Medicine and Health Sciences Commons^™

An Approach To The Failed Ankle Arthrodesis, Steven M. Raikin, Venkat Rampuri

Department of Orthopaedic Surgery Faculty Papers

Ankle arthrodesis remains the gold standard of surgical treatment for advanced ankle joint arthritis. Failure can occur as a result of infection, nonunion or malunion, resulting in pain and poor function. This paper offers a systematic approach to preventing, and managing these problems should they occur. Revision arthrodesis performed with a detailed understanding of the appropriate alignment and mechanics of the ankle joint, combined with meticulous attention to understanding and reversing the cause of the failure can result in successful salvage and restoration of function.

Recognizing A Dysfunctional Swallowing Pattern Using Surface Electromyography (Semg), Michelle F. Couto

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: The purpose of this study was to determine if a surface electromyography (sEMG) assessment of swallowing is better at identifying Oral Muscular Dysfunction (OMD) than a clinical evaluation (observation & digital palpation) of swallowing. The assessment was conducted on children ages 9 to 17, who were patients at the Orthodontic Department at Loma Linda University, School of Dentistry. Additionally, the prevalence of a “perceived” swallowing dysfunction was assessed.

Methods: This study included 39 randomly selected subjects from the orthodontic patients at Loma Linda University. Each subject’s “dry” swallow was evaluated using two separate methods: (a) sEMG and (b) digital …

Study To Prospectively Evaluate Reamed Intramedually Nails In Patients With Tibial Fractures (S.P.R.I.N.T.): Study Rationale And Design, Franklin D. Shuler Md, Phd

Orthopaedics

Background: Surgeons agree on the benefits of operative treatment of tibial fractures – the most common of long bone fractures – with an intramedullary rod or nail. Rates of re-operation remain high – between 23% and 60% in prior trials – and the two alternative nailing approaches, reamed or non-reamed, each have a compelling biological rationale and strong proponents, resulting in ongoing controversy regarding which is better.

Methods/Design: The objective of this trial was to assess the impact of reamed versus non-reamed intramedullary nailing on rates of re-operation in patients with open and closed fractures of the tibial shaft. The …

Anthony Frederick Depalma, Md: Educator, Researcher And Clinical Care Doctor., Phillip J. Marone

Department of Orthopaedic Surgery Faculty Papers

My first meeting with Dr. DePalma was in 1957 as an intern in his office on the 6th floor of the Curtis Clinic. He and I spoke for a while about the residency and he looked at me and said “you know you are going to be 33 years old before you make a plug nickel.” I replied, “well I don’t make any money now, so what is the difference?” He laughed and I got the residency. In the next two years, I spent many hours in the operating room with Dr. DePalma and learned quickly how skilled a surgeon …

Hemorrhage Into An Occult Spinal Ependymoma After Epidural Anesthesia, Peter G. Campbell, John K. Birknes, Ashwini D. Sharan, James S. Harrop, Alexander R. Vaccaro, John K. Ratliff

Department of Orthopaedic Surgery Faculty Papers

Summary of Background Data: Five cases of hemorrhage into a spinal neoplasm after spinal or epidural anesthesia are reported in the literature. Presentation ranges from severe low back pain to acute cauda equina syndrome.

Methods: A case study of a patient who hemorrhaged into an intradural, extramedullary spinal cord mass was performed. A detailed literature review is also provided.

Results: A 27 year old female underwent epidural anesthesia for Cesarean section delivery. She presented with a 3 week history of increasing low back pain with bilateral radiculopathy. Imaging studies revealed a large hemorrhagic intradural mass compressing the lower conus medullaris …

Surgical Versus Nonsurgical Therapy For Lumbar Spinal Stenosis., James N Weinstein, Tor D Tosteson, Jon D Lurie, Anna N A Tosteson, Emily Blood, Brett Hanscom, Harry Herkowitz, Frank Cammisa, Todd Albert, Scott D Boden, Alan Hilibrand, Harley Goldberg, Sigurd Berven, Howard An

Rothman Institute Faculty Papers

BACKGROUND: Surgery for spinal stenosis is widely performed, but its effectiveness as compared with nonsurgical treatment has not been shown in controlled trials.

METHODS: Surgical candidates with a history of at least 12 weeks of symptoms and spinal stenosis without spondylolisthesis (as confirmed on imaging) were enrolled in either a randomized cohort or an observational cohort at 13 U.S. spine clinics. Treatment was decompressive surgery or usual nonsurgical care. The primary outcomes were measures of bodily pain and physical function on the Medical Outcomes Study 36-item Short-Form General Health Survey (SF-36) and the modified Oswestry Disability Index at 6 weeks, …

Surgical Versus Nonsurgical Therapy For Lumbar Spinal Stenosis., James N Weinstein, Tor D Tosteson, Jon D Lurie, Anna N A Tosteson, Emily Blood, Brett Hanscom, Harry Herkowitz, Frank Cammisa, Todd J Albert, Scott D Boden, Alan Hilibrand, Harley Goldberg, Sigurd Berven, Howard An

Rothman Institute Faculty Papers

BACKGROUND: Surgery for spinal stenosis is widely performed, but its effectiveness as compared with nonsurgical treatment has not been shown in controlled trials.

METHODS: Surgical candidates with a history of at least 12 weeks of symptoms and spinal stenosis without spondylolisthesis (as confirmed on imaging) were enrolled in either a randomized cohort or an observational cohort at 13 U.S. spine clinics. Treatment was decompressive surgery or usual nonsurgical care. The primary outcomes were measures of bodily pain and physical function on the Medical Outcomes Study 36-item Short-Form General Health Survey (SF-36) and the modified Oswestry Disability Index at 6 weeks, …

First Successful Autologous Chondrocyte Implantation In Pakistan, Tashfeen Ahmad, Masood Umer, Loay Lubbad, Riaz Hussain Lakdawala, Anwar Ali Siddiqui

Section of Orthopaedic Surgery

Osteochondritis dissecans entails a hyaline cartilage defect of the articular surface causing pain and functional restriction in young adults, sometimes resulting in early degenerative arthritis. Conventional treatment methods such as abrasion chondroplasty and mosaicplasty have limitations in terms of quality of the resultant cartilage and donor site morbidity. A more recent technique, autologous chondrocyte implantation (ACI) results in hyaline cartilage formation and gives good long-term outcome, but requires a high-level cell culture facility and two surgical procedures. The patient was a young female with knee pain, intermittent locking and feeling of "joint mouse". MRI scan and arthroscopy showed a 2 …

Neuronal Regeneration In Denervated Muscle Following Sensory And Muscular Neurotization, Shahryar Noordin, Mahmood Ahmed, Rasham Rehman, Tashfeen Ahmad, Pervaiz Hashmi

Section of Orthopaedic Surgery

Background and Purpose: Neurotization of denervated muscles has been shown to improve muscle bulk, but the neuronal regeneration response has not been compared previously in different surgical techniques of neurotization. Thus, using a rat model of experimental skeletal muscle denervation, we studied neuronal regeneration following sensory neurotization by two methods: sensory nerve to motor branch of muscle and direct sensory nerve implantation to muscle.
Material and Methods: The lateral head of the gas-trocnemius muscle was denervated in 36 rats, of which the first 12 served as denervated controls. In the second group of 12, the sural nerve was anastomozed to …

Understanding The Relationship Between The Diligence Inventory-Higher Education Edition And The Myers-Briggs Type Indicator In The Admission Of College Students To An Orthopaedics-Based Honors Program, Michael A. Harstine

Dissertations

Problem. The Orthopaedic Scholar Institute (OSI) Team realized its need for a more objective selection and admission process that, as much as possible, quantified the characteristics desired in OSI students rather than relying solely on referral perception, intuition, and an interview, but it did not have a clear method or approach to do so. Administering standardized inventories that highlighted these desired characteristics and aided in the selection and admission process seemed to be an objective approach to obtain more quantifiable data. The problem for my study was, therefore, whether the Myers- Briggs Type Inventory (MBTI) alone could measure a student’s …

Bone Stress Injury Of The Ankle In Professional Ballet Dancers Seen On Mri., Ilan Elias, Adam C Zoga, Steven M Raikin, Judith R Peterson, Marcus P Besser, William B Morrison, Mark E Schweitzer

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Ballet dancers have been shown to have a relatively high incidence of stress fractures of the foot and ankle. It was our objective to examine MR imaging patterns of bone marrow edema (BME) in the ankles of high performance professional ballet dancers, to evaluate clinical relevance. METHODS: MR Imaging was performed on 12 ankles of 11 active professional ballet dancers (6 female, 5 male; mean age 24 years, range 19 to 32). Individuals were imaged on a 0.2 T or 1.5 T MRI units. Images were evaluated by two musculoskeletal radiologists and one orthopaedic surgeon in consensus for location …

Developmental Dysplasia Of Hip--Where Do We Stand?, Masood Umer, Haq Nawaz

Department of Surgery

No abstract provided.