Digital Commons Network^™

Comparison Of Autograft, Allograft, And Conduits For Peripheral Upper Extremity Nerve Repair A Critical Review Of The Current State Of Bone Grafting In Orthopaedic Surgery, Samantha Meacock

Bone Bulletin

Introduction

Several mechanisms of injury can cause peripheral nerve injury (PNI) and subsequent impaired quality of life with loss of motor and/or sensory function. Trauma is a common cause of injury with the most commonly injured nerves being the radial (53%), ulnar (32%), and median nerves (15%).¹ The preferred treatment for PNI is reconnecting severed nerve ends anatomically with tension-free end-to-end direct nerve repair of healthy fascicles. However, if the nerve ends cannot be brought together without tension, gapping can occur, and a direct tension-less repair is not possible.⁵ In the case of a lengthy nerve gap, a …

A Critical Review Of The Current State Of Bone Grafting In Orthopaedic Surgery, Joseph Kelly

Bone Bulletin

Introduction

Millions of people around the world currently suffer from orthopaedic injuries and illness due to trauma, degenerative diseases, cancer, and infections that require bone grafting techniques to heal. Bone grafting allows a surgeon to replace missing, broken, or infected bone with a substitute that returns the structural integrity of the bone. Bone grafting can rebuild bones but can also help bones with existing defects to heal properly. There are multiple types of bone grafts, and each may be indicated in different scenarios to optimize healing, restore function, and prevent complications depending on the bone in question. The three broad …

Distal Radius Fractures: A Common Injury With Disproportionate Results, Brady Stillman

Bone Bulletin

Introduction

A distal radius fracture (DRF) is a common upper-extremity injury that occurs when the radius is fractured near the wrist, usually after falling on an outstretched or flexed hand. DRFs account for one-sixth of fracture-related emergency department visits.² In a 2009 study, a sample of 87 million Americans with upper-extremity fractures revealed the most common fracture sites were the distal radius and ulna.³ The distal radius was the most common fracture site in patients younger than 18 and older than 49, and the incidence is increasing in older adulthood.^{3, 4} A DRF can be classified as …

Innovative Pain Management Protocols In Orthopedics And Their Role In Reducing Postoperative Opioid Use, Jake Lamonaca

Bone Bulletin

Background

The opioid epidemic has emerged as one of the most pressing public health challenges of our time, marked by significant increases in opioid-related dependence, abuse, and death in recent years. Excess prescription of opioids represents a major contributing factor to this crisis.¹ The origins and impact of the opioid epidemic in the United States are documented in Sam Quinones research narrative, Dreamland. He highlights how pharmaceutical companies leveraged misinterpreted research—particularly a 1980 letter published in The New England Journal of Medicine suggesting a low risk of addiction associated with opioids—to normalize their widespread prescription. This flawed evidence served …

Analyzing The Common Criteria And Decision-Making Process For Opting Between Same-Day And Overnight Surgeries For Improved Patient Management, Gaston Davis

Bone Bulletin

Introduction

Within the scope of sports medicine, the decision to opt for same-day or overnight surgeries is multifactorial and relies on many interplaying considerations. Common factors include patient health, surgical complexity, and post-operative care requirements. This article explores the criteria and decision-making process involved in choosing between these two surgical options for common sports-related injuries, such as shoulder, elbow, hand, hip, knee, and ankle injuries.

Posterior Shoulder Dislocations In The Setting Of Seizures, Alex Charlton

Bone Bulletin

The shoulder joint provides an exceptional range of motion that allows for flexion, extension, adduction, abduction, internal rotation, external rotation, and 360-degree circumduction; however, this mobility comes at the expense of decreased stability.¹ Shoulder dislocations account for 50% of all joint dislocations, with anterior dislocation being the most common and usually associated with trauma.² In comparison, about 2-5% of shoulder dislocations are posterior and are often associated with more unique etiologies.¹ One of the most interesting resulting from a tonic seizure in an individual with epilepsy.

Patient Specific Implants In Total Shoulder Arthroplasty, Alexander Zavitsanos

Bone Bulletin

Primary total joint arthroplasty (TJA) is one of the most commonly performed procedures in the United States, and is expected to be utilized more in the coming decades, with estimates of around 2 million TJAs performed annually by 2030.^1,2 While the first attempts at TJA occurred in the late 1800s, utilizing a variety of implant materials such as ivory and rubber, over the past 100+ years, the methods employed in TJA and the quality of implants used have progressed immensely with advances in material science and procedural methods^8-12. However, the implants currently used in all types of …

Management Of Periprosthetic Humeral Fractures Following Shoulder Arthroplasty, Akshay Khanna

Bone Bulletin

Introduction Since the introduction of reverse total shoulder arthroplasty (RTSA) in 2004, the total incidence of primary total shoulder arthroplasties in the United States has doubled to over 30 cases per 100,000 persons.^1,2 Despite overall complication rates decreasing with the advancement of novel techniques and implant designs, there are rising concerns regarding the frequency of certain complications including glenohumeral instability, rotator cuff tearing, and periprosthetic fracture.^3,4 Glenoid fractures are relatively rare, occurring at a rate of 1.4% in one national registry study.^19,20 The risk of periprosthetic humeral fracture, however, is of particular concern because of how devastating …

Revolutionizing Spine Surgery: The Potential Role Of Ai In Enhancing Surgical Workflow And Patient Outcomes, Samuel Ezeonu

Bone Bulletin

Introduction

With the growing incidence of degenerative spine pathology¹, surgeons have been tasked to treat more patients than ever. According to Mani et al., the number of single and multilevel fusion procedures are both projected to double over the next 25 years.² In light of this trend, several strategies have been proposed to reduce the resultant burden placed on hospitals and surgeons, while maintaining optimal standards of care. Namely, the use of artificial intelligence (AI) is a growing field that has greatly increased in the last decade. AI has the potential to relieve the cognitive workload placed …

The Future Of Robot-Assisted Surgery In Foot And Ankle Procedures, Sam Duggan

Bone Bulletin

Robot-assisted surgeries are becoming common in most fields of orthopaedics by providing increased accuracy and precision, reducing revision procedures.^1,2 Surgeons specializing in hip and knee, and more recently, spine, have seen tremendous increases in the use of robotics. Still, foot and ankle surgery has had little to no adoption of robotics due to the complex foot and ankle anatomy, in addition to small operating windows; however, usage in spine surgery may be a strong indicator of future use in foot and ankle surgery, as spine surgery similarly requires extreme precision in small operating spaces, with the added benefit of …

Exploring Robotic-Assisted Total Knee Arthroplasty, Sahil Shah

Bone Bulletin

Background and Introduction of Total Knee Arthroplasty

Within the field of orthopedics, joint replacements rank amongst the most common procedures. Among those, total knee arthroplasty (TKA) is the most commonly conducted joint replacement procedure at approximately 51.02% of arthroplasties between 2012 and 2022.¹ Annually, the American Academy of Orthopedic Surgeons estimates more than 700,000 TKAs are performed within the United States.² The procedure was introduced in 1968 to relieve severe joint pain and stiffness, as well as restore mobility in patients suffering from “end-stage degenerative knee osteoarthritis” or rheumatoid arthritis.³ TKAs revolutionized the treatment plan for patients …

Challenges And Concerns Of Artificial Intelligence In Shoulder And Elbow, Claude J. Regis

Bone Bulletin

Background

Artificial intelligence (AI) is rapidly transforming shoulder and elbow surgery, driving significant advancements across various domains. Currently, AI is enhancing diagnostic accuracy through imaging-based analysis, predictive modeling of clinical outcomes, implant identification, and automated image segmentation.^1,2 AI-driven personalized treatment plans are also anticipated to optimize patient care by tailoring interventions based on individual data analysis.³ Additionally, deep learning algorithms have been developed to automatically classify large sets of preoperative and postoperative radiographs in the setting of shoulder arthroplasty.⁴ These technologies, combined with AI, could revolutionize surgical training and intraoperative guidance, offering real-time data and enhanced visualization. …

Foreword, Alan S. Hilibrand

Bone Bulletin

As the Director of Undergraduate medical education for the Department of Orthopedic Surgery at the Sidney Kimmel Medical College, I am happy to once again oversee the third annual issue of the Bone Bulletin. Through the activities of the DePalma Orthopaedic Society, medical students at SKMC have an excellent venue to learn about orthopaedic surgery, and through articles in this publication our surgeons at Rothman Orthopaedics have enthusiastically mentored younger students interested in the field of orthopedic surgery. The DePalma leadership has worked hard on many initiatives in recent years: providing forums for orthopaedic faculty to speak about their …

Editors' Note, Liam Gibbons, Amit Syal

Bone Bulletin

We are thrilled to introduce the third edition of the Bone Bulletin, DePalma Orthopaedic Society’s student-run, non-peer reviewed journal for Sidney Kimmel Medical College (SKMC) students. The journal aims to offer an additional avenue for medical students to engage with orthopaedics in medical school. Through the 1-on-1 mentorship with physicians from the Rothman Orthopaedic Institute, students gain hands-on experience writing about and directly engaging with current orthopaedic research and developments.

After each edition, it’s been exciting to see the journal continue to grow, with increasing numbers of students eager to get involved. This year, we are proud to announce …

A Sad And Untimely Loss Of A (Gental) Giant Within Our Profession, Our Lives, Our Hearts, Richard A. Mufson

SFDDA Newsletter

Editorial feature from lead editor, Dr. Richard Mufson

The 7 Habits Of Highly Effective Dentists: Habit 6 "Synergize", Mark Limonsani

SFDDA Newsletter

Series based on Steven Covey's "The Seven Habits of Highly Effective People" seeks to inspire and guide readers on their journey to personal and professional excellence. This article focuses on the sixth habit, "Synergize."

Sfdda Newsletter Fall 2023

SFDDA Newsletter

SFDDA Newsletter includes regular columns with regional news impacting the South Florida District membership including: columns from the President and editor, feature articles relating to the field of dentistry, association events and upcoming activities, component news, continuing education opportunities, and classifieds.

Sfdda Newsletter Spring 2023

SFDDA Newsletter

SFDDA Newsletter includes regular columns with regional news impacting the South Florida District membership including: columns from the President and editor, feature articles relating to the field of dentistry, association events and upcoming activities, component news, continuing education opportunities, and classifieds.

Sfdda Newsletter Winter 2023

SFDDA Newsletter

SFDDA Newsletter includes regular columns with regional news impacting the South Florida District membership including: columns from the President and editor, feature articles relating to the field of dentistry, association events and upcoming activities, component news, continuing education opportunities, and classifieds.

Sfdda Newsletter Fall 2022

SFDDA Newsletter

SFDDA Newsletter includes regular columns with regional news impacting the South Florida District membership including: columns from the President and editor, feature articles relating to the field of dentistry, association events and upcoming activities, component news, continuing education opportunities, and classifieds.

Sfdda Newsletter Summer 2022

SFDDA Newsletter

SFDDA Newsletter includes regular columns with regional news impacting the South Florida District membership including: columns from the President and editor, feature articles relating to the field of dentistry, association events and upcoming activities, component news, continuing education opportunities, and classifieds.

Sfdda Newsletter Spring 2022

SFDDA Newsletter

SFDDA Newsletter includes regular columns with regional news impacting the South Florida District membership including: columns from the President and editor, feature articles relating to the field of dentistry, association events and upcoming activities, component news, continuing education opportunities, and classifieds.

The 7 Habits Of Highly Effective Dentists: Habit 5 "Seek First To Understand, Then To Be Understood.", Mark Limonsani

SFDDA Newsletter

Series based on Steven Covey's "The Seven Habits of Highly Effective People" seeks to inspire and guide readers on their journey to personal and professional excellence. This article focuses on the fifth habit of building understanding.

Medication Access And Training Expandsion (Mate) Act, Richard A. Mufson

SFDDA Newsletter

Article provides helpful answers in regards to the new eight hour CE requirement for DEA license renewal.

Sfdda Newsletter Summer 2023

SFDDA Newsletter

SFDDA Newsletter includes regular columns with regional news impacting the South Florida District membership including: columns from the President and editor, feature articles relating to the field of dentistry, association events and upcoming activities, component news, continuing education opportunities, and classifieds.

Implementing A Sustainability Approach By Converting Plastic Bottle Waste From A Mischievous Substance To A Beneficial Material By Means Of Zero Residue Level Concept, Younus Mohammed Abed, Fatima Allawi, Shahad Mudhafar Ali, Salem Jawad Alhamd, Thekra Atta Ibrahim, Mohammed Nsaif Abbas

Karbala International Journal of Modern Science

Plastic waste represents a serious environmental and health hazard due to its non-biodegradability and toxic leachates. This study investigates the potential conversion of plastic waste into a sustainable raw material for producing a useful substance. This investigation focuses on repurposing PET beverage bottles—a major contributor to microplastic pollution—into high-value activated carbon (AC) for water treatment, aligning with circular economy principles. The chemical preparation method for AC using phosphoric acid as an activating agent was evaluated. Results demonstrated the successful conversion of 68% of plastic waste into AC under the following conditions: pyrolysis temperature of 700°C, pyrolysis time of 7 hours, …

Deep Neck Space Infection As A Complication Of Transesophageal Echocardiogram For Atrial Flutter Ablation, Anish K Shrestha, Naffa Faisal, Kanchana Bali, Nadine Safi, Maria E. Mesalles, Nahar Saleh

Journal of Community Hospital Internal Medicine Perspectives

Transesophageal echocardiography is a relatively safe procedure; however, there are rare complications associated with it. Multiple attempts during TEE can lead to injury of hypopharyngeal or parapharyngeal wall leading to an infection. Here, we describe a case of hypopharyngeal-parapharyngeal abscess resulting from multiple TEE attempts during cardioversion leading to a prolonged hospital course.

A Rare, Cephalosporin-Induced Rash: Acute Generalized Exanthematous Pustulosis, Mark A. Colantonio, Danielle Sblendorio, Elizabeth Hart, Vincent Melemai, Joshua Wiley

Journal of Community Hospital Internal Medicine Perspectives

Acute generalized exanthematous pustulosis is an uncommon cause of rash, typically presenting with pustules with an erythematous base and associated skin-peeling. Frequently caused by medications, including penicillins and quinolones, cephalosporins are rarely reported as an offending agent. Here, we present a case of rare acute generalized exanthematous pustulosis secondary to recent cephalosporin use presenting to our rural healthcare facility. We aim to raise awareness of this unusual rash secondary to cephalosporin use.

First Report Of Successful Rituximab Therapy In Idiopathic Sclerosing Mesenteritis, Indira Acharya, Carey Field, Mary E. Clark

Journal of Community Hospital Internal Medicine Perspectives

Sclerosing mesenteritis (SM) is a rare idiopathic fibroinflammatory disorder of the bowel mesentery adipose tissue.While the use of rituximab has been documented in IgG4-related SM, its effectiveness in idiopathic, IgG4-unrelatedSM remains unknown. We present a case of idiopathic SM successfully managed with rituximab, suggesting thatthis treatment may be an option for patients who either have contraindications to or have not responded to current first-line therapies.

Walking Pneumonia - Not Always So Timid A Case Of Severe Ards Due To Fulminant Mycoplasma Pneumonia, Tharun Shyam, Momna Noor, Yan Naing Tun, Saumya Nanda, Omair Khan, Ravikaran Patti

Journal of Community Hospital Internal Medicine Perspectives

Mycoplasma pneumoniae pneumonia (MPP) most commonly presents as bronchitis or as a self-limited ‘walking’ community acquired pneumonia. A fulminant form of MPP may occur in 0.5% to 2% of patients and is characterized by rapidly progressive respiratory failure and Acute respiratory distress syndrome (ARDS). Our case highlights the importance of considering fulminant MPP as a cause of ARDS, especially in the young adult and middle-aged population. We review the current literature and management principles of this rare disease with an emphasis on antibiotic stewardship and corticosteroid therapy. Further research is needed to better understand patterns of antibiotic resistance and to …