Orthopedics Commons^™

Trends And Outcomes In Fixation Of Distal Radius Fractures In Elderly Patients: Should Gender Play A Role In Surgical Decision Making?, Rabia Qureshi, Kenny Ling, Sydney Laramie

Stony Brook Orthopaedic and Musculoskeletal Journal

See article.

Impact Of Teriparatide On Surgical And Medical Outcomes In Osteoporotic Patients Undergoing Multilevel Anterior Cervical Discectomy And Fusion, Samuel Akhnoukh, Uttsav Patel, Kenny Ling, Ivan Zapolsky

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: Osteoporotic patients undergoing multi-level anterior cervical discectomy and fusion (ACDF) are at increased risk of pseudarthrosis and perioperative complications, including higher rates of reoperation compared to non-osteoporotic individuals. Teriparatide, an anabolic agent used in osteoporosis treatment, has shown promise in enhancing fusion and reducing complications in lumbar spine procedures, but its role in multi-level ACDF remains unclear.

Purpose: The purpose of this study was to evaluate the impact of postoperative teriparatide use on outcomes in osteoporotic patients undergoing multi-level anterior cervical discectomy and fusion (ACDF). Specifically, the study aimed to determine whether teriparatide could reduce long-term complications such as …

Identifying Authenticity In Orthopaedic Residency Applications: Can Selection Committees Detect Ai-Written Personal Statements, Samir Baig, Lekha Yaramada, David E. Komatsu, James Barsi

Stony Brook Orthopaedic and Musculoskeletal Journal

See article.

Hypertensive Status Predicts 30-Day Postoperative Complications Following Open Reduction Internal Fixation Of Distal Radius Fractures, Nishank Mehta, Emma Smolev, Dorian Cohen, Kenny Ling, Becka Konnayil, Samantha Muhlrad, Edward D. Wang

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: The primary objective of this study was to investigate the association between preoperative hypertension and postoperative complications following open reduction internal fixation of distal radius fractures.

Methods: All patients who underwent open reduction internal fixation (ORIF) for distal radius fractures (DRF) between 2015 to 2021 were queried from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. Postoperative complications were reported within 30 days of procedure. We identified a total of 26,138 patients and 31.5% (n=8,225) of patients had hypertension. Hypertension was defined as blood pressure greater than 140/90 as documented in the medical record, requiring …

Femoral Avascular Necrosis And Triptan Therapy: A Multicenter Retrospective Study, Joseph Bisiani, Francisco Martos Jr., Brian Lynch

Stony Brook Orthopaedic and Musculoskeletal Journal

Aims: Migraines are one of the most common neurological disorders that patients typically suffer from. One of the more common prescription medications for migraines are triptans, which can lead to vasoconstriction throughout the peripheral vasculature as a potential side effect. However, a possible risk of femoral avascular necrosis may arise from these treatments, as it has been well known that a lack of blood flow to the femur can arise due to this peripheral vasoconstriction. Therefore, research is warranted for whether taking anti-migraine medications is associated with a higher risk of developing avascular necrosis within the femur, an area highly …

Extensor Tendon Injuries: Does Repair Technique Influence Re- Rupture Rate?, Rahul Rai, Joseph Bisiani, Athikur Rahman, David Komatsu, Lawrence Hurst

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: Extensor tendon injuries are common injuries to the hand. When poorly managed, these injuries can have significant long-term effects on a patient’s hand function. There are multiple described repair techniques to repair an injured extensor tendon. The aim of this study was to determine if there was a correlation between extensor tendon repair technique and subsequent re-rupture rate.

Methods: A retrospective analysis was conducted on patients who underwent extensor tendon repair at our institution, utilizing the electronic medical record database of patients with extensor tendon injuries from 2015 to 2024. Data were collected on patient demographics, injury mechanisms, tendon …

Biomechanical Comparison Of Posterolateral Fibula Plating With Independent Syndesmotic Screw Fixation Versus Direct Lateral Plating With Syndesmotic Screw Fixation Through Plate, Dmitriy Butsenko, Zack Bonick, J Gary Bledsoe, Michael E. Doany

Stony Brook Orthopaedic and Musculoskeletal Journal

Syndesmotic fixation has been extensively investigated. Screw size, number, position, orientation, and flexible fixation options have all been investigated at length. There is however a lack of knowledge of any difference between an independent syndesmotic screw versus onethrough a lateral plate. The purpose therefore is to perform a biomechanical assessment of syndesmotic fixation comparing independent screw vs screw through plate combination, analyzing torsional strength of both constructs. To perform this, seven matched cadaveric through tibia-fibula lower leg specimens were prepared by creating an oblique fracture performing surgical syndesmotic disruption. The specimens were then randomized into the direct lateral through plate …

Association Between Glp-1 Agonist Use And Site-Specific Fracture Risk: A Retrospective Cohort Analysis, Nathan Zou, Joseph Bisiani, Brian Lynch

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: Type 2 diabetes and obesity rates are expected to rise, possibly increasing the usage of Glucagon-like peptide-1 (GLP-1) agonists. Use of these agents for nondiabetic patients for weight loss I s approaching the number prescribed for diabetes. GLP-1 agonists may influence bone metabolism by promoting formation and reducing resorption, but their impact on fracture risk remains unclear. While some studies show no association, others suggest increased vulnerability. Most prior research has examined overall fracture risk without considering specific skeletal sites. This study aimed to compare site-specific fracture rates in adults with T2DM or obesity receiving GLP-1 therapy with those …

All Inside Meniscus Repair - How Close Is Too Close?, Frederick Hance, Kenny Ling, Liam Edwards-Gaherty, Diana Patterson

Stony Brook Orthopaedic and Musculoskeletal Journal

Although rare, neurovascular injuries are major complications. The purpose of this study was to use cadaveric dissection to determine the proximity of medial and lateral meniscus repair to major neurovascular structures in the posterior knee. We hypothesized that repair of the posterior horn of the medial and lateral menisci would be within 1 centimeter proximity of a key neurovascular structure.

The study was performed on 4 fresh-frozen cadaveric specimens that included the full knee joint spanning from the distal femur to proximal tibia and fibula. Following identification and tagging of the key structures, arthroscopic meniscus repair was simulated using Arthrex …

Liv Selection In ‘Tweener’ Patients Treated With Magnetically Controlled Growing Rods Vs. Posterior Spinal Fusion, Brandon Yoshida, Claudia Leonardi, Jacquelyn Valenzuela-Moss, Lindsay M. Andras, Tyler A. Tetreault, John B. Emans, John T. Smith, Joshua M. Pahys, G. Ying Li, Michael J. Heffernan

School of Public Health Faculty Publications

Purpose: The purpose of this study was to compare the LIV selection in ‘tweener’ patients treated with MCGR or PSF. Methods: A multicenter pediatric spine database was queried for ambulatory patients ages 8–11 years treated by MCGR or PSF with at least 2-year follow-up. The relationship between the LIV and preoperative spinal height, curve magnitude, and implant type were assessed. The relationship between the touched vertebrae (TV), the last substantially touched vertebrae (LSTV), the stable vertebrae (SV), and the LIV were evaluated. Results: One hundred and fifty-nine patients met inclusion criteria. Preoperative curve magnitude was similar between groups (MCGR 68 …

Rule Breakers Achieve Successful Shoulder Balance: Unraveling The Myth Of Upper Instrumented Vertebrae Selection Criteria, Luke C. Drake, Peter W. D’Amore, Bailli Fontenot, Tyler A. Tetreault, Manaf Younis, Claudia Leonardi, Jaquelyn Valenzuela-Moss, Lindsay M. Andras, Michael J. Heffernan

School of Medicine Faculty Publications

Purpose: This study compared shoulder balance outcomes in “rule breakers” (RB) vs. “rule followers” (RF) based on commonly utilized upper instrumented vertebrae (UIV) selection guidelines. Methods: Adolescent idiopathic scoliosis (AIS) patients (Lenke 1–4) who underwent posterior spine fusion (PSF) with minimum 2-year follow-up had radiographic measurement of shoulder balance including first rib angle (FRA), T1 tilt, coracoid process height difference (CPHD), and clavicle angle (CA) at preop, postop, 6-month, 1-year, and 2-year timepoints. Postoperative outcomes were compared between RB and RF groups defined based on the UIV selection guidelines of Rose and Lenke. Results: Among 88 patients (43 RF, 45 …

Anterior Solid Dual-Rod Instrumentation And Fusion For Flexible Thoracolumbar Or Lumbar Spinal Deformities In Adolescent Idiopathic Scoliosis., Mckenna C. Noe, Kenneth A. Furlough, Richard M. Schwend

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Anterior spinal instrumentation and fusion (ASIF) via a thoracolumbar approach has been used to treat Lenke 5 adolescent idiopathic scoliosis for decades. Advances in ASIF technique and instrumentation have yielded significant improvements in rates of instrumentation failure, need for reoperation, instrumented and adjacent segment kyphosis, and pseudarthrosis. Despite reports of ASIF's success using these strategies, a detailed technical description with illustrations of this procedure in the literature is lacking.

METHODS: We present a detailed illustrated surgical technique guide for anterior solid-rod instrumentation via a thoracoabdominal approach in the correction of a Lenke 5 adolescent idiopathic scoliosis deformity.

RESULTS: ASIF …

Evaluation Of Tibial Slope On Radiographs In Pediatric Patients With Tibial Spine Fractures: An Age- And Sex-Matched Study, Chang Ho Shin, Akbar N Syed, Morgan E Swanson, Indranil V Kushare, Kevin G Shea, Asteroid, Theodore J Ganley, Soroush Baghdadi, Aristides I Cruz, Henry B Ellis, Peter D Fabricant, Theodore J Ganley, Daniel W Green, Alicia Kerrigan, Julia Kirby, Mininder Kocher, Indranil V Kushare, R Jay Lee, James P Macdonald, Scott D Mckay, Shital N Parikh, Neeraj M Patel, Yi-Meng Yen, Gregory A Schmale, Kevin G Shea, R Justin Mistovich

Faculty, Staff and Students Publications

BACKGROUND: A recent study has reported that the radiographic measurement of posterior tibial slope (PTS) is larger in male pediatric patients with tibial spine fractures (TSF) than in controls. However, they found no difference in PTS between female patients and controls.

PURPOSE: (1) To identify whether PTS is larger in female pediatric patients with TSF than in female controls and (2) to validate the relationship between PTS and pediatric TSF in male patients.

STUDY DESIGN: Cross-sectional study; Level of evidence, 3.

METHODS: After an a priori power analysis, 84 pediatric patients with TSF (50 female patients and 34 male patients) …

Back Pain In Adolescent Idiopathic Scoliosis: Frequency And Risk Factors, Stefan Sarkovich, Claudia Leonardi, Matthew Darlow, Davis Martin, Peter Issa, Tara Soria, Amy Bronstone, Carter Clement

School of Public Health Faculty Publications

Purpose: Although back pain is commonly reported in patients with adolescent idiopathic scoliosis (AIS), factors that influence the presence and severity of back pain in AIS, including curve-specific variables, have not been well studied. This study aims to describe the prevalence and severity of back pain in AIS patients and determine the extent to which patient characteristics, including curve-specific factors, are associated with a higher risk of back pain in AIS. Methods: The study was a retrospective medical records review of adolescents (aged 10–17 years) diagnosed with AIS between 01/01/2018 and 12/31/2021 at an academic tertiary children’s hospital. Patients with …

Failure Of Pavlik Harness Treatment In Infants Under 6 Months Old With Dislocated Hips: Short- And Intermediate-Term Results Of Subsequent Treatment Modalities, Ahmet Imerci, Mihir M. Thacker, James Richard Bowen

Jefferson Hospital Staff Papers and Presentations

OBJECTIVE: This study aimed to determine the short- and medium-term outcomes of hip dislocation in infants who failed Pavlik harness therapy and were subsequently treated with brace, closed reduction (CR) or open reduction (OR) before 6 months of age.

METHODS: Fifty infants (66 hip dislocations) who failed Pavlik harness therapy between 2000 and 2018 and were treated with a rigid abduction brace or undergoing a CR or OR/cast were evaluated. All demographic data obtained from the medical system, developments and complications during the follow-up and treatment process were recorded and evaluated.

RESULTS: Fifty infants (66 hips) with dislocated hips failed …

Opioid Use After In Situ Fixation Of Slipped Capital Femoral Epiphysis, Stephanie Coupal, Colleen Moreland, Jonathan R. Warren, Mckenna C. Noe, Lisa Berglund, Caleb Grote

Research Days

Preliminary results of a prospective single-institution study evaluating opioid use following in situ screw fixation of Slipped Capital Femoral Epiphysis (SCFE) in pediatric patients.

Outcomes Of Toddler’S Fractures After Implementation Of Comprehensive Care Management Protocol With Controlled Ankle (Cam) Boots, Sheena J. Amin Md, Janet K. O'Rear Bsn, Julia Leamon Msn, Olivia R. Pruss Bs, Mckenna C. Noe Bs, Micah K. Sinclair Md, Caleb W. Grote Md, Phd

Research Days

A study comparing skin breakdown complications in patients being treated for toddler's fractures at a single academic medical center before and after implementation of a new management and immobilization protocol involving the use of CAM boots.

Conservative Management Of Medial Femoral Condyle Osteochondritis Dissecans In The Pediatric Knee, Kennedy J. Morey, Brian Harvey, Kennison Adams, El Domingo-Johnson, Angie Vanderpool, Natalie Stork, Donna Pacicca, Brian Lee, Kevin Latz

Research Days

This study investigates the effectiveness of various non-operative treatments for osteochondritis dissecans (OCD) lesions in the medial femoral condyle (MFC) of the knee, a condition commonly affecting pediatric populations. Our project aims to evaluate outcomes such as symptom resolution, return to activity, and the potential for avoiding surgical intervention among patients undergoing different methods of conservative management. Through a retrospective analysis of patients, the study identifies trends in the effectiveness of different conservative treatment methods.

Health Disparities In Slipped Capital Femoral Epiphysis (Scfe) Presentation, Rithika Ginjupalli, George Thomas, Rohit Siddabattula, Richard M. Schwend, Caleb Grote

Research Days

This study identifies various health disparities in SCFE presentations using neighborhood-level determinants COI and ICE in addition to sociodemographic determinants such as race and gender.

Improving Awareness And Utilization Of Safety Net Resources After Extremity Firearm Injury, Colleen M. Moreland, Caleb W. Grote, Richard M. Schwend, Julia G. Harris

Research Days

The orthopaedic surgery department can improve follow-on care for pediatric survivors of extremity firearm injuries by creating and implementing a checklist of defined safety net resources.

Electrical Stimulation Of The Medial Pin After Insertion Is Safe And Effective In Preventing Iatrogenic Ulnar Nerve Neuropraxias In Type Iii Supracondylar Fractures. A Case Series Of 128 Consecutive Patients., Lucas Georger B.A., Mckenna Noe B.S., Richard M. Schwend M.D.

Research Days

This case series explores the safety and efficacy of using a disposable nerve stimulator for intraoperative stimulation of both medial and lateral pins in Gartland type III supracondylar humerus fractures, revealing no instances of ulnar nerve stimulation response or postoperative iatrogenic ulnar nerve injury, thereby highlighting the potential for this cost-effective approach to ensure stable medial column pin fixation without ulnar nerve complications.

Safety And Efficacy Of Intraoperative Vectored Traction With Gardner-Wells (Gw) Tongs For Pediatric Spine Deformity Surgery - A Series Of 1000 Cases, Lucas Georger B.A., Krish Sardesai B.A., Andrew Dumas B.S., Mckenna Noe B.S., Richard M. Schwend M.D.

Research Days

Conducting an ongoing exploration, this study delves into the safety and efficacy of Gardner-Wells Tongs in pediatric spinal deformity surgery, involving a series of 418 cases, revealing a 5.5% complication rate primarily associated with facial swelling and abrasions, emphasizing the need for further investigation to validate the safety and effectiveness of this intervention.

Resection And Reconstruction Of Ewing Sarcoma Of The Cuboid Utilizing Vascularized Fibular Autograft: A Case Report, Brandon Cunha, Alexandre Arkader

Rowan-Virtua Research Day

Ewing Sarcoma (EWS) rarely presents in the bones of the foot, and particularly in the cuboid, making it an exceedingly rare occurrence. We present the case of a 7-year-old female diagnosed with EWS of the right cuboid, detailing the management and outcomes of this rare presentation. The patient, now almost 5 years post-initial local control, exhibits restored foot function, a normalized gait, and no evidence of disease recurrence. This case underscores the potential for preserving lower extremity function and improving postoperative quality of life in rare presentations of EWS through innovative reconstruction strategies.

Investigating The Factors That Lead To Sports Related Injuries In Children, Kinjal Shah, Shawna Rotoli

Rowan-Virtua Research Day

This project’s focus is to investigate if playing contact versus non-contact sports at a young age leads to more sports related injuries and to identify which factors correlate with increased injury rate in order to develop the most effective prevention and treatment methods. Data was collected through a survey including questions that delve deeper to quantify the amount of strain being put on the youth athlete’s body such as hours played a week, level of competitiveness, weeks played in a year, contact versus non-contact sport, and number of sports played. The following set of questions then addressed the actual injury …

Complications Following Hemivertebrectomy For Congenital Scoliosis, Sanjana Davuluri, Taemin Oh, Kyrillos Akhnoukh, Zachary Weingrad, Michael Lesgart, Terrence Ishmael, Joshua Pahys, Amer Samdani, Steven Hwang

Rowan-Virtua Research Day

Introduction:

Hemivertebrae are rare congenital anomalies that can cause severe scoliosis requiring surgical correction. We aimed to determine whether severity of deformities is associated with more long-term surgical complications following surgical correction.

Methods:

We performed a retrospective, single-institution review on patients who underwent hemivertebrectomy and spinal fusion for congenital scoliosis between 2008-2020. We extracted pertinent data on demographics, radiographic parameters, operative details, and complication rates. Subgroup analyses were also done by complication severity, deformity complexity, and construct length.

Results:

In our series, 30 patients underwent hemivertebrectomy and fusion. Mean age was 9±4.2 years and there was 2:1 male preponderance, with …

Adductor Canal Regional Anesthetic Placement In Pediatric Patients For Knee Arthroscopy: Defining The Optimal Location And Analysis Of Other Trends, Isaac Jin, Christine Song, Sujay Deshpande, Andrew Yang, Ethan Schollaert, Neha Divi, Aysha Hasan Md

Tower Health Research Day

No abstract provided.

Anterior Hip Pain In Adolescent Female Wrestler, Melanie Kennedy

Posters

No abstract provided.

Lowest Instrumented Vertebrae In Early Onset Scoliosis: Is There A Role For A More Selective Approach?, Michael J. Heffernan, Claudia Leonardi, Lindsay M. Andras, Bailli Fontenot, Luke Drake, Joshua M. Pahys, John T. Smith, Peter F. Sturm, George H. Thompson, Michael P. Glotzbecker, Tyler A. Tetreault, Benjamin D. Roye, Ying Li

School of Public Health Faculty Publications

Purpose: This purpose of this study was to assess the impact of patient and implant characteristics on LIV selection in ambulatory children with EOS and to assess the relationship between the touched vertebrae (TV), the last substantially touched vertebrae (LSTV), the stable vertebrae (SV), the sagittal stable vertebrae (SSV), and the LIV. Methods: A multicenter pediatric spine database was queried for patients ages 2–10 years treated by growth friendly instrumentation with at least 2-year follow up. The relationship between the LIV and preoperative spinal height, curve magnitude, and implant type were assessed. The relationships between the TV, LSTV, SV, SSV, …

The Utility Of Interventional Anesthesia, Kylie Daguio, Kiley Jackson, Samantha Boever, Andrew Chang, James Keane, Leonard B. Goldstein

SOMA Faculty Publications

no abstract

Advancing Virtual At-Home Care For Community Health Center Patients Using Patient Self-Care Tools, Technology, And Education [Letter], Cheryl Modica, Joy H. Lewis, Curtis Bay

SOMA Faculty Publications

Abstract

Introduction

Health centers are community-based, patient directed primary care providers that offer accessible, high-quality primary care within medically underserved communities. Screening for cancer and managing complex chronic conditions such as diabetes, hypertension, obesity, and depression are vital services for the vulnerable populations seen by community health centers. Delivering care for complex chronic conditions and preventive services using virtual models that integrate self-care tools and technology is an important approach to increasing access for hard-to-reach patients served by health centers.

Objective

This study aimed to explore the use of a virtual care model, applied using a systems approach and patient-driven …