Wounds and Injuries Commons^™

Women’S Health Considerations In Traumatic Brain Injury, Sindhoori Nalla

Department of Rehabilitation Medicine Faculty Papers

Purpose of Review: Biological sex differences are an important factor to consider when treating TBI, as there can be a disproportionate manifestation of symptoms and recovery process when comparing females to males. Historically, these differences have not been well studied, and there is still much to be understood as to why these differences exist. Recent Findings: A number of factors are thought to contribute to disparities with women who have a TBI, including lack of well-designed research studies focused on women, hormonal fluctuations at the time of and as a result of a TBI, psychosocial comorbidities, and societal norms/expectations. While …

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.

Stingers—A Review Of Current Understanding And Management, Teleale Gebeyehu, James Harrop, Stavros Matsoukas, Alexander Vaccaro

Department of Neurosurgery Faculty Papers

Abstract: A stinger is the transient sensory and motor loss of one upper extremity caused by a stretch or compression injury to the brachial plexus or the exiting cervical nerve roots. Athletes from contact sports like American football, rugby, wrestling, and horseback riding are most affected. Given today’s competitive athletic culture and recent advancements in sports medicine, understanding the clinical, diagnostic, and therapeutic aspects of stingers is crucial. Thus, this narrative review highlights current knowledge of pathology, clinical features, diagnostic modalities, radiologic measurements, management, rehabilitation, and return-to-play protocols. Recent and prominent English publications on adult athletes revealed that the brachial …

Operating Room Acquired Pressure Injury Prevention, Audrey E. Dillon, Lexi K. Johnston, Grace L. Johnston, Amy N. Cochran

SPARK Symposium Presentations

Our change project focuses on preventing pressure injuries in OR patients using an alternating pressure overlay and gel pad system during surgery and recovery. Pressure injuries cost the healthcare system upwards of $26 billion annually, and surgery patients are at high risk due to prolonged immobility, constant pressure on one area, hemodynamic changes, and excessive moisture. Nurses can play a critical role in reducing healthcare costs and improving patient outcomes by utilizing proper training and outcome tracking. The estimated cost of implementing this system is $37,000, significantly lower than the long-term cost of pressure injuries. Key
stakeholders include nurse managers, …

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 …

High Rate Of Complications With Exchange Nailing For Femoral Nonunions, Benjamin Averkamp, Ziqing Yu, Julia C. Mastracci, Matthew J. Braswell, Andrew T. Chen, Luke A. Lopas, Ishani Sharma, Hassan Farooq, Hassan Mir, Jessica Rivera, Rachel B. Seymour, Joseph R. Hsu, Evidence-Based Musculoskeletal Injury & Trauma Collaborative, Robert D. Zura, Marc Schatz, Et Al

School of Medicine Faculty Publications

Objectives: To evaluate rates of nonunion repair, osseous healing, and outcomes in femoral nonunions with contemporary healing. Design: Retrospective review. Setting: Five academic level 1 trauma centers. Patients/Participants: This study includes adult patients (age older than 18) seen at one of the participating institutions between 2012 and 2019 who sustained a femur fracture (OTA/AO 31, 32, 33) initially treated with intramedullary fixation that developed nonunion and were treated with exchange nailing for the index nonunion surgery. Seventy-nine patients with femoral nonunion met inclusion criteria. Intervention: Exchange nailing for treatment of femoral nonunion. Main Outcome Measurements: The primary outcome measure was …

A Sex Comparison Of Fall And Fracture Occurrence In The Elderly Diabetic Population: A Quantitative Study, Fahamina Ahmed, Kaylin Miller, Meva Beganovic, Ali Siddiqui, Candice Smith

School of Medicine Faculty Publications

AIMS: To assess differences in falls and fractures in men and women with type 2 diabetes mellitus (T2DM) within a diverse population in Southeast Louisiana. METHODS: A list of 1200 patients was generated through an electronic health record system using keywords: diabetic diagnosis, falls, and fractures to conduct this retrospective cohort study. This chart review included adults with T2DM who experienced at least one fall and/or fracture between January 2018 and May 2023 at East Jefferson General Hospital located in Metairie, Louisiana. Only falls and fractures that resulted in a hospital visit were included. Results were compared between males and …

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 …

Pre-Hospital And Post-Hospital Quality Of Care In Traumatic Spinal Column And Cord Injuries In Iran, Arman Zeinaddini-Meymand, Vali Baigi, Mohammad Mehdi Mousavi-Nasab, Sina Shool, Mohsen Sadeghi-Naini, Zahra Azadmanjir, Seyed Behnam Jazayeri, Samuel Berchi Kankam, Mohammad Dashtkoohi, Aidin Shakeri, Esmail Fakharian, Leila Kouchakinejad-Eramsadati, Habibollah Pirnejad, Homayoun Sadeghi-Bazargani, Laleh Bagheri, Yasaman Pourandish, Malihe Amiri, Ahmad Pour-Rashidi, James Harrop, Vafa Rahimi-Movaghar

Department of Neurosurgery Faculty Papers

STUDY DESIGN: A retrospective study.

OBJECTIVES: The quality of care (QoC) for spinal column/cord injury patients is a major health care concern. This study aimed to implement the QoC assessment tool (QoCAT) in the National Spinal Cord/Column Injury Registry of Iran (NSCIR-IR) to define the current state of pre- and post-hospital QoC of individuals with Traumatic Spinal Column and Spinal Cord Injuries (TSC/SCIs).

METHODS: The QoCAT, previously developed by our team to measure the QoC in patients with TSC/SCIs, was implemented in the NSCIR-IR. The pre-hospital QoC was evaluated through a retrospective analysis of NSCIR-IR registry data. Telephone interviews and …

Utilization Of Suprathel® In Delayed Surgical Management Of Toxic Epidermal Necrolysis (Ten): A Case Report, Isabella Lipkin, Michelle Hughes, W. B. Hughes Md

Jefferson Hospital Staff Papers and Presentations

Given the lack of established practice guidelines for the management of cutaneous symptoms associated with toxic epidermal necrolysis, treatments range from various dressings to skin substitutes. The following report details a case of a 21-year-old male patient with this diagnosis who presented nine days after rash eruption from an outside hospital with no signs of healing. The patient was then successfully managed surgically eleven days after symptom onset with debridement of epidermal blisters and placement of Suprathel®. To our knowledge, this publication is the first to describe the potential of this synthetic skin substitute in promoting epidermal regeneration for delayed …

Time To Initiation Of Antiresorptive Agents In Multiple Myeloma To Reduce Skeletal Related Events, Amman Bhasin, Adam Binder, Leland Damron, Amry Majeed, Adam Barsouk, Kelly Hughes, Thomas Jefferson University, Abdullateef O. Abdulkareem, Tingting Zhan, Divya Polu, Sai Gundepalli, Srinivas Devarakonda

Kimmel Cancer Center Faculty Papers

Purpose: Current treatment guidelines strongly support the use of antiresorptive therapy in patients with newly diagnosed multiple myeloma (NDMM) with the goal of preventing skeletal related events (SRE). Despite these concrete, data-driven recommendations, the impact of delays in antiresorptive initiation in NDMM patients is understudied. Through a multicenter retrospective study, we examined the impact of delays in antiresorptive initiation on the rates of SREs. We furthered our exploration of this topic in a separate retrospective analysis with a focus on reasons for delays in antiresorptive therapy initiation. Methods: Electronic health records from two large academic institutions were used to identify …

Rectus Abdominis Repair Compared To Posterior Wall Mesh Reinforcement In Athletes With Sportsman's Hernia: A Systematic Review, Jonathan Mckeeman, Benjamin Johnson, Jessica C. Rivera

School of Medicine Faculty Publications

Athletic pubalgia is a relatively uncommon injury that is not fully understood. There are few high-level studies comparing treatments of athletic pubalgia, and this investigation seeks to utilize original articles to compare two common techniques for treatment of athletic pubalgia. The purpose of this study is to compare two prominent procedures, i.e., rectus abdominus repair and posterior wall reinforcement, through a systematic review. Inclusion/exclusion criteria were identified and then applied to search strategies in PubMed and MEDLINE. Two reviewers screened articles based on the agreed-upon criteria in a primary screen of titles and abstracts and a secondary screen of full-text …

Acute Carpal Tunnel Syndrome Secondary To Handcuffs Necessitating Emergency Orthopedic Consultation And Operative Intervention, Fabian Jano, Kelly Mackenzie, Vivek Biololikar, David Goldberger, Andrei Tuluca

Department of Emergency Medicine Faculty Papers

We present a case of acute carpal tunnel syndrome secondary to tight handcuffs in a detained patient. The severity of the motor and sensory deficits prompted consultation with orthopedic specialists and admission for an observation period with ultimate emergency operative intervention. Handcuff neuropathies are well documented in the literature, mainly involving the superficial branch of the radial nerve, which has strict sensory input into the dorsum of the hand. Less common median nerve neuropathies have also been documented following handcuff injury; however, none have required emergency intervention. We aim to highlight this unusual presentation and the emergency nature of the …

Management Of Hip Fracture Patients On Direct Oral Anticoagulants: A Survey Of Orthopaedic Trauma Surgeons, Systematic Review, And Meta-Analysis, Clay Spitler, Robert Rutz, Nigel Blackwood, Meghan Wally, Joseph Johnson, Peter Krause, Jaimo Ahn, Zuhair Mohammed, Mark Mcclure, Rebecca Billings, Ziqing Yu, Matthew Yeager

School of Medicine Faculty Publications

OBJECTIVES: This systematic review examined the literature regarding management of fracture patients who take direct oral anticoagulant (DOAC) medications, with a focus on delay in surgical treatment, and need for transfusions. In addition, a survey of orthopaedic trauma surgeons was conducted to gain insight on current practices. DATA SOURCES: A review of PubMed, Cochrane, Embase, and Scopus databases was performed from inception through March 2024, including English language publications. STUDY SELECTION: Studies were included if they reported time to surgery and transfusion rates among fracture patents who were taking DOAC medications. Additional data points were collected on an "if-reported" basis, …

From Lost Balance To Leaky Chyle: A Case Report Of Traumatic Chylothorax, Taylor Johnson, Glenn Carlos

South Atlantic Division GME Research Day 2025

No abstract provided.

Hook, Line And Lid: Managing A Fishhook Injury To The Eye, Daniel Tate, Lisa Persaud, Jonathan Leggett

South Atlantic Division GME Research Day 2025

No abstract provided.

Effects Of Rideshare Services On Alcohol Related Motor Vehicle Collision (Mvc) Outcomes, David Bassa, Morgan Johnson, Devika Pavuluri, Michael Truitt

North Texas Research Forum 2025

BACKGROUND: In 2022, The National Highway Traffic Safety Administration (NHTSA) reported over 42,000 motor vehicle collisions (MVCs) deaths with 31% of MVC deaths secondary to alcohol (AR-MVCs). In 2010, rideshare services (RSS) were introduced to the market providing a new method of transportation with the potential to reduce the incidence of driving under the influence (DUI). We analyzed the NHTSA database to evaluate trends in alcohol related MVC deaths (AR-MVC Deaths) since the initiation of ride share services. METHODS: Fatality Analysis Reporting System (FARS) source from the NHTSA was used to obtain data from years 2009 and 2022 from 50 …

Prevention Of Transmetatarsal Amputation In A Diabetic Patient With A Chronic Foot Ulcer Including Osteomyelitis By Minimally Invasive Surgery Floating Lesser Metatarsal Osteotomies In Conjunction With Adipose Injectable Filler, Francois M. Lokenye Dpm, Orlexia Thomas Dpm, Lady Paula Dejesus Dpm, Facfas, Facpm, Dwsp

Posters

Problem: Diabetic foot ulcers (DFUs) complicated by osteomyelitis often result in transmetatarsal amputations, leading to significant morbidity.

Objective: To evaluate a minimally invasive surgical approach combining floating lesser metatarsal osteotomies with adipose injectable filler to prevent transmetatarsal amputation, enhance wound resolution, and improve foot biomechanics

Bucks Traction In The Emergency Departments (Ed) In North Texas Division (Ntxd), Mason Poffenbarger, Neil Werthmann, Cody Beltran, Hannah Affleck, Kristen Payne, Caleb Shin, Hans Drawbert, Hayley Buehler, James Drinan, Sanjay Sharma, Diona Johnson, John T. Riehl, Adam Green

North Texas Research Forum 2025

Implementing Buck’s traction for elderly hip fracture patients in the emergency department (ED) is often inefficient, leading to prolonged setup times, increased staff workload, and delays in patient care, ultimately impacting ED length of stay (LOS). This quality improvement project aims to streamline the process by establishing a standardized storage system for traction equipment, optimizing bed compatibility, developing a clear workflow flowchart, and providing targeted staff training. By improving organization and efficiency, we anticipate a reduction in setup time, enhanced workflow, and decreased ED LOS for hip fracture patients. Measuring pre- and post-intervention times will ensure continuous refinement, ultimately leading …

Lessons Learned: A Multicenter Approach To A Mass-Casualty Incident, Kristen Payne, Elizabeth Kim, Luis Taveras, Morgan Collom, Danielle Pigneri

North Texas Research Forum 2025

Background: On May 6, 2023, an armed gunman opened fire at a shopping mall in Allen, Texas. Eight people including the perpetrator were killed with more injured. Medical City McKinney, a level 2 trauma center received seven patients. Medical City Plano, a level one trauma center received one patient. Medical City Dallas Children’s Hospital, a level three pediatric trauma center received one pediatric patient. Methods: Medical City North Texas Division command center engaged Emergency Department leadership at North Texas facilities to prepare for transfer of patients. Ground transport and an air medic team on standby was staged early on. Nearby …

Traumatic Rupture Of Gall Bladder After Blunt Trauma, Chris Robert, Alicia Lay

North Texas Research Forum 2025

Introduction: Gallbladder injury accounts for less than 1% of the patient presenting with blunt abdominal trauma, due to its protected location in the undersurface of the liver. Case report: A 41-year-old male presented to the emergency department after a motor vehicle collision. Patient was hemodynamically stable; on exam, patient had focal tenderness in the lower abdomen. Initial lab results revealed elevated blood alcohol of 302 mg/dl, elevated lactate of 3.9 mmol/l, a white blood cell count of 6.76 K/mm3, and a hemoglobin of 15.2 g/dl. Patient was pan-scanned as per trauma protocol. A computed tomography scan revealed a mesenteric hematoma …

Incidence Of Allergic Reactions To Cefazolin In Patients With Penicillin Allergy Undergoing Operative Repair Of Pelvis Or Extremity Fracture, Hans Drawbert, Laclan Anderson, Marisa Fat, John Riehl

North Texas Research Forum 2025

Introduction Surgical site infections (SSI) account for 20% of all healthcare associated infections with an estimated yearly cost of $3.3 billion in the US alone (1). Cefazolin (Ancef) is a commonly used prophylactic antibiotic in orthopaedic surgery and has been shown to reduce SSI compared to other antibiotics, but potential cross-reactivity in patients with a penicillin allergy (PA) leads to concerns regarding the safety of cefazolin administration. This study evaluates the incidence of allergic reactions to cefazolin in patients undergoing orthopaedic surgery with a PA. Methods A retrospective cross-sectional database review study was conducted. Patients aged 18 or over who …

Complete Gastric Transection After Blunt Force Trauma, Sydney Parker, Sophia Jimenez, Riley Blanton, Samprit Karra, Alejandro Garcia

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Nfl Kick-Off Rule Change: A Comparative Analysis Of Injury Incidence, Troy Puga, Tanner Haechten, Coleman Cush, Mckenna Box, Hans Drawbert, John Riehl

North Texas Research Forum 2025

Introduction: Kickoffs in the National Football League (NFL) remain one of the most dangerous plays during an NFL game, with high levels of injuries. In 2024, the NFL implemented kickoff rules intended to reduce the number of injuries during this play, and improve player safety. The purpose of this study is to evaluate the effect of the 2024 NFL kickoff rules on the incidence of injuries during the kickoff. Methods Injuries on kickoffs were identified for the 2024, 2023, and 2022 NFL seasons using the transcribed game book for each game on the official NFL website. Injury type was confirmed …

The Major League Baseball Pitch Clock: One Year Position Player Injury Analysis, Troy Puga, Nicholas Scigliano, Mckenna Box, John T. Riehl

North Texas Research Forum 2025

Background In 2023, Major League Baseball (MLB) implemented the pitch clock. The effects of the pitch clock on player injury rates is largely unknown, and some, including the major league baseball players association, have suggested that pitchers may be at an increased risk of injury with its implementation. Position players have received little attention in these discussions, even though they may be at the same theorized risk of injuries. The aim of this study is to determine if implementation of the 2023 MLB pitch clock influenced the incidence of injuries in position players. It is hypothesized that implementation of the …

Retrospective Cross-Sectional Analysis Of Glp-1 Receptor Agonist Effects On Outcomes Of Hemiarthroplasty For Femoral Neck Fractures In Diabetics, Mckenna W. Box, Troy Puga, Neil Werthmann, Yingxian Liu, John T. Riehl

North Texas Research Forum 2025

Introduction: To determine if the use of glucagon-like peptide-1 receptor agonists (GLP-1RA) in type 2 diabetic mellitus (T2DM) patients affects outcomes after hemiarthroplasty for femoral neck fractures (FNFs). Methods: A retrospective cross-sectional analysis of a local hospital system database was performed using Current Procedural Terminology (CPT) and International Classification of Diseases (ICD-10) codes to identify T2DM patients who were at least 18 years of age who underwent hemiarthroplasty (HA) for FNFs and were on a GLP-1RA at the time of injury. A random patient sample of those who underwent HA and were not on a GLP-1RA was used as a …

Lost Work Due To Burn Related Disability In A Us Working Population, Hannan A. Maqsood, Zhaohui Fan, Naveen F. Sangji, Danielle Pigneri

North Texas Research Forum 2025

Introduction: Burn injuries can require hospitalization, operations, and long-term reconstruction. Burn-injured patients can experience short- or long-term disability. We investigated lost workdays (LWDs), short-term disability (STD), and long-term disability (LTD) in the 12-month period following a burn injury. Methods: An observational cohort study was conducted using a commercial claims database, IBM® MarketScan®. Patients aged ≤65 years with an ICD-10 burn diagnosis from 2018 to 2019 were included. The International Classification of Diseases, 10th Revision (ICD-10), procedure and Current Procedural Terminology (CPT) codes were used to identify patients undergoing burn-related operations. Patients were mapped to data tables for LWDs, STD, and …

Leveraging Clinical Standards To Improve The Translational Relevance Of Therapies For Experimental Spinal Cord Injury, Aaron L. Silverstein

Theses and Dissertations--Neuroscience

Efforts to improve treatment of spinal cord injury (SCI) often use animals to develop effective therapeutics, intending to improve the survival and the quality of life of persons with SCI. Over half of all SCIs in the United States occur at the cervical level and often cause locomotor deficits and life-threatening breathing dysfunction. Thus, my dissertation is focused on this important patient population.

After beginning with a description of translational research and surveying SCI from a clinical standpoint, I turned to describe experimental models of cervical SCI and more detailed neuroimmunological findings relevant to my work. Then, I conducted a …

Fabricating Silver-Ceria Polymer Nanocomposite Scaffolds For Biomedical Therapeutic Applications, Shreya S. Pawar

Honors Undergraduate Theses

Improper healing of bone fractures and limited regeneration of bone following bone tumor resection remain a prevalent complication worldwide. Long-term effects of this include joint instability, limited movement, and arthritis. Bone infections (osteomyelitis), reactive oxygen species (ROS) generation via excessive inflammation, and underlying conditions such as osteoporosis can contribute to suboptimal bone tissue regeneration. ROS accumulation stimulates osteoblast apoptosis, while promoting osteoclast differentiation. These processes inhibit mineralization and osteogenesis. Conventional therapeutics involve the utilization of drugs and bone grafts. However, these approaches pose limitations and can result in subsequent complications. Microbial infections, ROS accumulation, and excessive inflammations are factors that …