Anatomy Commons^™

Comparative Analysis Of Antegrade And Retrograde Nailing For Proximal, Shaft, And Distal Femur Fractures, Saahil Noupada

Rowan-Virtua Research Day

Background:

Antegrade and retrograde intramedullary nailing are widely used for femoral fractures, yet their relative advantages across fracture locations remain debated. This study compares union rates, time to union, malunion, and functional outcomes between approaches, stratified by AO/OTA classification.

Methods:

A systematic review of PubMed, Embase, Cochrane Library, Web of Science, and Scopus (2015 to 2025) was performed. Studies reporting outcomes of antegrade and/or retrograde nailing for proximal (31), diaphyseal (32), and distal (33) femoral fractures were included. Data on demographics, fracture classification, fixation method, and outcomes were extracted. Risk of bias was assessed using ROBINS-I. Pooled estimates were calculated …

Early Recurrent Midgut Volvulus Post Ladd's Procedure In A Newborn: A Case Report, Nicole Clarke, Joanna Sajdlowska, John Paul Bustamante, Nishith Bhattacharyya

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Ladd's procedure is the standard surgical intervention for intestinal malrotation. Although generally curative, rare cases of early postoperative complications, including adhesions or recurrent volvulus, can necessitate reoperation. We present the case of a full-term newborn girl who underwent emergent Ladd's procedure on Day 3 of life for malrotation with volvulus. She was discharged on postoperative Day 17 but returned the following day with recurrent bilious emesis. Imaging suggested partial obstruction. Exploratory laparotomy revealed recurrent volvulus with two twists at the duodenojejunal junction, which was successfully reduced. The patient recovered well and was discharged on postoperative Day 8. This case underscores …

The Evolvement Of The 100 Most Cited Articles In Spine Surgery In The Last Decade Compared To All-Time, Mark Miller, Matthew Meade, Ruchir Nanavati, William T Diciurcio, Maneesha Palakurthi, Adam Kohring, Justin Le, Christopher Giuditta, Christopher Kepler, Barrett Woods

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Decision-making in spine surgery is continuously shaped by advancements in the field through evidence-based medicine. This is demonstrated through the evolution of the quality and impact of scientific research within the field of spine surgery. To date, there is limited literature investigating interval changes in methodological rigor of scientific investigation within the field of spine surgery.

METHODS: The top 100 cited articles were recorded for manuscripts from January 1, 2013, to December 31, 2023, and the top 100 most cited manuscripts of all time for spine surgery, via the Scopus abstract and citation database. Data collected included year of …

Establishing The Dose-Response Effect Of Myofascial Release On Muscle Physiology, Sanjana Davuluri, Seth Spicer, Tyler Pigott

Rowan-Virtua Research Day

Context: Osteopathic manipulative treatment (OMT) is often indicated for back pain due to its high tolerability and post-treatment improvement in patients’ self-reported pain and functionality. Specifically, myofascial release (MFR) has been found to yield a significant improvement in both symptoms and quality of life. Until recently, there has not been much data published about the quantifiable effect of MFR and other OMT modalities on muscle physiology, especially taking treatment dose and force into consideration. Therefore, quantifying the changes in muscle characteristics through myotonometry would greatly benefit the field of osteopathic medicine in order to create more personalized treatment plans …

The Relationship Between Running Cadence And Stress Fractures In Competitive Distance Runners, Jason A. Richwall

Rowan-Virtua Research Day

Running is one of the most popular sports and forms of exercise worldwide. Stress fractures are a common and potentially season-ending injury among competitive distance runners, with recurrence rates as high as 22%. Biomechanical factors, including running cadence, have been implicated in injury risk, but their precise role remains an area of active investigation. This literature review examines the relationship between cadence and stress fractures, drawing data from both observational and experimental studies. Observational studies suggest that low cadence and rearfoot striking are associated with increased risk of bone stress injuries. Experimental studies reinforce these findings, demonstrating that increased cadence …

Case Report: A Severe Case Of Post-Operative Ogilvie Syndrome Requiring Surgical Intervention, Aashna A. Chaudhry

Rowan-Virtua Research Day

Ogilvie Syndrome is an acute colonic pseudo-obstruction described as a paralysis of the colon with no real mechanical obstruction. This condition is oftentimes a benign post-surgical complication but can progress in severity if not treated appropriately. This case report presents a unique clinical case in which an adult female patient developed a severe case of Ogilvie syndrome postoperatively requiring surgical intervention.

Association Of Perioperative Factors With Lymph Node Positivity In Bladder Cancer Following Radical Cystectomy, Alyssa Laguerta, Kimberly Toumazos, Virgil Kevin Demario, Vaishnavi Patel, Balaji Reddy, Mark Quiring, Evan Jones, Young Son, Ronald Clearie, Thomas Mueller

Rowan-Virtua Research Day

Introduction and objectives: The treatment of bladder carcinoma relies on a multimodal approach, including chemotherapy, radical cystectomy, and lymph node dissection, but clear guidelines for the optimal strategy remain ambiguous. Radical cystectomy is complex, with high morbidity and mortality, yet limited research has focused on its short-term implications for lymph node-positive bladder cancer. This study aims to address these gaps by identifying perioperative factors linked to lymph node positivity and comparing outcomes between lymph node-positive and negative patients.

Methods: We conducted a retrospective analysis of 4382 bladder cancer patients who underwent radical cystectomy, collecting comprehensive clinical and surgical data. Clinical …

The Use Of Intramedullary Screw For Fixation Of Distal Ulnar Fractures, Adam Lencer, John Pignataro, Justin Le, Joyce Daniel Suarez, Michael Rivlin

Rowan-Virtua Research Day

Background

Distal ulna fractures frequently accompany distal radius fractures but are often underappreciated in both clinical and research contexts. While conservative management is frequently employed, particularly following volar locking plate (VLP) fixation of the radius, certain indications, such as distal radioulnar joint (DRUJ) instability, comminution, or high-energy trauma, may necessitate surgical fixation. This study evaluates patient-reported outcomes among patients with distal radius fractures treated operatively, comparing those with and without concomitant distal ulna fractures, and further stratifying based on the method of ulna fixation.

Methods

This retrospective review included 477 patients treated operatively for distal radius fractures by a single …

Igg4-Related Autoimmune Pancreatitis In Patients With Prior Occupational Exposure: A Case Report And Review Of Risks Concerning Blue-Collared Workers, Zachary A. Coren, Justin Le, Jason Tran, Nicholas Moscardelli, Krish Patel, Joshua Coren

Rowan-Virtua Research Day

Autoimmune pancreatitis (AIP), a manifestation of IgG4-related disease (IgG4-RD), is a rare, often misdiagnosed condition that can closely mimic pancreatic cancer, particularly in its clinical and radiographic presentation. We report the case of a 76-year-old retired plumber who presented with painless jaundice and was initially suspected to have pancreatic cancer based on imaging findings. Subsequent endoscopic evaluation, biopsy, and markedly elevated serum IgG4 levels led to a diagnosis of type 1 AIP. Treatment with corticosteroids resulted in rapid clinical improvement and reduction in IgG4 levels, confirming the diagnosis.

This case highlights the diagnostic challenges of AIP, especially among blue-collar workers …

Is The Vaping Epidemic Linked To Neurologic Changes And Mental Health Diagnoses Amongst Us Adolescents?, Tracy Lin, Victoria Shwe

Rowan-Virtua Research Day

Vaping has significantly increased among U.S. adolescents, driven by the rise of e-cigarettes and flavored pods. Nicotine exposure during brain development is linked to changes in the limbic-dopaminergic system, white matter integrity, and increased risk of emotional and behavioral dysregulation. Higher rates of depression, anxiety, and suicidality are reported among adolescent users, with greater symptom severity seen in those with high vaping dependence. Though studies show correlation rather than causation, findings suggest vaping may contribute to rising mental health diagnoses. Addressing vaping’s neurological and psychological impact is critical to guiding prevention efforts, regulatory policies, and support for at-risk youth.

Autoimmune Encephalitis Presenting As Pseudodementia (Case Report), Renita Ng, Christie Richardson

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Patients with autoimmune encephalitis frequently present with psychiatric symptoms including psychosis, behavioral changes, and affective disorders. Because of this, misdiagnosis of a primary psychiatric disorder in a case of autoimmune encephalitis is not uncommon. We present a case of autoimmune encephalitis in a 72 year old who was initially thought to have psuedodementia or catatonia due to variable collateral who later on LP was found to have markers and responded to steroid treatment. This case highlights the importance of maintaining a broad differential with patients who present with psychiatric alterations and to consider other causes of behavioral change.

Volatile Anesthetic Exposure During Organogenesis (Weeks 6-9): Implications For Fetal Brain Development, Cheryce Daniel, Kylon Coombs

Rowan-Virtua Research Day

Organogenesis, particularly during gestational weeks 6 through 9, represent a critical window for fetal brain development. During this period, neurogenesis, neural tube closure and synaptic organization are actively occurring. Disruption of these processes, especially from exogenous agents, can result in lasting developmental consequences.

The U.S Food and Drug Administration has issued warnings regarding the use of anesthetic agents such as isoflurane, sevoflurane, and desflurane. Noting the potential risk of neurotoxic effects on the developing brain. This warning is particularly highlighted when administered drugs are present for long periods of time or during repeated procedures. The goal of this literature review …

Case Report: A Case Of Tracheal Perforation, Cyrus Davati, Eric Maddock

Rowan-Virtua Research Day

Here we present the case of a 93-year-old female with a past medical history of arthritis and dementia who came to the hospital for a change in mental status and decreased responsiveness at home. The patient was intubated at home by EMS secondary to continued respiratory distress. The patient had a history of a productive cough over the past three days. The patient arrived at the emergency department with continued respiratory failure. During the ED evaluation, the patient was noted to have tracheal rupture. The patient was admitted to the ICU for severe sepsis and continued on broad spectrum IV …

Case Report: Pigtail Suprapubic Catheter Placement In A Patient With Acute Urinary Retention And Abdominal Mesh, Clara Keum, Zamran Masih, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Acute urinary retention (AUR) is a urological emergency that requires immediate bladder decompression and management of the underlying condition to prevent further complications such as urinary tract infection and renal failure. When standard urethral catheterization is not feasible, a suprapubic catheter can be used to achieve adequate bladder drainage. However, in patients with structural or anatomical challenges, such as the presence of surgical mesh, suprapubic catheter placement can be difficult. This case report presents the successful placement of an 8.5 French pigtail catheter and urinary drainage in an 86-year-old male with abdominal mesh who presented with AUR.

Case Report: A Case Of Transient Dress Syndrome (Drug Rash With Eosinophilia And Systemic Symptoms), Dip Patel, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 41-year-old female with a history of hypertension who presented with fever and a diffuse erythematous rash after taking trimethoprim-sulfamethoxazole (TMP-SMX) for an ear infection. Due to her symptoms, mild eosinophilia, and elevated liver function tests, Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) was suspected. Although the patient’s rash had resolved by the time of initial evaluation, it recurred overnight, reinforcing suspicion for DRESS syndrome. TMP-SMX was discontinued, and acetylcysteine was administered due to the patient’s high-dose use of acetaminophen in the days prior to her hospital presentation. Infectious and autoimmune workups were negative. …

Aortic Dissection Triggered By Self Stimulation, Anna M. Delancy, Robin Lahr

Rowan-Virtua Research Day

Aortic dissection is a life-threatening condition requiring immediate diagnosis and intervention. Untreated aortic dissection has a mortality rate of 1-2% per hour. Misdiagnosis occurs in approximately 33.8% of cases, with common symptoms including chest pain, back pain, and syncope. It is important to have a high index of suspicion and utilize appropriate diagnostic tools, such as CT angiography, for prompt diagnosis. Here we describe a rare scenario of a patient with Marfan syndrome ultimately found to have a Stanford A/DeBakey I aortic dissection after a masturbation event. Prompt recognition and treatment of this lethal disease are essential to reduce the …

Case Report: Petersen Hernia, A Rare Cause Of Bowel Ischemia, Brian Lim, Dhara Patel, Adeshola Fakulujo, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 52-year-old female with history Roux-en-Y gastric bypass (RYGB) three years ago prior to presentation to the emergency department (ED) with sudden onset epigastric abdominal pain with radiation into the back of two hours duration. She was diagnosed with bowel ischemia due to internal hernia through a Petersen’s mesenteric defect. A Petersen’s mesenteric defect is one of the three possible internal hernia sites and occurs between the Roux limb mesentery and a defect in the transverse mesocolon.

Abdominal complaints are common in the emergency department with wide differential ranging from benign to emergent with need …

Mitral Kombat: A Case Of Paravalvular Leak And Hemolysis After Tmvr, Isaac Su, Kishan B. Patel

Rowan-Virtua Research Day

A 71-year-old woman with prior TMVR presented with dyspnea, jaundice, and hypoxia. She was found to have severe anemia with lab evidence of mechanical intravascular hemolysis due to a paravalvular leak (PVL), a known TMVR complication. This case highlights the importance of recognizing post-operative complications in valve replacement patients, including PVL-related hemolysis.

Incidence, Risk Factors, And Clinical Outcomes Of Heterotropic Ossification Following Reverse Shoulder Arthroplasty, Adam Friedman, Clarence Clark Ii, Jaylyn Thompson

Rowan-Virtua Research Day

Introduction: Heterotropic ossification (HO) is the pathologic formation of bone in soft tissue, often following trauma or surgery. HO is a common radiographic finding after reverse shoulder arthroplasty (RSA), yet its incidence, risk factors, and clinical significance remains under-explored. Despite the relatively high incidence, the etiology, risk factors, and functional outcomes are not understood.

Methods: This is a literature review to understand the incidence, risk factors, and clinical outcomes of HO following RSA. Pubmed, Embase, and Web of Science were the databases used to review nine peer-reviewed sources. No restrictions were placed on publication date due to the sparsity of …

Mapping Fat Embolism As A Complication Of Liposuction And Fat Grafting: A Systematic Review Of Anatomical And Technical Risk Factors, Jared Garfinkle, Jack Hennen, Wen Luo

Rowan-Virtua Research Day

Fat grafting (FG) and liposuction are widely performed aesthetic procedures with associated fat embolism risks. However, no comprehensive review has specifically mapped the anatomical distribution and technical causes of fat embolism events across these procedures. This review aims to characterize regional and procedural frequencies of fat embolism to inform safer surgical practices. A review was conducted using PubMed, Embase, Scopus, and Cochrane. Included studies were English-language case reports/series, retrospective reviews, and systematic analyses reporting fat embolism following liposuction or FG. Among 227 FG cases, the most frequent regions were the face (n=120), gluteal region (n=91), genitalia (n=9), and chest (n=7). …

Does Sports-Specialization Increase The Risk Of Injury In Youth Athletes?, Kinjal Shah

Rowan-Virtua Research Day

Sports specialization, defined as intensive, year-round training in a single sport for more than eight months per year, has become increasingly prevalent among youth athletes. While it is often pursued with the goal of elite performance, early specialization may increase the risk of both physical injuries and psychological strain. This risk is especially pronounced in individual sports such as swimming and tennis, where early and focused training is frequently encouraged. This study explores the association between early sports specialization and injury risk in young athletes, with the goal of identifying contributing factors and informing prevention strategies. Evidence suggests that while …

Periprosthetic Femur Fractures After Total Hip Arthroplasty: Risk Factors And Management Strategies, Clarence Julian Clark Ii, Adam Friedman, Jaylyn Thompson

Rowan-Virtua Research Day

Background: Periprosthetic femur fractures (PFFs) are increasingly recognized as a significant complication following total hip arthroplasty (THA), particularly as the number of procedures rises. While THA is one of the most successful orthopedic surgeries, PFFs can compromise outcomes and demand complex management.

Objective: To review current literature and identify patient- and implant-related risk factors for PFFs, as well as to summarize effective management strategies guided by classification systems.

Methods: A structured literature review was conducted using PubMed, focusing on articles published in the past 10 years. Eight peer-reviewed studies were selected based on relevance to femoral fractures post-THA. Data on …

The Importance Of How And When In Measuring Epicardial Adipose Tissue, Brian Fardman, Juan Antonio Requena-Ibáñez, Carlos García Santos-Gallego, Anderly José Rodriguez Cordero, Samantha Sartori, Javier Sanz Sanz, Valentin Fuster, Juan José Badimon

Rowan-Virtua Research Day

Epicardial Adipose Tissue (EAT) is drawing increasing attention. As a quantifiable, modifiable, and potentially new cardiovascular therapeutic target, its accurate measurement is particularly relevant. In Cardiac Magnetic Resonance (CMR) different methods can be used to assess EAT burden. We take advantage of CMR-studies of EMPATROPISM trial to assess EAT through three different methods, evaluate the effect of Empagliflozin and look for significant difference in the ability to detect changes in serial measurements. In some settings such as treatment-induced changes or patient follow-up, multi-slice method of EAT evaluation provides higher accuracy to detect significant differences, otherwise unnoticed by single-slice approaches.

The Gut Microbiome And Knee Osteoarthritis: A Review Of Emerging Pathophysiologic Links, Krisha S. Patel, Maduka Gunasinghe, Umer Shah, Kushkumar K. Patel, Zarif Ladak

Rowan-Virtua Research Day

Background

Knee osteoarthritis (OA), a multifactorial degenerative joint disease with growing prevalence in aging and obese populations, leads to disabling pain. Traditionally viewed as mechanically driven, increasing research implicates systemic inflammation and metabolic and neuroimmune modulation. The gut microbiome—an ecosystem of commensal organisms regulating host immune, metabolic, and inflammatory regulation—has emerged as a potential contributor to OA pathogenesis and symptom severity. This review aims to synthesize literature evaluating associations between gut microbiota composition and knee OA, focusing on inflammatory pathways, pain modulation, and emerging therapies.

Methods

A literature search was conducted using PubMed, Embase, Scopus, and Web of Science. Inclusion …

Frequency Modulation Of Deep Brain Stimulation Targeting The Periaqueductal Gray: Effects On Pain Perception And Autonomic Regulation, Jack Hennen, Avneet Chawla, Jared Garfinkle, Wen Hao Luo

Rowan-Virtua Research Day

Introduction:

The periaqueductal gray (PAG) is a midbrain structure, and effective target for deep brain stimulation (DBS), involved in the modulation of a multitude of sensory and autonomic processes. It has distinct functional columnar organization, with each column playing its own role in alteration of the body’s ability to respond to pain and stressful stimuli.

Background:

Research regarding the effects of DBS on the PAG has shown the four main subregions of the PAG: the dorsomedial PAG (dmPAG), dorsolateral PAG (dlPAG), lateral PAG (lPAG), and ventrolateral PAG(vlPAG), produce various physiologic outputs when stimulated. These outputs are region and frequency dependent. …

Effects Of Social Isolation On Cecum Opioid Receptor Expression And Affective Behavior, Jordan Riser, John Tkaczynski, Nicole Shellenbarger, Maya Patel, Daniel Chandler, Daniel Manvich

Rowan-Virtua Research Day

BACKGROUND

Psychological stress can induce gastrointestinal symptoms and exacerbate existing gastrointestinal disorders, indicating an interaction between the central and enteric nervous systems. Central nervous system activation of opioid receptors stimulates sympathetic outflow to the enteric nervous system, delaying motility and reducing gastrointestinal secretions, producing a similar clinical presentation to IBS.

HYPOTHESIS

We hypothesize that social isolation induces anxiety states, disrupting homeostatic noradrenergic activity in the brain and gut, leading to neurophysiological changes in the cecum characterized by altered expression of opioid receptors.

METHODS

Sprague-Dawley rats were housed in either group (control) or socially isolated conditions. Affective behavior was assessed using …

Clinical Outcomes For Patients With Obstructive Shock With Pe In Octogenarians, Nonagenarians, And Centenarians: An Analysis Of The National Inpatient Sample, Tony Elias, Fady Beshara, Daniel Basta, Mena Elmalh, Matthew Ebrahim, Taha Wasim Syed, Olga Sarah, Abdallah Hussein

Rowan-Virtua Research Day

One of the most common causes of obstructive shock is massive pulmonary embolism. I these patients with compounded morbidities and limited filling of the heart we sought to sample databases to analyze the inpatient outcomes of the population.

Left Atrial Appendage Occlusion In Heart Failure Patients: A Nationwide Evaluation Of Clinical Outcomes, Tony Elias, Fady Beshara, Daniel Basta, Mena Elmalh, Matthew Ebrahim, Taha Syed, Olga Sarah, Abdallah Hussein

Rowan-Virtua Research Day

Between 2010-2019 the global risk of atrial fibrillation has risen. Our research sought to explore the database of patients with AF who underwent left atrial appendage occlusion.

Clinical Outcomes For Patients Who Have Hyperlipidemia Who Underwent Mechanical Directed Thrombolysis For Pulmonary Embolism: An Analysis Of The National Inpatient Sample, Tony Elias, Fady Beshara, Daniel Basta, Mena Elmalh, Matthew Ebrahim, Taha Syed, Olga Sarah, Abdallah Hussein

Rowan-Virtua Research Day

Mechanical-directed thrombolysis for PE is a recently established therapy option for patients with sub-massive PE with hemodynamic instability. With limited availability on the impact of superimposed anemia on patients that undergo MDT treatment we sought to look more closely at the inpatient population.

Outcomes Of Octogenarians, Nonagenarians, And Centenarians That Underwent Left Atrial Appendage Occlusion: A Population-Based Study, Tony Elias, Fady Beshara, Daniel Basta, Mena Elmalh, Matthew Ebrahim, Taha Syed, Olga Sarah, Abdallah Hussein

Rowan-Virtua Research Day

An evaluation of that national inpatient sample database to explore the outcomes for patients above the age of seventy who underwent left atrial appendage occlusion.