Medical Specialties Commons^™

Open Fractures: A Review, Alex Telis

UNM Orthopaedic Research Journal

Open fractures occur most commonly in men aged more than 50 years, which may result in lifetime costs for patients and healthcare systems. In the past 5 years, high-quality evidence for direct treatment of these fractures has increased. The expedient administration of intravenous antibiotics continues to be one of the most predictive factors of infection prevention. Open fractures are complicated injuries to classify owing to multiple factors that will be reviewed in the current study: severity of fracture and soft-tissue injury, thoroughness of debridement, time to initial treatment, modality of antibiotic delivery, and timing of definitive fracture fixation and soft-tissue …

Correlating Patient-Specific Anthropometric Variables With Soft-Tissue Thickness At The Superolateral Arthrocentesis Entry Site To The Knee, Savannah P. Krebsbach, Tony G. Pedri, Paul J. Johnson, Christina G. Kurnik, Gehron P. Treme

UNM Orthopaedic Research Journal

Background: Irrigation for treating septic joints in adults in the emergency department is possible but requires the development of novel systems that fit all body habitus. However, varying body habitus and age of patients may affect the amount of soft tissue surrounding the knee joint capsule. We examined whether the dimensions of the soft-tissue thickness at the superolateral approach of entry to the arthrocentesis site correlated with patient anthropometric data such as age, sex, height, weight, and body mass index (BMI, kg/m2).

Methods: Using the diagnosis code 844.2 (International Classification of Diseases, Ninth Revision), we reviewed findings of magnetic resonance …

Patterns In Bone Drilling Performance Before And After The 2017 Motors Skills Course Of The Southwest Orthopaedic Trauma Association, Naghmeh Zamani, Bill Lou, Ashkan Pourkand, Christina Salas, Deana Mercer, David I. Grow

UNM Orthopaedic Research Journal

Background: Although experience within the operating room can help surgeons learn simple bone-drilling techniques, outside training may be better suited for complex procedures. We adapted a rotary handpiece to evaluate bone drilling skills of orthopaedic resident physicians during the 2017 motor skills course of the Southwest Orthopaedic Trauma Association (SWOTA).

Methods: A total of 25 postgraduate year-one orthopaedic residents from seven institutions were asked to perform a bicortical drilling task three times before and after attending a motor skills course. Kinetic and kinematic data were collected using force, acceleration, and visual sensors.

Results: A total of 16 parameters were measured. …

Pelvic Ring Emergency Stabilization System (Press), Christina Salas, Thomas R. Howdieshell, Rachel Tufaro, Lauren Long, Ava K. Mauser, Aneesha Kondapi, Sherif H. Aboubakr

UNM Orthopaedic Research Journal

Pelvic ring fractures can be lethal owing to the potential for hemodynamic instability or arterial hemorrhage when the pelvic volume is increased. Pelvic binders are the standard of care used to provide circumferential compression to the pelvis, reducing the volume and increasing the intra-pelvic pressure. While commercially available options have been shown to provide adequate stability to the unstable pelvis, the circumferential nature of the binders limits access to the abdomen and groin regions, where accessibility is often necessary during the course of emergency treatment. We introduce a new technology known as the Pelvic Ring Emergency Stabilization System (PRESS). The …

Comparison Of Techniques Used For Application Of Hip Spica Cast To Treat Femoral Shaft Fractures In Children: Long-Term Follow-Up, Selina R. Silva, Elizabeth A. Szalay, Charlotte E. Orr, Brielle Payne Plost, Geneva Tranchida

UNM Orthopaedic Research Journal

After treatment using hip spica casts, femoral shaft fractures in children can appear well reduced in the operating room. However, the resulting bone length may quickly angulate or shorten. We describe a technique that places a well-molded hip spica cast to help decrease the risk of revision procedures and malunited fractures. We compared results of patients aged 1 to 6 years treated by one pediatric orthopaedic surgeon using the casting technique described (Group A, n = 25) to those treated by other orthopaedic surgeons who did not use the technique (Group B, n = 46). Although not statistically significant, results …

Subperiosteal Abscess Of The Distal Radius In A 13-Year-Old Boy: A Case Report, Anastasiya K. Haponyuk, Deana M. Mercer

UNM Orthopaedic Research Journal

Children and adolescents have the tendency to develop osteomyelitis in metaphyseal sinusoids because turbulent blood flow increases the probability of bacterial growth. Osteomyelitis in children is frequently misdiagnosed owing to lack of symptoms and specific findings from laboratory tests. Without rapid antibiotic treatment of osteomyelitis, complications such as subperiosteal abscesses may occur. We describe a 13-year-old boy who underwent irrigation and debridement to treat a subperiosteal abscess of the right distal radius and ulna, caused by acute osteomyelitis. After debridement, the patient was placed on a continuous 6-week course of nafcillin infusion through a peripherally inserted central catheter (PICC). The …

Rhabdomyolysis Of The Abdominal Wall In A 23-Year-Old Football Player: A Case Report, Brandon J. Hockenberry, Christopher A. Mcgrew, Shane P. Cass, James P. Toldi

UNM Orthopaedic Research Journal

Rhabdomyolysis is a syndrome caused by injury to skeletal muscle, which results in leakage of large quantities of potentially toxic intracellular contents into plasma. Causes include direct trauma, drug use, genetic muscle diseases, hyperthermia, seizures, ischemia, and severe exertion. We describe a rare case of exercise related rhabdomyolysis of the abdominal wall in a 23-year-old football player. He presented with painless hematuria after starting a new abdominal workout routine to lose weight. Although the workout was not excessively strenuous, it involved new exercises targeting a poorly trained muscle group. Results of initial workup indicated severely elevated levels of creatine kinase. …

Suspected Propofol-Related Infusion Syndrome After Lumbar Spinal Fusion With Total Intravenous Anesthesia: A Case Report, Tony G. Pedri, Matthew G. Wharton, Andrew J. Paterson

UNM Orthopaedic Research Journal

Propofol-related infusion syndrome (PRIS) is a welldocumented yet rare complication of prolonged infusions of propofol. It is characterized by a myriad of metabolic abnormalities, including cardiac arrhythmias, rhabdomyolysis, acute kidney injury, metabolic acidosis, and other disturbances. First described in children receiving extended propofol infusions to maintain sedation while in the intensive care unit, PRIS has now been described in every age group. It typically results in death. Management of this potentially devastating complication involves supportive treatment of the metabolic problems encountered and discontinuing the use of propofol. We describe a patient with suspected PRIS who underwent a two-stage lumbar spine …

Cutaneous Manifestations In The Fingertips After A Supracondylar Humerus Fracture In A 6-Year-Old Girl: A Case Report, Dan M. Quan, Kristin M. Loker, Lauren Mercer, David M. Bennett, Deana M. Mercer

UNM Orthopaedic Research Journal

A 6-year-old girl jumped from a swing and fell on her left arm, presenting to our clinic with a supracondylar fracture of the distal humerus. The child underwent closed reduction and percutaneous pinning. At 3-week follow-up, anterior interosseous nerve palsy was noted with concurrent manifestations in the median nerve distribution. Our patient was treated nonoperatively; at 8-week follow-up spontaneous resolution of cutaneous and motor symptoms was observed. Healthcare professionals should be aware that cutaneous lesions may develop after injury to the median nerve of the proximal forearm, which can result from supracondylar humerus fractures.

Posttraumatic Radioulnar Synostosis In A 63-Year-Old Man With Isolated, Non-Displaced Ulna Shaft Fracture: A Case Report, Audrey A. Rich, Deaba M. Mercer

UNM Orthopaedic Research Journal

Radioulnar synostosis in adults is a rare pathological fusion of the two forearm bones. When seen in adults, it is an uncommon complication after a minimally displaced ulnar fracture. We describe a 63-year-old man who presented with radioulnar synostosis after closed treatment of a left ulna midshaft fracture sustained 7 months earlier. At 10 weeks after presentation, the patient underwent radioulnar synostosis excision with nonsteroidal adjuvant therapy. At 18 months postoperatively, no pain was noted, with complete degree of flexion. Healthcare professionals should consider treating radioulnar synostosis with an operative excision in adults as initial management when forearm pronosupination is …

Radiographic Features And Remodeling Of Proximal Radius Osteomyelitis In A 14-Month-Old Child With Long-Term Follow-Up: A Case Report, Christopher L. Shultz, Deana M. Mercer

UNM Orthopaedic Research Journal

Pediatric primary hematogenous osteomyelitis is uncommon. Studies have been mainly small case series with limited clinical and radiographic followup. We present a child with primary hematogenous osteomyelitis and osteolysis of the proximal radius. Inflammatory laboratory values were normal, and blood and elbow aspirate cultures were negative for osteomyelitis. Diagnosis was made by findings of magnetic resonance imaging. The patient was successfully treated with intravenous antibiotics. At 4-year follow-up, she had normal range of motion and near symmetric proximal radial morphological features radiographically. To our knowledge, this is the most long-term radiographic follow-up of a patient with spontaneous osteomyelitis. The reported …

Open Reduction And Internal Fixation For Treating Pertrochanteric Femoral Fracture Below A Hip-Resurfacing Implant In A 65-Year-Old Man: A Case Report, Alex Telis, Christopher R. Hanosh

UNM Orthopaedic Research Journal

Periprosthetic proximal and pertrochanteric femur fractures around a well fixed hip resurfacing implant present a challenge to orthopaedic surgeons, as they do not allow the most biomechanically favorable fixation constructs in patients with otherwise highdemand levels of physical activity. A 65-year-old man hit a tree while skiing. He presented to our emergency department with a right-sided pertrochanteric fracture of the proximal femur beneath an implant used in prior hip resurfacing. The patient underwent open reduction and internal fixation with intraoperative fluoroscopyassisted manipulation to ensure fixation of the hip resurfacing. At 6-week follow-up, a slight varus collapse at the fracture was …

Recurrent Trigger Finger In The Early Postoperative Period: A Case Report, Kavita T. Vakharia, Moheb S. Moneim

UNM Orthopaedic Research Journal

Postoperative complications of trigger finger, a type of tendon entrapment, are low, and there is little information regarding evaluation after a complication occurs. Recurrent trigger finger is a rare occurrence, but often requires additional procedures to relieve symptoms. Here we present a case of recurrent trigger finger in the immediate postoperative period after the patient developed a cyst distal to the A1 pulley and synovitis. The first procedure demonstrated a thickened and tight A1 pulley as well as synovitis around the tendon. The patient developed continued clicking and trigger symptoms distal to the A1 pulley at the level of the …

Delayed Below-Knee Amputation For Treating Open Pantalar Dislocation With Extruded Talus: A Case Report, Jory Wasserburger, Andrew W. Parsons, Jessica C. Mcmichael, Richard A. Miller

UNM Orthopaedic Research Journal

Pantalar dislocation occurs when the talus is dislocated from the ankle, subtalar, and talonavicular joints. An extruded talus is seen when the talus protrudes out of an open wound with little or no soft-tissue attachment. We describe a 62-year-old man who underwent debridement and irrigation for treatment of a pantalar dislocation with an extruded talus. About 1 year postoperatively, he underwent a below-knee amputation. This case highlights the difficulties and complications associated with this injury.

Orthopaedic-Based Treatment Of Laurin- Sandrow Syndrome In A 13-Month-Old Child: A Case Report, Marcella R. Woiczik, John C. Carey, David M. Bennett, Brielle Payne Plost

UNM Orthopaedic Research Journal

Laurin-Sandrow syndrome (LSS) is a rare condition with only a few published cases in studies. This syndrome, originally described by Laurin in 1964 and again by Sandrow in 1970, can involve digit duplication with mirror hand and foot deformity, ulnar and tibial dimelia, and abnormalities of the knee, ankle, and nasal passages. A 7-month-old male infant presented to our clinic with limited function of his hands and feet due to multiple abnormalities. Results of clinical and radiographic examinations were suggestive of LSS, confirmed by a geneticist. Amputations through the knees, reconstructive pollicization of the right hand, and surgical removal of …

Acute Gluteus Medius And Minimus Intramuscular Tear In A 59-Year-Old Half-Marathon Runner: A Case Report, Claire E. Zeorlin, Eric R. Reynolds, Dustin L. Richter, Christopher A. Mcgrew

UNM Orthopaedic Research Journal

Acute gluteus medius and minimus tears are an infrequent and possibly underdiagnosed cause of lateral hip pain. When reported, they most commonly occur at the distal tendinous attachment at the insertion on the greater trochanter or at the musculotendinous junction. It is rare for muscle belly or proximal muscle tears to occur. They are more prevalent in the setting of degenerative joint disease, but cases have also been described in previously healthy athletes without preexisting joint or muscle disease. We describe a 59-year-old man who developed considerable pain and swelling on the left side of the hip during a halfmarathon …

Hosting Two Programs Of The Perry Initiative In Albuquerque: Inspiring New Generations Of Women Engineers And Orthopaedists, Sahar Freedman, Deana M. Mercer, Christina Salas

UNM Orthopaedic Research Journal

No abstract provided.

The Impact Of An Educational Intervention To Enhance Self-Management In Type 2 Diabetes Patients, Demetria Bates

Doctoral Dissertations and Scholarly Projects

Type 2 diabetes mellitus is a chronic health condition that requires patients to be engaged in their health care. Knowledge of the disease and self-management skills are key components to improving health and outcomes in diabetes patients. Due to the lack of self-management skills, diabetes patients are at risk for diabetes-related health complications. Hemoglobin A1c is a measure that demonstrates the average blood glucose level, which is an indicator of diabetes control. Medical treatments and education are continuously improving and readily for type 2 diabetes. The purpose of this project was to enhance knowledge and self-management skills among chronic care …

Anxiety Reduction Among Washington County Jail Inmates: A Community Service Project, Tyler J. Back, Laura Bakke, Daniel Cuppy

All Electronic Theses and Dissertations

The general principle of anxiety has been thoroughly studied in many populations and shown to have variable underlying etiology, partially related to abnormalities in brain chemistry as well as unfamiliar or uncomfortable social situations. The role of environmental factors pertaining to anxiety is the particular interest of this community service project, to which the research team and the staff of the Washington County Jail have focused the efforts of this community service project in improving and reducing anxiety levels among Washington County Jail inmates.The research team and the staff of the Washington County Jail identified the use of pharmacologic agents …

The Prevalence Of Cigarette Smoking Among Registered Nurses And Certified Nursing Assistants, Ana R. Brown, Taylor Paulson, Kathryn A. Peterson

All Electronic Theses and Dissertations

Cigarette smoking is a dangerous addiction that affects over 45 million Americans. Smoking has been proven to cause a variety of diseases that result in about 480,000 U. S. deaths per year. Healthcare workers have the ability and responsibility to assist patients in smoking cessation; however, a significant number of healthcare workers also participate in cigarette smoking. Studies have shown that healthcare workers with higher levels of education are less likely to smoke; physicians are less likely to smoke than registered nurses, who are less likely to smoke than licensed practical nurses. There is a lack of research done on …

Physician Assisted Suicide: Attitudes Of The Minnesota General Population, Jennifer M. Bretscher, Tammy J. Estrem

All Electronic Theses and Dissertations

Having the choice to hasten death via physician assisted suicide (PAS) is becoming increasingly more popular in the United States. The majority of states do not yet have laws that legalize PAS, but many, including Minnesota, are currently entertaining legislation to allow PAS as an end-of-life option if a person is over the age of 18 and has a terminal illness with only six months to live. To date, little research has been done to evaluate the attitudes about PAS in the Minnesota general population. The goal of this study was to determine whether demographics, namely, age, gender, educational level, …

Personal Health Habits Of Pas And The Effect These Habits Have On Preventive Health Counseling Practices, Emily A. Carstens, Megan L. Englund

All Electronic Theses and Dissertations

Chronic disease is the leading cause of morbidity and mortality in the United States. The burden of chronic disease can be largely prevented by following a healthy lifestyle. Individuals often receive their knowledge about preventive health recommendations from their primary care provider, and healthcare providers are more likely to counsel patients about the healthful behaviors they themselves practice. This study utilized a survey distributed to the Wisconsin Academy of Physician Assistants to assess the personal health habits of physician assistants and the effect personal health has on preventive health counseling practices. A personal health score and counseling score were calculated …

A Community Outreach Project Assisting Evergreen Elementary School With Students’ Nutritional Needs, Robin C. Erickson, Nicole Roach, Megan Smith

All Electronic Theses and Dissertations

Nine months out of the year, students within the United States attend elementary school to be educated on English, mathematics, history, and other topics. The Anoka- Hennepin School District’s philosophy of an elementary education highlights many important factors for success in school but neglects to highlight nutrition as one of the factors. The purpose of our community outreach project is aimed at reducing the stress of hunger for the students at Evergreen Elementary School (EES) by implementing a food drive. Through the food drive, the project team members were able to collect various donations including food, clothing items, and hygiene …

Barriers To Preventive Care For The Immigrant Population In Minnesota, Andrew Kenneth Gernand, Dustin Wayne Kingsley, Daleso Yadetta

All Electronic Theses and Dissertations

Immigrants in Minnesota face several barriers regarding access and use of preventive healthcare services. Current literature indicates a high area of need exists within the immigrant population for the prevention of chronic illness. Language, health literacy, cultural norms, and citizenship all play a role in limiting the use of preventive care. As the number of elderly immigrants increases and the overall immigrant population steadily rises in the United States, it is in the best interest of patients and providers to prevent or reduce the burden of long term diseases like diabetes, cancer, and hypertension. Knowing that barriers are present within …

Examining The Effects Of Caffeine, Sleep And Exercise On The Academic Performance Of Pa Students, Saira Haq, Katelyn M. Walsh

All Electronic Theses and Dissertations

Caffeine is the most widely consumed stimulant drug in the world and is consumed by nearly ninety percent of North Americans (Mednick, Cai, Kanady, & Drummond, 2008). Since caffeine is a highly consumed drug amongst a wide variety of demographics, it is important to consider the ramifications of caffeine on a person’s general well-being. In recent years, there has also been an increasing correlation between the number of individuals consuming caffeine and the rise of insufficient sleep (Mednick et al., 2008). Due to the high demands and stresses of college and graduate school, it is not surprising that many students …

Factors Influencing Provider Antibiotic Prescribing Behaviors: A Qualitative Study, Patrick Kevin Hayden, Emily Palmer

All Electronic Theses and Dissertations

The prevalence of antibiotic resistance has grown steadily over the past few decades. Hundreds of thousands of people are dying each year due to the unavailability of previously effective antibiotic regimens. A major influence in the continued progression of this resistance can be attributed to the overuse and inappropriate prescribing of antibiotics. This study explored the factors that influence medical providers to use or prescribe antibiotics in situations when they are not indicated. The study was conducted through a semi-structured interview to providers from Minnesota and Wisconsin who work or have previously worked in urgent cares or emergency rooms. Providers …

Prevention And Education Of Sexually Transmitted Diseases Within Lesbian, Gay, Bisexual, Transgender, And Queer Adolescents, Kalie S. Johnson, Hayden Middleton

All Electronic Theses and Dissertations

Sexually transmitted diseases (STDs) are becoming an increasingly significant issue faced by high school adolescents in the United States. According to the Centers for Disease Control and Prevention (CDC), adolescents 15 to 21 years of age account for over half of the STDs acquired in the United States every year. The lesbian, gay, bisexual, transgender, and queer (LGBTQ) sub-group of adolescent populations is at a higher risk for STDs than their heterosexual counterparts, and with ten percent of American adolescents identifying as lesbian, gay, bisexual, transgender, or queer, the prevention and education of STDs in this sub-population is of utmost …

Attitudes Towards Vaccinations In The Minnesota Slavic Community, Maksim Kozak, Hannah Margaret Roy, Rachel Van Heest

All Electronic Theses and Dissertations

The incidence of vaccine preventable illnesses is increasing in the United States. Negative attitudes towards vaccinations, or vaccine hesitancy is fueling the decreasing vaccination rates. Ascertaining the level of vaccine hesitancy in susceptible populations is essential in combatting the rise of vaccine preventable illnesses in the United States. Very little research has previously been compiled on vaccine attitudes in Slavic immigrants. Slavic immigrants identify racially as “white” on surveys, masking differences in the Slavic population from the much larger Caucasian population in the United States. In order to better understand the level of vaccine hesitancy in the Minnesota Slavic immigrant …

Factors Contributing To Physician Assistant Burnout, Sarah F. Leonard, Tiffany J. Mellang, Connor Sacks

All Electronic Theses and Dissertations

Workplace burnout is known to be extremely prevalent among employees in the medical professions. For other health care professions such as physicians or nurses there is a plethora of existing literature on workplace burnout, but there is a lack of research on workplace burnout as it relates to Physician Assistants (PAs). This research study sought to discover what potential factors are specifically contributing to workplace burnout among PAs, symptoms of burnout experienced, and the personal strategies that PAs have found useful in coping with burnout. Interviews with ten currently practicing PAs in the Minnesota and Wisconsin region were conducted to …

The Impact Of Religious Beliefs Of Medical Practitioners On The Prescribing Of Contraceptives, Ashley M. Overby, Kayla Westling

All Electronic Theses and Dissertations

For centuries, the use of artificial birth control has been a highly debated topic across different religions and this debate continues to remain strong today. Living in a country made up of diverse cultural backgrounds and beliefs, religious differences may influence the way practitioners and patients interact with each other when it comes to a variety of medical issues, especially contraception. There is little research, however, that has been done to evaluate for a significant correlation between religious views of practitioners and their tendencies to prescribe contraceptives to patients. A questionnaire was distributed to the Association of Physician Assistants in …