Medical Specialties Commons^™

Revisional Arthrodesis Of Tarsometatarsal (Lisfranc) Complex Injury Secondary To Non-Union, Lei Wilson, Randy Semma

Posters

The tarsometatarsal joint and its components provide structural support for the foot. Notably the Lisfranc ligament is a fundamental stabilizer for the midfoot. Injuries to this component are complex and can be debilitating. These injuries require surgical intervention when significant displacement resulting in instability is involved.

Following success of several previous repairs of Lisfranc fractures and dislocations, a treatment algorithm has been proposed. This case report demonstrates the success of the algorithm which has allowed the surgeon to perform reduction and repair in a reproducible, step-wise manner with minimal difficulty to ensure successional revisional arthrodesis of a non-union

Cohort Study Using A Survey To Evaluate The Effects Of Sleep On Hba1c Levels And Foot Pathology In Patients Seen In The Podiatry Clinic, Carmen Johnson, Eric Li, Jihan Toma, Marshall G. Solomon

Posters

We investigate the impacts of sleep issues on patients in the podiatry clinic by comparing HbA1c, sleep, and foot pathology. Diabetic foot pathology of peripheral arterial disease, peripheral neuropathy, lower extremity ulcerations, and a history of lower extremity amputation all increase the patient's risk of future amputation. Once a patient has an amputation of the lower extremity the five-year mortality rates are 40-70%. So, limb salvage not only improves the quality of life, but also increases the life expectancy for patients. Through a survey and chart review, we are investigating possible impacts of sleep issues on diabetic patients seen in …

Septic First Metatarsophalangeal Joint Arthrodesis With Alternative Mini-Rail Fixation, Brenna Barker, Morgan Gascoyne, Randy Semma

Posters

For non-infection cases, first metatarsal phalangeal joint arthrodesis is a definitive procedure for painful, arthritic joints.

Standard fixation methods include screws, plates, staples, or a combination of the three.

For complex septic joint cases, an alternative method of fixation is needed to reduce the risk of infection retention.

The Diagnosis Of Polyarteritis Nodosa In The Setting Of Lower Extremity Lesions: A Case Report, Eric Li, Jihan Toma, George Gopoian

Posters

Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis affecting medium-sized arteries, involving multiple organs, with the most frequently affected tissues being skin and peripheral nerves (1). The distinct pearl neckless pattern led to the naming of this condition (2). Cutaneous polyarteritis nodosa (CPAN) is a variant of PAN confined to the skin, muscles and peripheral nerves in the absence of any systemic involvement (1). This rare form of systemic necrotizing vasculitis is limited to the medium-sized arteries of the skin and has a more favorable prognosis (1). PAN is also linked to Hepatitis B(2). The current diagnostic criteria for CPAN …

Repair Of Achilles Tendon Re-Rupture With Fhl Transfer: A Case Study, Taylor Allison, Joshua Kazdan

Posters

The Achilles tendon consists of the soleus muscle and two heads of the gastrocnemius muscle. Loss of its function can result in loss of plantarflexion strength, which can impact activities of daily living. In a study by Scheller et al, Achilles tendon ruptures were missed on initial evaluation on 25% of their patients. Other studies have reported a similar incidence of misdiagnoses. Patients may also delay treatment due to decreased pain after the initial injury. Ruptures diagnosed 4 weeks from injury are often considered chronic, and many of these patients benefit from surgical repair. A flexor hallucis longus (FHL) transfer …

Antibiotics Vs Surgical Resection In Foot And Ankle Osteomyelitis, Travis Rich, Marshall G. Solomon

Posters

Osteomyelitis, a serious bone infection, is particularly challenging in diabetic patients due to poor vascularization and impaired immune response.1 Timely and effective treatment is essential to prevent severe complications, including limb loss or even death.2 This study aims to evaluate the likelihood of surgical excision or amputation versus antibiotic treatment alone in diabetic patients with bone biopsyconfirmed acute osteomyelitis of the lower extremity.

Clinical Characteristics And Outcomes In Patients With Coronary Artery Aneurysms (Caa) Presenting With Acute Coronary Syndrome (Acs) Or Cardiomyopathy, Advaitha Misra, Mathangi Keshavan, Ersida Zerdelija, Zain Abidi, Alexandra Corrado, James Benke, Hassan Dalloul, Anton Salwan

Posters

Coronary artery aneurysms and ectasia are rare conditions with an incidence estimated at < 1% [1]. It is defined as either a focal or diffuse dilation of a coronary segment of at least one and a half times the adjacent normal segment [2,3].The most common etiology is atherosclerosis, although a variety of other culprits are implicated in its pathogenesis, such as vasculitidies and connective tissue disorders [3,4,5]. Its management is largely driven by the etiology of the coronary artery segment dilation and the presentation of disease at the time of diagnosis. Management strategies employ a judicious combination of medical therapy, percutaneous and surgical interventions. The presence of coronary artery aneurysm or ectasia has been associated with poor long-term outcomes [6,7,8]. Complications from coronary artery aneurysm influence management, largely guided by clinician judgment and limited published data. Given the paucity of evidence in the management of these conditions, we present a case series of three patients with coronary artery aneurysm or ectasia with varying presentations and their corresponding management. We aim to contribute to the growing body of evidence for the management of this elusive cardiac condition.

Seeing Double An Atypical Presentation Of Rcvs, Lauren Kassab, Alexander Ismail, Jonathan Doty

Posters

Reversible cerebral vasoconstriction syndrome (RCVS) is a syndrome characterized by reversible, multifocal narrowing of the cerebral arteries and a thunderclap headache (reaching a peak intensity within one minute). A less severe headache, or lack thereof, is rare (1). Additional neurologic symptoms are typically dependent on the sequelae of focal intracranial stenosis, including ischemia, PRES, and IPH. Common precipitants are cannabis, SSRIs, alcohol, cocaine, and eclampsia. Depending on the inciting cause, presentations can also widely vary over a course of months - years. Diagnosis can be pervasive, as noninvasive vascular imaging has an 80% sensitivity (2). Definitive diagnosis is made with …

Laryngeal Tuberculosis Mimicking Laryngeal Candidiasis, Claire Walters, Maranda Saigh, Eytan Keidar

Posters

Tuberculosis (TB) from the bacterium Mycobacterium tuberculosis and candidiasis from the fungus Candida albicans are both opportunistic pathogens with the ability to instigate infections within the larynx with similar clinical features, yet vastly different diagnostic parameters and treatment regimens.

Here, we highlight a case of an Indian woman on immune-modulating drugs who presented with severe laryngeal symptoms initially presumed to be laryngeal candidiasis but was later discovered to be laryngeal tuberculosis.

Failed Medial Column Fusion Due To Subtalar Joint Instability, Travis Rich, Randy Semma, Michele Bertelle-Semma

Posters

CNA is a destructive complication affecting the bone and joint structure, most often in diabetics w/ longstanding peripheral neuropathy.

High incidence of major amputation associated with Charcot foot.

Stepping Into Relief: Conquering Rheumatoid Arthritic Foot Pain With Podiatric Management, Natalie Diaz, Marshall Solomon, Inocencio Cuesta

Posters

Rheumatoid arthritis (RA) is a chronic multifactorial autoimmune disease that causes progressive joint destruction along with causing cutaneous manifestations such as nodules. RA negatively impacts life by producing pain, impairing quality of life and biomechanical function of the lower extremities.

Kaposi Sarcoma Case Study, Mohamed Elshebiny, Marshall G. Solomon

Posters

No abstract provided.

Jamestown Canyon Virus Meningoencephalitis: A Case Report, Amy Ishbia, Hannah Guide, Matthew Sierra, Jonathan Doty

Posters

Jamestown Canyon virus is a rare mosquito-borne orthobunyavirus that typically is asymptomatic or causes mild symptoms. However, it can rarely cause severe neuroinvasive disease [2,5]. The primary hosts include white-tailed deer, although moose, elk, and bison can also be hosts [2].

Typically, cases are seen between April and September, with a bimodal distribution peaking in spring and late summer [2].

Number of cases in the U.S. in 2024: 16 total cases, 11 neuroinvasive [1]. Number of cases in the U.S. between 2011-2023: 308, with 10 deaths, 206 neuroinvasive. One case was reported from Alpena, MI, where our patient resided [1].

Cd21 Stains Dendritic Networks In Tertiary Lymphoid Structure Of Transplant Renal Biopsies To Avoid Misdiagnosis Of Borderline Changes, Brandon D. Metcalf, Wei Li, Hassan Kanaan, Ping L. Zhang

Posters

Tertiary Lymphoid Structures (TLS) have been described as germinal center-like lymphoid structures composed dendritic network, mixed lymphocytes and high endothelial venules in internal organs following primary lymphoid organs (thymus and spleen) and secondary lymphoid structures (lymph nodes and native lymphoid structures along GI tract).

The TLS is mainly located at peri-glomeruli, peri-vascular areas or renal pelvis following inflammatory insults. A recent study indicates that TLS can been seen up to 19 % of protocol transplant renal biopsies (TRB) (JASN, 2022;33:186-200).

We hypothesize that CD21 staining can identify dendritic cells of TLS so that borderline changes are not over-diagnosed.

Pyogenic Tenosynovitis Of Tibialis Anterior Tendon After Cat Bite, Daniel Blascak, David Sosnoski, Aaron Seidman

Posters

Pyogenic tenosynovitis is a bacterial infection of the synovial sheath that surrounds a tendon.

Commonly occurs within flexor tendons of the hand; theoretically can occur within any sheathed tendon.

Delayed diagnosis may lead to spread of infection to surrounding tissues and tendon rupture.

Tibialis anterior tendon is encased in a synovial sheath that runs from above the superior extensor retinaculum to the talonavicular joint.

Only five cases of pyogenic tenosynovitis of the tibialis anterior tendon have been reported in the literature.

None of the reported cases were due to animal bite injury.

The Role Of Adverse Childhood Events On The Progression Of Chronic Kidney Disease In Children: A Ckid Study, Ana Cortez, Matthew Matheson, John Cowden, Bradley Warady, Darcy K. Weidemann

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There is a paucity of research on the relationship between adverse childhood events (ACEs) and chronic kidney disease. The effect of ACEs on the long-term health outcomes of cardiovascular disease, cancer, and chronic lung disease first emerged in a paper published in 1998. The National Institutes of Health sponsored the ACE Study, which Kaiser Permanente carried out in California. The study used a 17-question survey addressing seven exposures: psychological, physical, contact-sexual abuse, substance abuse, mental illness, mother being treated violently, and criminal behavior in the household. The results revealed a strong relationship between childhood exposure to ACEs and health outcomes. …

Thyroid Dysfunction In Patients Receiving Immune Checkpoint Inhibitors, Emily Metzinger, Jennifer Boyd, Julia Broussard, Christopher Klockau

Posters

Objectives: The use of immune checkpoint inhibitors (ICIs) in cancer treatment is increasing. Literature about endocrinopathies associated with ICIs in children is limited. This study investigates ICIs and thyroid dysfunction in pediatric patients at one institution.

Methods: Retrospective chart review of patients ages 1 to 19 was completed who received any of the following ICIs between January 2000 and November 2023: PD-1 inhibitors (nivolumab or pembrolizumab), PD-L1 inhibitors (durvalumab or atezolizumab), and CTLA-4 inhibitors (ipilimumab or tremelimumab). Patients were excluded if thyroid function tests (TFTs) were not available to review or if patients passed away within 30 days of ICI …

Molecular Characterization Of Kif11 Variants In Familial Exudative Vitreoretinopathy, Konstantinos Koustas, Kenneth P. Mitton, Wendy Dailey, Kimberly A. Drenser

Posters

Pediatric retinal diseases including Familial exudative vitreoretinopathy (FEVR) and Norrie Disease are linked to mutations in Wnt signaling network genes like FZD4, LRP5, TSPAN12, and NDP (see Figure-1). Active Norrin signaling is crucial for the normal growth and proliferation of developing retinal vasculature. Similarly, the absence of KIF11's kinesin activity can hinder the growth and proliferation of retinal vasculature, leading to peripheral avascular neural retina. According to the UniProt database there are about 41 disease causing variants for KIF11, and 17 specifically associated with FEVR. Nextgeneration sequencing was employed to sequence 76 subjects, aiming to identify novel variants to broaden …

The Use Of A Short And User-Friendly Questionnaire As A Screening Tool To Identify Potential Gaps In Nutrition Knowledge Of Adolescent Athletes, Roben Ohev Shalom, David Lick, Virginia E. Uhley

Posters

Nutrition knowledge in adolescent athletes is rarely formally assessed by physicians. Current popular nutrition questionnaires include the CDC’s Youth Risk Behavior Survey (YRBSS) and the Nutrition for Sport Knowledge Questionnaire (NSKQ). These questionnaires are long and are not optimal to assess nutrition knowledge in adolescent athletes at their preparticipation examinations. A systematic review conducted by Tam et al, showed that questionnaires would benefit from interactive and attractive features including images. A novel nutrition questionnaire was adapted from the NSKQ that was user friendly, short in length, electronic and included images. We hypothesized that through collecting physicians feedback on the questionnaire …

Cancer Screening Guidelines In Midwest Adult Correctional Facilities, Stephen Greenwell, Jason Adam Wasserman

Posters

National cancer screening guidelines (CSGs) exist to promote early cancer detection, reducing mortality, morbidity, and cost. The incarcerated population is at increased risk for certain cancers, decreased cancer screening, and barriers to treatment. In this study we investigate how state and federal prison CSGs differ from the National Comprehensive Cancer Network’s (NCCN) CSGs.

Assessing Impact Of Image-Based Immunization Education On Pediatric Vaccine Uptake Within Families Of Low English Literacy, Ahmed Ali, Mariam Bassalious, Sharfaa Chowdhury, Coral Hufnagel, Salwa Bajjey, Amaal Haimout, Nelia Afonso, Raouf Seifeldin

Posters

• Vaccinations have been hailed as the most effective public health strategy in mitigating infectious diseases. Since the advent of vaccines at the end of the 18th century, the incidence, prevalence, and mortality of vaccine-preventable diseases have markedly decreased.
• Vaccine hesitancy has been increasing within the last decade due to various reasons including misinformation and a lack of understanding. 2 This is especially true amongst patients with limited literacy skills as traditional vaccine education material is not optimal for their understanding.
• Several studies across various healthcare disciplines have shown that the use of picture-based health education for patients with limited literacy …

Predictors Of Icu Admission Following Endoscopic Endonasal Skull Base Surgery, Brandon Prentice, Max Dehaan, Adam Folbe

Posters

• Endoscopic Endonasal Skull Base Surgery (EESBS) encompasses a wide range of surgeries; pituitary adenoma resection is the most common of these.
• Patients routinely are admitted to the ICU post-operatively for monitoring of serious complications such as intracerebral hemorrhage and meningitis.
• Some complications such as diabetes insipidus, however, do not require a stay within the ICU and can be managed as an out-patient.
• Besides adding stress and discomfort to the patient, stays in the ICU are costly with one study reporting a cost of $2,902 per day.
• Previous studies identified preoperative hypertension and large tumor volume (>4500 mm3) as risk …

Comparing The Outcomes Of Titanium And Stainless Steel Flexible Nails In Repairing Pediatric Long Bone Fractures, Novelpreet Boparai, Suzan Kamel-Elsayed, Ehab Saleh

Posters

• Traditionally, pediatric femoral fracture treatment favored conservative methods.
• Surgical intervention was deferred until age 6, as non-operative approaches often resulted in complications.
• Titanium elastic nailing (TENS) emerged as an effective treatment for diaphyseal femoral fractures in ages 6 to 16. However, the choice between TENS and stainless steel elastic nailing (SSENS) remains debated due to inconsistent findings.

Public Perception Of Robotic Assisted Total Hip Replacement Surgery, Marvee Espiritu, James E. Feng, Phillip Vartanyan, Drew Moore, Robert Moore, Mark Karadsheh

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• Robotic or technology assisted THA has received significant attention recently due to its precision in acetabular cup placement within the Lewinnek safe zone.1
• Few studies have assessed the public’s perception of robotic-assisted THA.3,4 Insight into patients’ perception of robotic-assisted THA may yield valuable information that may impact further integration of the technology within hospitals and surgeon training.

Morbidity Of Tendon Harvest Site For Acl Autograft; A Systematic Review, Jessi Fore, Betina Hinckel, Elijah Auch

Posters

Primary anterior cruciate ligament (ACL) ruptures are highly common and lead to a significant number of primary ACL reconstruction surgeries in the U.S.1. When choosing a graft, surgeons can pick between auto- and allografts2. An autograft can include a bone-patellar tendon-bone (BPTB) graft, a hamstrings tendon (HT) graft, or a quadriceps tendon (QT) graft2. Currently, there is a wide range of research on graft types, but no paper compares all threes graft types directly. This review will compare literature to determine the morbidity associated with each graft type and determine which autograft is best for primary reconstruction.

Metastatic Osteosarcoma Involving The Skin: A Systematic Review Of Patient Demographics, Clinical Characteristics, And Treatment Outcomes, Sarah Fried, Ameen Suhrawardy, Rafey Rehman, Malik Al-Jamal, Drew Moore, Darius Mehregan

Posters

Skeletal osteosarcomas - most common primary malignant bone tumor1 and commonly metastasize to:

• Lungs (95%)2 •

Other bones (50%)2 •

Kidneys (12%)2 •

Rarely to the skin3

Extraskeletal osteosarcomas (ESOS) – soft tissue tumors that may also metastasize to the skin4,5,6

Value in gathering data on this rare phenomenon:

• Informs biology and dermatologic care of patients suffering from this cancer.

This systematic review characterizes metastatic osteosarcomas involving the skin.

Assessing Patient Preferences For Technology-Assisted Versus Traditional Total Knee Arthroplasty Using A Validated Online Survey Marketplace: Before And After Patient Education, Tanner J. Hafen, James E. Feng, Phillip Vartanyan, Drew Moore, Robert Runner

Posters

• Computer (CA) and robotic (RA) assisted TKA has becoming increasingly prevalent in orthopaedic surgery1,2.
• There is limited insight into the public perception of CA and RA3.

Outcomes Of Primary Acl Repair For Proximal Tears: A Systematic Review And Meta Analysis, Collin Braithwaite, Tanner Hafen, Robert Dean, Joseph Guettler, James Bicos

Posters

The purpose of this study was to determine which primary ACL repair technique resulted in the lowest failure rates postoperatively.

Pediatric Upper Cervical Spine Trauma: A 10-Year Single Center Retrospective Study, Sazid Hasan, Muhammad Waheed, Shahrukh Naseer, Jad G. Khalil, Ehab S. Saleh

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This study seeks to answer whether or not there is a significant association between mechanism of injury and patient age, and to elucidate any notable differences in overall outcomes based on various treatment modalities.

Accuracy Of Ora And Newer Generation Formulas For Iol Power Calculation After Prior Refractive Surgery, Raheel Khan, Mark Rolain

Posters

• Patients with cataracts have cloudiness of the lens that impairs vision.
• It must be replaced with a prosthetic lens however the lens’ refractive power has to be calculated using formulas to predict the kind of lens that will be implanted for best visual outcomes.
• Patients that have had prior refractive surgery of the cornea do not have as good refractive outcomes after cataract surgery.1
• The concern is that there is not a goldstandard formula that can be used for this population to predict the refractive power of the lens that should be implanted.
• Optiwave refractive analysis (ORA) is a new …