Wounds and Injuries Commons^™

Mathematical Modeling Of The Combined Effects Of Thermal Burn And Local Irradiation, Quintessa Hay, Rachel Jennings, Amy Creel, Kyle Gaffney, Christina Wagner, Kidist Maxwell, Ginu Unnikrishnan, Tyler Dant

Biology and Medicine Through Mathematics Conference

No abstract provided.

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 …

Case Report: Anaphylaxis-Induced Cardiac Arrest Leading To Multiorgan Failure, Dhruvin Patel, Russell Mordecai, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Anaphylaxis is a severe, life-threatening hypersensitivity reaction that can rapidly progress to cardiovascular collapse and cardiac arrest. Cardiac arrest due to anaphylaxis is uncommon but associated with significant morbidity and mortality. Survivors often face complex critical care courses, including multiorgan dysfunction and challenges in neurologic prognostication following hypoxic-ischemic brain injury.

Facial Skin Discoloration After Topical Silver Sulfadiazine: A Case Report, Hannah Culleny, Philip Carhart, James Espinosa, Neel Parikh, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

Silver sulfadiazine (Silvadene) is a topical antimicrobial commonly used in burn management. Although generally well tolerated, excessive or prolonged application may result in cutaneous pigmentation changes due to silver deposition.

Here we present the case of a a 45-year-old woman who presented with diffuse gray-blue facial discoloration five days after sustaining a minor thermal injury. She had been prescribed topical silver sulfadiazine but applied the medication to her entire face and continued use after wound resolution. Physical examination demonstrated asymptomatic hyperpigmented gray-blue macules confined to areas of application. There were no signs of inflammation or systemic involvement. Discontinuation of the …

When Venom Isn’T The Only Threat: Roseomonas Mucosa Bacteremia Following A Snake Bite, Cyrus Davati, Kishan Patel, James A. Espinosa Md, Alan Lucerna

Rowan-Virtua Research Day

Snake bites in the ED  overall are rare in the United States. While mortality is low due to modern interventions, the sequelae - including tissue necrosis, digit amputation, and subsequent infection  remain a significant concern.  Here we present the case of a  presumptively non-venomous snakebite, which  was associated with R. mucosa bacteremia.

Molten Sugar Burn To The Dorsal Foot: A Case Highlighting Unique Thermal And Adhesive Injury Mechanisms, James Espinosa, Alan A. Lucerna

Rowan-Virtua Research Day

This brief case report emphasizes injury mechanism and anatomic vulnerability rather than burn management, as treatment of deep partial-thickness burns is well established. The clinical value of this case lies in recognizing molten sugar as a uniquely hazardous thermal agent capable of producing deceptively deep injury, particularly when contact occurs on the dorsal foot.

Shopping Cart–Related Injuries In Children: Brief Clinical Review And Public Health Implications, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Shopping cart–related injuries represent a common yet underrecognized mechanism of pediatric trauma. National estimates suggest approximately 24,000 children annually are treated in U.S. emergency departments for shopping cart–related injuries, with falls accounting for the majority of cases. Younger children, particularly those under 5 years of age, are disproportionately affected, and head and facial injuries predominate.

Objective:

To provide a concise clinical and public health review of shopping cart–related pediatric injuries, with emphasis on epidemiology, injury patterns, and opportunities for prevention within emergency department practice.

Methods

Narrative review of national injury surveillance data, prior epidemiologic studies, and consumer safety guidance addressing …

From Confirmation To Guidance: Making The Case For Intraprocedural Pocus As The Next Developmental Step In Ultrasound-Supported Shoulder Reduction A Conceptual Practice Proposal And Research Agenda, James Espinosa

Rowan-Virtua Research Day

Point-of-care ultrasound (POCUS) is well established for the diagnosis of shoulder dislocation and for the confirmation of successful reduction. However, its role during the reduction maneuver itself remains under-described. This conceptual practice proposal argues that intraprocedural POCUS represents the logical next developmental step in ultrasound-supported shoulder reduction. By introducing real-time visualization of humeral head translation during reduction attempts, clinicians may identify ineffective vectors earlier, adjust technique midstream, and potentially reduce repeated attempts or escalation of procedural sedation. This work does not present outcome data but instead proposes a practical framework, workflow model, and research agenda for intraprocedural implementation. Future study …

The Physics And Biology Of High-Risk Falls: Biomechanical Analysis And Physics Assists In Understanding Why The Threshold For High-Risk Was Lowered To 10 Feet, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background: Recent revisions to the National Guideline for the Field Triage of Injured Patients lowered the high-risk fall threshold from >20 feet  to >10 feet for all ages. Guideline changes are multifactorial and typically reflect epidemiologic registry data, injury severity trends, and systems-level performance feedback. However, biomechanical analysis assists in understanding the importance of the change.

Objective: To demonstrate that a 10-foot fall generates sufficient kinetic energy and deceleration forces to exceed structural tolerance thresholds in multiple human tissues, and to show that fundamental physics independently supports the recent trauma protocol change.

Methods: Application of gravitational motion equations (v = …

The Epidemiology Of Sledding Injuries: Clinical Patterns And Public Health Prevention Strategies, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background: Sledding is a widely enjoyed winter recreational activity among children and adolescents. Although commonly perceived as low risk, sledding can result in extremity fractures, head injuries, and collision-related trauma. Emergency Departments frequently encounter sledding injuries during winter months, providing both clinical insight and opportunities for injury prevention counseling. An estimated 20,000–30,000 sledding-related injuries occur annually in the United States, most involving children and adolescents.

Objectives: To describe patterns of sledding injuries presenting to the Emergency Department and highlight practical safety recommendations physicians can communicate to families.

Methods: Conceptual review integrating Emergency Department observational experience with published literature on pediatric …

Investigating Extracellualr Vesicles Role In The Pathogenesis Of Acute Lung Injury, Ruben Manuel Luciano Colunga Biancatelli, Pavel Solopov, Tierney Day, Anca Dobrian, John D. Catravas

Cardiovascular Research Symposium

Background: Extracellular vesicles (EVs) are small lipid-bound particles containing proteins and RNAs, whose role in intercellular communication and signaling is critical for homeostasis or inflammatory responses. Patients with acute lung injury display changes in EVs number, cargo content and signature compared to healthy individuals.

Hypothesis: We have hypothesized that EVs may play a role in the pathogenesis of acute lung, by transferring harmful mediators of inflammation and disrupting recipient cells homeostasis.

Methods: C57BL/6j mice (8-10 weeks old, 25g BW) were intratracheally instilled with 50µL of 5*1010- 11 EVs isolated from Human Lung Microvascular Endothelial cells (HLMVEC) exposed to 1 µg …

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 …

Assessing The Accessibility Of Wound Care Education For Unhoused Individuals Of South Jersey, Marilyn A. Chen, Selma S. Benkhoukha, Allysone Martinez

Rowan-Virtua Research Day

Unhoused individuals face disproportionately high rates of wound-related complications due to environmental exposure, limited access to hygiene facilities, and delayed care. This study assessed the accessibility of wound care for the unhoused population in South Jersey, where approximately 2,607 individuals experience homelessness on any given night. Our research identified significant barriers to wound care access, including transportation limitations, lack of identification documents, absence of a physical mailing address, and language barriers. Data analysis revealed concerning trends: a 24% increase in New Jersey's homeless population in 2024, with Black/African American individuals representing 49% of the homeless population despite comprising only 12% …

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 …

An Unusual Cause Of Sepsis: Capnocytophaga Canimorsus, Capnocytophaga, Christopher Dellmyer, Kishan B. Patel

Rowan-Virtua Research Day

Septic shock can be caused by numerous different pathogens. A few of the more common causes are Streptococcus Pneumoniae, Staphylococcus Aureus, Escherichia Coli, Pseudomonas Aeruginosa, and Candida Albicans. Although these are the pathogens involved in the majority of septic shock cases, it is imperative to take the entire clinical picture into account when treating a patient with septic shock. Here we will discuss a seemingly unimpressive dog bite leading to Capnocytophaga canimorsus bacteremia, septic shock and end organ failure.

Traumatic Cavernous Carotid Fistula Following A Motor Vehicle Accident, Alec Mirchandani

Rowan-Virtua Research Day

Traumatic cavernous carotid fistulas are a rare but serious complication following blunt trauma, such as motor vehicle accidents, where the internal carotid artery is damaged, creating an abnormal connection with the cavernous sinus. This case report describes a 32-year-old female who presented with pulsatile proptosis, conjunctival chemosis, and visual disturbances following a motor vehicle accident. Imaging confirmed the presence of a traumatic cavernous carotid fistula. The patient underwent successful endovascular embolization, resulting in resolution of her symptoms. This report highlights the importance of early diagnosis and timely intervention, particularly through endovascular techniques, as the treatment of choice is to prevent …

A Twist Of Fate: A Case Of Spiral Humerus Fracture After Arm Wrestling, Alec Mirchandani, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Fractures of the humerus are relatively uncommon, with spiral fractures typically resulting from rotational forces. This case report describes a 25-year-old male who sustained a right-sided spiral humerus fracture during an arm-wrestling match. The diagnosis was confirmed through radiographic imaging, and the fracture was successfully managed with closed reduction and posterior long arm splinting. This case highlights the importance of recognizing less common mechanisms of injury, like arm wrestling, in the context of humeral fractures. It also emphasizes the effective non-operative treatment of such fractures in young, healthy individuals.

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 …

A Review Of Sutures And The Prospective Applications Of Nanofiber Technology In Suture Engineering, Hanna Brancaccio, Dominique Hassinger, Vincent Beachley

Rowan-Virtua Research Day

Introduction: Suturing is a method to close surgical or traumatic wounds to promote healing. The ideal suture should have high tensile strength that loses strength at the same rate as the healing tissue gains strength, be easy to handle and form secure knots, induce minimal inflammation, and stretch/recoil according to wound contraction. While there are suture materials available for use in various procedures that fulfill most requirements, no one suture possesses every desirable characteristic, and limitations are still prevalent. Nanofiber geometry has a well-known ability to modulate cell morphology, attachment, gene expression, extracellular matrix production, and macrophage polarization in …

Case Report : Perilunate Fracture After A Fall On An Outstretched Hand, Meghna Kurup, Nicholas Tomasello, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report the case of a 44-year-old male that presented to the emergency department (ED) with a fall on his outstretched hand and was subsequently diagnosed to have a trans-scaphoid perilunate dislocation. He underwent closed reduction of the dislocation in the ED and operative management ten days later. While wrist injuries are common in the ED, it is important to diagnose perilunate and lunate dislocations early as they can often be associated with avascular necrosis, neurological injury and poor functional outcomes if not managed in a timely manner.

Case Report: Heating Pad Usage Leading To Rhabdomyolysis And Acute Kidney Injury, Meghna Kurup, Swet Patel, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report the case of a 26-year-old male with a significant psychiatric and substance use history who came to the emergency department (ED) with deep partial second degree burns to his back subsequent to using a heating pad for unknown periods of time prior to presentation. Rhabdomyolysis and acute kidney injury that occurred in this patient due to his burns. It is important to understand that although beneficial, if heating pads are misused or overused, they can cause injury.

Massive Subcutaneous Hematoma Of The Back In Patient With Neurofibromatosis Type 1, Sriprachodaya Gaddam, Olivia Orris, Leigham Breckenridge, Michael Van Etten

Tower Health Research Day

No abstract provided.

Successful Limb Salvage In A Severe Diabetic Foot Infection: A Case Study Of Aggressive Surgical Intervention And Grafting Technique, Stephanie N. Campbell, Amanda Killeen, Michael Sobolevsky

Research Symposium

Background: Severe necrotizing diabetic foot infections are known to have high morbidity, high amputation risk, and high complication rates. Efforts at preserving the limb require significant surgical efforts and lengthy wound care. This process is more complicated in patients with significant housing instability.

Case Presentation: A 53-year-old male with uncontrolled diabetes (A1c 7.9%), housing insecurity, food insecurity presented with severe necrotizing diabetic foot infection with ascending cellulitis, infectious hemorrhagic bullae, multi-compartment abscesses of the foot and anterior leg. It is known that patients with diabetes are at increased risk of both amputation and surgical interventions than patients without diabetes. This …

Impact Of Diabetes On Fall Related Lower Limb Fractures, Bryce M. Bellon, Daniel Salinas, Patrick De La Torre Shutz, Hunter Butler, Sean Corcoran, Kelsey Baker

Research Symposium

Background: Diabetes is a disorder that affects many Americans, characterized primarily by hyperglycemia due to either insulin resistance or lack of insulin secretion. This condition not only impacts blood sugar levels but also has significant effects on bone health. In diabetes, bone density is often decreased due to reduced osteoblast activity, which is responsible for bone formation, and increased osteoclast activity, which leads to bone resorption. This imbalance accelerates the breakdown of bone. Additionally, diabetics frequently suffer from lower extremity arterial disease (LEAD), which results in poor vascularization of the lower limbs. These factors contribute to an increased risk of …

A Case Of Rhabdomyolysis Complicated By Acute Compartment Syndrome After A Ground-Level Fall, Barbara Malaga-Espinoza, Khairiya Haj-Yahya, Corey Haines

Research Symposium

Introduction: Rhabdomyolysis is the breakdown of skeletal muscle tissue that results in the release of intracellular contents such as myoglobin, CK, and electrolytes into the surrounding interstitium and circulation. Rhabdomyolysis is commonly precipitated by trauma, excessive physical exertion, infection, or drug toxicity. Compartment syndrome can be a complication of severe rhabdomyolysis, characterized by increased pressure in a closed anatomical space which can lead to compromised perfusion and ischemia. Timely identification and early surgical intervention are crucial to improving outcomes. Here we present a case of rhabdomyolysis complicated by acute compartment syndrome of the leg in the setting of prolonged poor …

Use Of Electrical Bone Growth Stimulators In High-Risk Patients Following Spinal Fusion, Soumya Malhotra, Khavir Sharieff

HCA-NSU MD Research Day

Title: Use of Electrical Bone Growth Stimulators in High-Risk Patients Following Spinal Fusion Authors: Soumya Malhotra, BA., MS1 & Khavir Sharieff, DO, MBA2 1Class of 2027, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, FL 2Assistant Professor of Surgery, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Tampa Bay, FLNova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine Objective: This study aimed to elucidate the advantages of EBGSs following high-risk spinal fusions. Background: Pseudarthrosis is a condition where bones fail to fuse after an injury or surgery. It causes significant …

Comparing The Effectiveness Of Hyaluronic Acid And Dextrose Prolotherapy Injections In The Treatment Of Lateral Epicondylitis: A Systematic Review And Meta-Analysis, Sara Ragab, Sami Dakhel, Jonathan Elias, Hesham Abdelfattah

Rowan-Virtua Research Day

Background: Lateral epicondylitis (LE), commonly referred to as tennis elbow, is characterized by micro-tears to the tendon origin that attaches to the outer portion of the elbow, with the extensor carpi radialis brevis being the most commonly affected tendon. It presents most often amongst manual workers and athletes that participate in repetitive movements. Patients may experience burning and aching sensations that can potentially radiate down to the wrist. Hyaluronic acid is a primary component of synovial fluid and has anti-inflammatory properties and also provides lubrication to joints. Prolotherapy involves injection of an irritant, most commonly dextrose, into the common extensor …