNM Orthopaedic Research Journal

Dislocation of the interphalangeal (IP) joints of the fingers, particularly on the ulnar side of the hand, is common; however, simultaneous dislocation of both IP joints of the same finger is uncommon, and no studies have reported this injury in patients with workers’ compensation claims. We describe a 56-year-old woman with simultaneous dislocation of distal and proximal IP joints, who was successfully treated using a dorsal blocking splint followed by several months of undergoing occupational therapy. She had sustained the injury from a fall on the ground at work and was promptly treated with open reduction at an outside facility. …

Metasynchronous Rupture Of Both Achilles Tendons In A Patient Undergoing Statin Therapy: A Case Report, Paul J. Johnson, Richard A. Miller

UNM Orthopaedic Research Journal

In treating cholesterol-related cardiovascular diseases, statins are commonly used as preventative medication and are associated with few side effects. However, recent studies have described a connection between statins and development of tendinopathy. Similar research has noted bilateral rupture of the Achilles tendon, a rare injury, in patients undergoing statin therapy. We describe a 74-yearold man undergoing statin (ie, simvastatin) therapy who presented with pain and swelling in the right ankle after exertional-type activity. Magnetic resonance imaging confirmed a rupture of the Achilles tendon, with rupture of the left Achilles tendon identified 5 weeks later without any obvious trauma-related event. Nonoperative …

Simultaneous Presence Of A Transligamentous Recurrent Motor Branch Of The Median Nerve And Palmaris Profundus Tendon In A Patient With Carpal Tunnel Syndrome: A Case Report, Dustin L. Larson, Moheb S. Moneim

UNM Orthopaedic Research Journal

Carpal tunnel syndrome (CTS) is the most frequently encountered entrapment of the peripheral nerves in the upper extremity. Abnormal anatomical variations involving the recurrent motor branch of the median nerve and presence of a palmaris profundus tendon have been reported. We present a 53-year-old man in whom open carpal tunnel release led to complete resolution of numbness, tingling, and pain in the right hand by 1 month postoperatively. Intraoperatively, the simultaneous presence of a transligamentous recurrent motor branch of the median nerve and palmaris profundus tendon in the carpal tunnel was found and excised. Surgeons should be aware of the …

Idiopathic Thrombocytopenic Purpura In A 21-Year-Old Collegiate Football Player: A Case Report, James A. Leinhart, Shane P. Cass, Matthew A. Tennison, Ronica A. Martinez, Christopher A. Mcgrew

UNM Orthopaedic Research Journal

Muscle cramps are commonly observed in collegiate athlete-patients; however, the condition may be a symptom of severe disorders. In particular, idiopathic thrombocytopenic purpura (ITP) may be a possible diagnosis and involves a decreased number of platelets in the bloodstream. We describe a 21-year-old collegiate player of American football with initially presented with cramping of the neck, abdomen, and forearms. Although findings of physical examination were normal, results of laboratory tests indicated ITP, and the patient was hospitalized for 3 days until the platelet count increased. Because the levels continued to decrease at 6-month followup, splenectomy and use of rituximab agents …

Notable Findings Of A Preparticipation Examination In An 18-Year-Old Volleyball Player: A Case Report, Stuart J. Lisle, Christopher A. Mcgrew

UNM Orthopaedic Research Journal

The preparticipation examination (PPE) is commonly performed to screen for potentially detrimental health conditions in competitive athletes to help decrease rates of morbidity and mortality associated with participation in sports. However, the significant clinical impact of PPE in the United States has yet to be determined. We describe an 18-year-old female athlete who presented with dizziness and a right-sided limp at 8 days after initial injury. Findings of PPE examination indicated that she had unknowingly sustained a concussion during a volleyball match and continued to play, which resulted in injury to the right foot. Despite abnormal findings of magnetic resonance …

Spare-Parts Technique For Concurrent Treatment Of Ectrodactyly Of The Feet And Syndactyly Of The Hands In A 2-Year-Old Boy: A Case Report, Brielle K. Payne, Mary E. Logue, Selina R. Silva, Deana M. Mercer

UNM Orthopaedic Research Journal

Syndactyly is the most frequently occurring congenital malformation of the limbs. Although common, few studies have reported treating syndactyly using Z-plasty with and without full-thickness grafting. We present a 2-year-old boy who presented to our clinic with ectrodactyly of the feet and simple complete syndactyly of two fingers on each hand. After ectrodactyly reconstruction, we used the excess foot skin to cover finger defects. The patient recovered well postoperatively, with matching skin and no trouble with hair growth. Use of a spare-parts technique can help avoid complications associated with harvesting grafts from other donor sites. The results reinforce the importance …

Becoming A Hand Surgeon, Moheb S. Moneim

UNM Orthopaedic Research Journal

No abstract provided.

The Groundwork And Legacy Of Our First Chair, George E. Omer Jr, Md, 1970–1990, Thomas A. Decoster

UNM Orthopaedic Research Journal

No abstract provided.

My Tenure As Department Chair, 1990-2006, Moheb S. Moneim

UNM Orthopaedic Research Journal

No abstract provided.

My Chair Story: Listening With Leadership, 2006–Present, Robert C. Schenck Jr

UNM Orthopaedic Research Journal

No abstract provided.

Federal Restrictions On Tribal Customary Law: The Importance Of Tribal Customary Law In Tribal Courts, Concetta R. Tsosie De Haro, Dine Nation

Tribal Law Journal

This article examines the adverse effects of federal case law and legislation on tribal courts and tribal courts’ ability to incorporate tribal customary law. Tribal customary law is the law given to tribes by holy deities which governs tribal ways of life. It is important to maintain tribal customary law because it strengthens tribal communities’ identities and cultural foundations. While Supreme Court precedent has, at different times, both restricted and promoted tribes’ ability to use tribal customary law to adjudicate the cases of tribal members, federal legislation including the Major Crimes Act, the Indian Civil Rights Act, the Tribal Law …

Black Water: The Devastating Effects Of Alcohol On The Core Values Of The A:Shiwi (Zuni), Christy Chapman

Tribal Law Journal

As in many Native American communities, alcohol use and abuse is an all too common problem among the Ashwi, members of Zuni Pueblo. Soon after the arrival of Anglo-American settlers, alcohol was introduced to the Zuni. Seeing its devastating effects, Zuni elders referred to this intoxicating substance as ‘black water.’ Since the introduction of black water, alcohol abuse among the Zuni has resulted in community members committing frequent criminal offenses, numerous health problems, and is the number-one cause of premature death among the Zuni.

Over the last century and a half, the devastating effects of black water have eroded the …

Postcolonial Management Of The Transboundary Guaraní Aquifer System: Indigenous Input As A Guide For Environmental Sustainability, Melissa Leonard

Tribal Law Journal

This article discusses the Guaraní Aquifer System, which is a vast groundwater source that spans across Argentina, Uruguay, Paraguay, and Brazil. The Guaraní Aquifer System is located beneath the ancestral homelands of the Guaraní indigenous peoples, yet it is exclusively managed by nation states. The Guaraní indigenous peoples have been deprived of their ancestral land and have no say in the utilization or management of the Aquifer. This article discusses social and legal theory relating to water management and governance, as well as Guaraní social organization, belief systems, and customary environmental law in the context of “postcolonial” water management. This …

Quality Improvement Conference: Effect Of Patient Safety Intelligence Inservice Training On Resident Psi Entry, Amanda Derylo, Josh Rider, Joanna Fair

Radiology Research and Scholarship

Hospital administrators rely heavily on incident reporting systems to capture adverse events. 13.5% of Medicare beneficiaries discharged in October 2008 experienced adverse events. 62% were not reported because staff did not perceive an event as reportable; 25% were not reported because staff commonly reported but did not report in this case. Nurses reported events most often. The Patient Safety Intelligence (formerly PSN) is an online adverse event reporting service provided by UNM Hospital. System-wide and departmental efforts to improve quality have included attempts to increase PSI reporting. A comprehensive ducational intervention program for anesthesiology resident physicians at the University of …

Unique Senior Radiology Resident Selectives (Areas Of Concentration) Integrating Clinical Experiences With Radiology Rotations, Joanna R. Fair, Gamaliel Lorenzo, Tyson Bolinske, Amanda Derylo, Hollie Medina

Radiology Research and Scholarship

With the restructuring of the ABR examinations to test core knowledge at the end of the PGY4 year, radiology residencies have increased flexibility in designing targeted educational experiences for senior residents. We have innovated the educational program for our senior residents by incorporating related clinical months alongside subspecialty-focused radiology rotations to create Areas of Concentration within select modalities. We now offer Areas of Concentration for up to 6 months to all PGY5 residents in our integrated (categorical) residency program. Residents may choose the clinical months from among those previously chosen by our residents, or may identify a faculty member in …

Otras Perspectivas (Other Perspectives), Volume 17, Issue 01, January 2016, Occupational Therapy Graduate Program

OTras Perspectivas: UNM Occupational Therapy Program Newsletter

Acknowledging that the success of the Occupational Therapy Program hinges on the mutual investment of community and friends beyond the local community, the UNM Occupational Therapy Program faculty and staff have initiated this newsletter. The goal is to provide an additional forum for communication, and provide updates about the program's development, faculty, students, alumni, and friends.

Isolated Gastric Tuberculosis Mimicking Malignancy, Wasim Memon, Saad Siddiqui

Department of Radiology

Isolated tuberculosis of upper gastrointestinal tract is a rare pathology, often mimicking malignancy in clinical presentation and radiological features. We present a case of middle aged gentleman with isolated tuberculosis of stomach, proven on histopathology and showing remarkable improvement on follow up.

Omental Infarction In A Child, Saad Siddiqui, Anwar Ahmed, Naila Nadeem

Department of Radiology

Omental infarction is a rare cause of acute abdomen in children. Typical findings on imaging establish the diagnosis. We present case of a 7 years old boy who presented with acute right iliac fossa pain with diagnosis of omental infarction on imaging and findings confirmed on laparotomy. Sound knowledge regarding this infrequent cause of acute abdomen in children is necessary for timely diagnosis.