Musculoskeletal System Commons^™

Selective Retention Of Birdshot Pellets In The Rearfoot: A Case Demonstrating Tissue Preservation And Functional Recovery, Yasim Zafar, Steven Bolton, Alexandria Armstrong, Hooman Mir

School of Podiatric Medicine - Student Research

Level of Evidence: III (Case Study)

Statement of Purpose: Gunshot wounds to the foot pose a unique surgical dilemma—whether to pursue aggressive foreign body removal or to preserve soft tissue integrity. This case highlights the management of a birdshot injury to the rearfoot where selective non-removal of pellets near the neurovascular bundle led to complete healing and full functional recovery. The purpose is to emphasize tissue preservation over aggressive exploration in complex ballistic foot injuries.

Case Study: A 26-year-old female sustained a birdshot gunshot wound to the right rearfoot. Multiple small entry wounds were noted on the posterior and plantar …

Soft Tissue Envelope Compromise Following Low-Side Motorcycle Accident: A Case Study And Literature Review, Steven A. Bolton, Ali Ahmad, Jonathan Rodriguez, Hooman Mir

School of Podiatric Medicine - Student Research

Purpose: This case report details a staged approach in managing a patient who presented to the ER with a displaced proximal second phalanx fracture, extensive soft tissue damage, and diffuse fracture blistering following a motorcycle crash. This case highlights that soft tissue damage may not always correlate with severe osseous injury.

Methodology: This case is a concurrent chart review of a 40-year-old who sustained a low side motorcycle injury resulting in a minimally displaced avulsion fracture of the medial 2nd toe proximal phalanx base with extensive soft tissue damage, fracture blisters, and lower extremity edema.

Procedures: Radiographic evaluation demonstrated no …

Corticobasal Syndrome With Mixed Pathology In The Absence Of Grn Mutation: A Clinico-Pathological Case Of Ftld-Tdp With Coexisting Alzheimer’S And Lewy Body Pathology, Hugo Zamarron, David Irwin, Jeffery Phillips, Edward Lee, Matthew Tisdall, Corey Mcmillan

Research Colloquium

Background: Corticobasal syndrome (CBS) is a neurodegenerative disorder characterized by often asymmetric fronto-pariteal and extra-pyramidal features that is traditionally associated with tauopathy, but pathological findings are heterogenous, including other forms of frontotemporal lobar degeneration (FTLD) and mixed pathologies of aging. We present clinical, radiographic, and histopathologic features of asymmetry in a unique patient with CBS and underlying FTLD with TDP-43 pathology (FTLD-TDP), co-occurring with other age-related pathologies.

Case Presentation: A 76-year-old man presented with progressive cognitive and motor dysfunction including asymmetric parkinsonism, left-sided dystonia and rigidity, apraxia, visuospatial impairment, and a subtle social disorder including apathy and social withdrawal. The …

When Creatine Kinase Soars: A Case Of Viral Myositis In The Absence Of Rhabdomyolysis, Jose J. Loayza Pintado, Jorge Aboytes Trevino, Andres Suarez Parraga

Research Symposium

Background: Myositis is muscle inflammation commonly causing symmetrical pain, especially in the proximal muscles, often triggered by viral infections. Epstein-Barr Virus (EBV), a human-exclusive virus, is linked to acute viral myositis (AVM). Typically, AVM presents with sudden bilateral muscle pain and systemic symptoms like fever, nausea, and vomiting, occurring after a recent respiratory or gastrointestinal infection. Diagnosis involves measuring creatine kinase (CK) levels, liver function tests, and viral studies. While viral myositis is self-limiting and generally resolves within two weeks with supportive care, complications like rhabdomyolysis can occur. We present a case of EBV-induced viral myositis with significantly elevated CK …

Staged Reconstruction And Salvage Of 5th Finger With Corticocancellous Distal Radius Autograft: A Case Report, Emmanuel Franco, Zayd Ayas, Frank Gerold

Research Symposium

Background: Finger reconstruction in the aftermath of severe trauma poses significant challenges in restorative surgery, particularly when addressing extensive soft tissue damage, comminuted fractures, and simultaneous neurovascular complications. This study presents a case of a patient with a complicated distal phalangeal fracture that pursued digit salvage.

Case Presentation: Patient is a 31-year-old woman who sustained a severe injury to her right 5th digit during an ATV rollover. The trauma resulted in an exposed and comminuted fracture of the proximal phalanx with associated loss of soft tissues, flexor tendon, radial nerve injury, and vascular compromise. She elected to pursue digit salvage …

Vertebral Morphology Of Loeys-Dietz Spine, Myung-Jin Cha, William Elnemer, Paul D. Sponseller

Research Colloquium

Introduction: Understanding pedicle and laminar anatomy is crucial for secure fixation of spinal instrumentation and to ultimately prevent complications such as pseudoarthrosis. This study explores the spinal morphology in the LD vertebrae and compares it to vertebrae of TDP.

Methods: The morphology of 36 vertebrae from T1 to L5 were measured in 4 LD syndrome patients, using MRI and CT scans. The morphology of 140 vertebrae from T1 to L5 were measured in non-connective tissue disorder patients, using MRI, CT, and X-rays. These values were then compared to each other. Comparisons via paired Student’s t-test were made between the concave …

Upper Extremity Neurologic Injury Following Surgery For Early-Onset Scoliosis, Myung-Jin Cha, Daniel Badin, Paul D. Sponseller

Research Colloquium

Introduction: In our study, we aim to characterize the incidence, risk factors, and outcome for and outcomes of upper extremity (UE) neurologic injury following operations for patients with early onset scoliosis (EOS).

Methods:EOS patients who underwent surgical correction of their scoliosis were selected from a multicenter database. The patient cohort was then analyzed in their demographics, etiology of scoliosis, details of the injury, type of spinal implant, and changes in cobb angle and kyphosis. Descriptive statistics were used to summarize this cohort of patients.

Results: Out of 4653 EOS patients who underwent surgery in the multicenter database, 10 patients …

Surgically Relevant Anatomy Of Marfan Spinal Deformity, Myung-Jin Cha, William Elnemer, Paul D. Sponseller

Research Colloquium

Introduction: Understanding pedicle and laminar anatomy is crucial for secure fixation of spinal instrumentation. This study explores the spinal morphology in the Marfan vertebrae and compares it to vertebrae of TDP.

Methods: The morphology of 134 vertebrae from T1 to L5 were measured in 16 Marfan patients with spine deformity, using MRI and CT scans. The morphology of 140 vertebrae from T1 to L5 were measured in TDP, using MRI, CT, and X-rays. These values were then compared to each other. Comparisons via paired Student’s t-test were made between the concave and convex side of the curve.

Results: On average, …

Variation In Functional Pelvic Tilt In Patients Undergoing Total Hip Arthroplasty With Acetabular Dysplasia, Myung-Jin Cha, Joel Wells, Yin Xi, Avneesh Chhabra

Research Colloquium

Purpose: It is important to clarify the link between acetabular dysplasia and pelvic tilt to optimize surgical planning and postoperative outcomes. We sought to investigate functional pelvic tilt in patients undergoing total hip arthroplasty with acetabular dysplasia.

Materials & Methods: From 2014 to 2020, pre-operative AP Pelvis X-rays, CT scans, and other patient-specific data such as pelvic tilt, lumbar lordotic angle, etc were collected as part of surgical planning for total hip arthroplasty. From this database, we investigated 678 female patients under the age of 50 that had undergone preoperative standing AP pelvis X-rays. Analysis was performed by investigating how …

Characterization Of Epithelial Growth Factor Transcripts Identified In Crotalus Atrox Venom, Ivan Lopez, Ying Jia

Research Symposium

Epithelial Growth Factor (EGF) is the primary source in regeneration and stimulation of essential fibroblasts cells commonly found in epithelium. Studies have shown that snake venom components are becoming a growing factor in treating illnesses such as cancer, muscular dystrophy, chronic pain, blood pressure, blood clotting, etc. EGF in human cells contains a promising quaternary structure that can bind to snake venom metalloproteinases, proposing a means of activating biochemical responses through protein-protein interactions to regulate unwanted cellular functions. This supports promising research in achieving a greater understanding of regulation along cellular pathways through ligands, increasing the likelihood of targeting unwanted …

Changes In Severity Of Pelvic Floor Dysfunction After Hip Surgery, Amisha Mehta, Joel E. Wells, Sonia Wadekar, Taylor Price, Donald Kasitinon

Research Symposium

Introduction: Despite growing evidence that suggests an association between hip pathology and pelvic floor disorder (PFD), the comprehensive effects of hip surgery on PFD symptoms are not well understood. The primary purpose of this study was to report the role of surgical hip procedures on the severity of PFD symptoms.

Methods: A prospective database of demographic and outcome data for all female patients that were operated on between 2019-2020 at a single institution was queried. The PDFI-20 was used to assess symptom severity, and cases with both pre and postoperative surveys were included (n=62). MCID was used to determine significance …

The Morbidity Of Greater Trochanteric Pain Syndrome Is Similar To That Of Pre-Tha Hip Osteoarthritis, Sonia Wadekar, Avneesh Chhabra, Emily Middleton, Yin Xi, Joel Wells

MEDI 9331 Scholarly Activities Clinical Years

Aims: We sought to characterize the morbidity upon presentation of GTPS and compared it to patients with end-stage, hip osteoarthritis (OA) awaiting total hip arthroplasty (THA). We hypothesize that patients with GTPS will have similar or worse morbidity than hip OA patients.

Methods: This retrospective case-control study examined patient reported outcomes measures (PROMs) on activity limitations, quality of life, pain, and level of disability, in 156 GTPS patients (193 hips) and 300 pre-THA hip OA patients (326 hips). All patients presented at a single academic medical center. Patients with secondary hip conditions or previous hip surgeries were excluded from the …