Orthopedics Commons^™

The Impact Of Cholesterol Deposits On The Fibrillar Architecture Of The Achilles Tendon In A Rabbit Model Of Hypercholesterolemia., Andrzej Steplewski, Jolanta Fertala, Ryan Tomlinson, Kevth'er Hoxha, Lin Han, Ocean Thakar, Jason Klein, Joseph A. Abboud, Andrzej Fertala

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Increased tendon pain and tendon damage is a significant complication related to hyperlipidemia. Unlike the well-established pathogenesis associated with increased serum concentrations of total cholesterol, triglycerides, and low-density lipoprotein in atherosclerotic cardiovascular disease, the role of hyperlipidemia in promoting tendon damage remains controversial and requires mechanistic clarity.

METHODS: In this study, we analyzed the consequences of hypercholesterolemia on the integrity of the collagen-based architecture of the Achilles tendon. The Achilles tendons from rabbits fed with normal-cholesterol (nCH) and high-cholesterol (hCH) diets were analyzed. We studied the morphology of tendons, distribution of lipids within their collagen-rich milieu, the relative amounts …

Limited Morbidity And Possible Radiographic Benefit Of C2, Peter G Passias, Cole A Bortz, Frank Segreto, Samantha Horn, Katherine E Pierce, Haddy Alas, Avery E Brown, Renaud Lafage, Virginie Lafage, Justin S Smith, Breton Line, Robert Eastlack, Daniel M Sciubba, Eric O Klineberg, Alexandra Soroceanu, Douglas C Burton, Frank J Schwab, Shay Bess, Christopher I Shaffrey, Christopher P Ames

Articles, Abstracts, and Reports

Background: The study aims to evaluate differences in alignment and clinical outcomes between surgical cervical deformity (CD) patients with a subaxial upper-most instrumented vertebra (UIV) and patients with a UIV at C2. Use of CD-corrective instrumentation in the subaxial cervical spine is considered risky due to narrow subaxial pedicles and vertebral artery anatomy. While C2 fixation provides increased stability, the literature lacks guidelines indicating extension of CD-corrective fusion from the subaxial spine to C2.

Methods: Included: operative CD patients with baseline (BL) and 1-year postop (1Y) radiographic data, cervical UIV ≥ C2. Patients were grouped by UIV: C2 or subaxial …

Performance Of The Promis In Patients Undergoing 3 Common Elbow Procedures, Edward O. Rojas, Natalie Glass, Jessell Owens, Chris A. Anthony, Matthew Bollier, Brian R. Wolf, Carolyn Hettrich

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background: Ulnar collateral ligament (UCL) reconstruction, distal biceps tendon repair, and elbow arthroscopic surgery are common elbow procedures performed in active patients.

Hypothesis: We hypothesized (1) good to excellent correlation between Patient-Reported Outcomes Measurement Information System (PROMIS) instruments and traditional orthopaedic upper extremity patient-reported outcome (PRO) measures; (2) that PROMIS instruments would demonstrate ceiling effects; and (3) that the PROMIS physical function computer adaptive test (PF CAT) would demonstrate a low question burden compared with other PRO instruments.

Study Design: Cohort study (diagnosis); Level of evidence, 2.

Methods: A total of 76 patients undergoing UCL repair/reconstruction, distal biceps tendon repair, …

Aseptic Loosening Of An Aptis Distal Radioulnar Joint Arthroplasty – Case Report, Karis Bennett, Srinath Kamineni

Orthopaedic Surgery and Sports Medicine Faculty Publications

Dysfunction of the distal radioulnar joint can cause significant pain and instability. The self-stabilizing APTIS distal radioulnar joint prosthesis is used as a solution for severe distal radioulnar joint pathologies. We present a case of a 60-year-old male, who received an APTIS distal radioulnar joint prosthesis which resulted in aseptic loosening within five years of the initial implantation. Infection, incorrect implantation, demographic differences and over-activity were all excluded as the source; therefore, mechanical aseptic loosening was concluded. Ultimately, two surgeries were required to resolve the patient's pain, which resulted in a one-bone forearm once the implant was extracted. The solution …

Comparison Of Surgical Outcomes Of The Posterior And Combined Approaches For Repair Of Cervical Fractures In Ankylosing Spondylitis., Panya Luksanapruksa, Paul William Millhouse, Victor Carlson, Thanase Ariyawatkul, Joshua Heller, Christopher K. Kepler

Department of Orthopaedic Surgery Faculty Papers

STUDY DESIGN: Retrospective cohort study.

PURPOSE: To evaluate surgical outcomes and complications of cervical spine fractures in ankylosing spondylitis (CAS) patients who were treated using either the posterior (P) or combined approach (C).

OVERVIEW OF LITERATURE: Ankylosing spondylitis typically causes progressive spinal stiffness that makes patients susceptible to spinal fractures. CAS is a highly unstable condition. There is contradictory evidence regarding which treatment option, the posterior or the combined approach, yields superior clinical results.

METHODS: A single institution database was reviewed for data in the period 1999 to 2015. All CAS patients who underwent posterior or combined instrumented fusion were …

Operative Times In Adolescent Idiopathic Scoliosis Surgery. What Do They Mean?, Joanne Abby Marasigan

Research Days

No abstract provided.

Improving Perioperative Warming Of Surgical Patients: Implementation Of A Warming Protocol, Maghy Schrage

Doctor of Nursing Practice Projects

Despite the ample amount of knowledge and interventions available to keep patients warm in the operating room, the issue of inadvertent perioperative hypothermia continues to be a problem affecting surgical patients. Unfortunately, even a mild degree of hypothermia can increase a patient’s chance for negative outcomes such as surgical site infections, bleeding, and higher risk for mortality. The project involved development of a warming protocol/guideline for a small community hospital. The implementation process consisted of two separate presentations tailored to educate both nursing and anesthesia staff about the importance of warming patients, reimbursement initiatives, and appropriate interventions.

The project study …

Arthroscopic Medial Meniscus Transplant Utilizing A Multi-Technique Fixation, Elizabeth Ford, Michael Defrance, Sean Mcmillan

Rowan-Virtua Research Day

Arthroscopic medial meniscus transplantation can be a daunting procedure for even the most skilled surgeon. While all-inside suture fixation devices have improved, the ability to successfully perform this procedure via arthroscopy is reliant upon the surgeon's ability to utilize a variety of fixation techniques. Based upon the review of the literature, this paper is the first of it's kind describing the methodology and algorithm for completing an arthroscopic medial meniscus transplant using four techniques.

A Case Of Atraumatic Posterior Thigh Compartment Syndrome, Nailah Mubin, Brian Katt

Rowan-Virtua Research Day

Compartment syndrome(CS) occurs when intra-compartmental pressures exceeds to a point where arterial, venous and lymphatic circulation of local tissues, muscles and nerves is compromised. CS is most common after a traumatic injury and usually occurs in the leg or forearm and less commonly in the thigh. Thigh compartment syndrome is rare due to its larger size and more compliant borders. We present a case of nontraumatic compartment syndrome in the posterior thigh associated with rhabdomyolysis and a sciatic nerve palsy which then required emergent fasciotomy. The patient's course was further complicated by acute renal failure due to the rhabdomyolysis and …

Rationale And Design Of The Hip Fracture Accelerated Surgical Treatment And Care Track (Hip Attack) Trial: A Protocol For An International Randomised Controlled Trial Evaluating Early Surgery For Hip Fracture Patients, Flavia K. Borges, Mohit Bhandari, Ameen Patel, Victoria Avram, Ernesto Guerra-Farfán, Alben Sigaman, Masood Umer, Maria Tiboni, Anthony Adili, John Neary

Section of Orthopaedic Surgery

Introduction: Annually, millions of adults suffer hip fractures. The mortality rate post a hip fracture is 7%-10% at 30 days and 10%-20% at 90 days. Observational data suggest that early surgery can improve these outcomes in hip fracture patients. We designed a clinical trial-HIP fracture Accelerated surgical TreaTment And Care tracK (HIP ATTACK) to determine the effect of accelerated surgery compared with standard care on the 90-day risk of all-cause mortality and major perioperative complications.
Methods and Analysis: HIP ATTACK
is a multicentre, international, parallel group randomised controlled trial (RCT) that will include patients ≥45 years of age and diagnosed …

Management Of Acute Traumatic Central Cord Syndrome: A Narrative Review, Srikanth N. Divi, Gregory D. Schroeder, John J. Mangan, Madeline Tadley, Wyatt L. Ramey, Jetan H. Badhiwala, Michael G. Fehlings, F. Cumhur Oner, Frank Kandziora, Lorin M. Benneker, Emiliano N. Vialle, Shanmuganathan Rajasekaran, Jens R. Chapman, Alexander R. Vaccaro

Department of Orthopaedic Surgery Faculty Papers

Study Design: Narrative review.Objectives:To provide an updated overview of the management of acute traumatic central cord syndrome (ATCCS).

Methods: A comprehensive narrative review of the literature was done to identify evidence-based treatment strategies forpatients diagnosed with ATCCS.

Results: ATCCS is the most commonly encountered subtype of incomplete spinal cord injury and is characterized by worsesensory and motor function in the upper extremities compared with the lower extremities. It is most commonly seen in thesetting of trauma such as motor vehicles or falls in elderly patients. The operative management of this injury has been historicallyvariable as it can be seen in …

Routine Patellar Resurfacing During Total Knee Arthroplasty Is Not Cost-Effective In Patients Without Patellar Arthritis, Harold I. Salmons, Bs, Benjamin Zmistowski, Md, Yale A. Fillingham, Md, Derek Ward, Md, Robert P. Good, Md, Jess H. Lonner, Md

Department of Orthopaedic Surgery Posters

• During total knee arthroplasty (TKA), whether or not one should routinely resurface the patella is controversial.
• Leaving an unresurfaced patella following index TKA may lead to anterior knee pain (AKP), patellofemoral crepitus, and future secondary resurfacing operations.
• However, routinely resurfacing the patella (PR) may lead to patellar fracture, aseptic loosening, patellar instability, avascular necrosis, and patellar clunk.
• The purpose of the present study is to utilize the existing level one evidence to assess the cost-utility of routine patella resurfacing during primary TKA.
• Hypothesis: Selective resurfacing of the patella is more cost effective than routine patellar resurfacing during primary TKA.

Infected Non-Union Of Tibia Treated With Ilizarov External Fixator: Our Experience, Shah Fahad, Aysha Habib, Muhammad Awais, Masood Umer, Haroon Rashid

Section of Orthopaedic Surgery

Introduction: Tibia is the most common long bone fractured due its vulnerable subcutaneous location and most often associated with acquired complications of delayed union or non-union due to infection. Amongst the various treatment options to treat them, the Ilizarov external fixator application is considered superior due to its multiple advantages. The objective of this study was to analyse the role of Ilizarov fixation in infected tibial non-union, as well as to assess bony union and associated functional outcomes.
Materials and Methods: A retrospective review was conducted for the duration between 1st January 2005 to 31st December 2016. Total of fifty-one …

Does Surgeon Experience Influence The Amount Of Radiation Exposure During Orthopedic Procedures?: A Systematic Review, Azeem Tariq Malik, Hamid Hussain Rai, Riaz Hussain Lakdawala

Section of Orthopaedic Surgery

With an increasing use of intraoperative fluoroscopy in operating rooms worldwide, the topic of radiation exposure has become a major concern among hospital staff, doctors and patients alike. Since fluoroscopy has become an integral part in orthopedic intraoperative management, we sought to identify whether surgeon grade or experience plays a role in the amount of radiation used and consequently exposed. We performed a systematic review examining the association between surgeon experience and radiation exposure using primary outcome measures (radiation dose and total screening time/fluoroscopy time). To be included in the review, the study population had to compare varying surgeon experience …

A Novel Handheld Robotic-Assisted System For Unicompartmental Knee Arthroplasty: Surgical Technique And Early Survivorship., Andrew K. Battenberg, Nathan A. Netravali, Jess H. Lonner

Department of Orthopaedic Surgery Faculty Papers

Technology, including robotics, has been developed for use in unicompartmental knee arthroplasty (UKA) to improve accuracy and precision of bone preparation, implant positioning, and soft tissue balance. The NAVIO™ System (Smith and Nephew, Pittsburgh, PA, United States) is a handheld robotic system that assists surgeons in planning implant positioning based on an individual patient's anatomy and then preparing the bone surface to accurately achieve the plan. The surgical technique is presented herein. In addition, initial results are presented for 128 patients (mean age 64.7 years; 57.8% male) undergoing UKA with NAVIO. After a mean of follow-up period of 2.3 years, …

Opioid Consumption After Orthopedic Surgery: Prospective Randomized Trial On The Effects Of Preoperative Counseling, Sage Vincent, Taylor Paskey, Elizabeth Critchlow, Erica Mann, Talia Chapman, Md, Kristin Sandrowski, Md, Asif Ilyas, Md

Phase 1

Introduction: Recently, there have been increases in morbidity and mortality associated with opioid medications. Physician overprescribing, particularly within orthopedics, contributes to large quantities of leftover opioids, leading to an increased risk of non-medical opioid use and abuse.

Objective: To understand the role of preoperative patient counseling on postoperative opioid consumption, a prospective randomized study was done, with the idea that patients receiving counseling would take fewer opioids than their control counterparts.

Methods: Patients undergoing elective outpatient orthopedic surgery at Jefferson affiliate hospitals were enrolled over a 3-month period. Patients were randomized to a control group or to receive preoperative counseling …

Motor-Vehicle Crash Patient Injury Patterns From A Level One Trauma Center In A Metropolitan City: A Cross-Sectional Study, Obada Hasan, Sadaf Sheikh, Asad Abbas, Nida Zahid, Naveed Baloch

Section of Orthopaedic Surgery

Introduction: Motorcycles are an inexpensive and popular mode of transportation in Karachi, Pakistan, despite the increasing number of motor vehicle injuries. Although motorcycle-related injuries have been studied previously, to our knowledge, there are no published reports on the orthopedic injuries associated with motorcycles crashes.
Methods: We conducted a cross-sectional study of medical records of patients with motorcycle-related injuries in 2015, at the Aga Khan University in Karachi, Pakistan. We reviewed the patient demographic and medical data, helmet use, the Glasgow coma score, the spectrum of injuries, length of stay, specific injury diagnosis, and final disposition of patients. Data were analyzed …

Analysing Outcomes Through Orthopaedic Trauma Registry: A Prospective Cohort Study, Tashfeen Ahmad, Zehra Abdul Muhammad, Shahryar Noordin, Ammar Humayun

Section of Orthopaedic Surgery

Objective: To develop a registry for recording injury-specific data to identify gaps and improve care.
Methods: The prospective cohort study was conducted at Aga Khan University Hospital, Karachi, from June 2015 to July 2018 though enrollment of patients with limb trauma is continuing to date. Data on injuries and management related to Tibia shaft fractures was collected from medical records, and outcomes were assessed on follow-up visits. Internationally validated injury-specific scores were utilised for assessing functional, clinical and radiological outcomes. SPSS version 19 was used for data analysis.
Results: There were 763 patients with 825 limb injuries. Of the injuries, …

Low Cost Reconstructive Options After Musculoskeletal Tumour Resection In Developing Countries: Affordable, Effective And Durable Alternatives, Arif Ali, Obada Hasan, Ahmed Habib, Masood Umer

Section of Orthopaedic Surgery

Over the last two, three decades, the overall survival rates for non-metastatic malignant tumours of the bone have dramatically improved. This has become possible due to the recent advances and multidisciplinary approach towards these diseases, specifically the advent of multi-agent chemotherapy and radiotherapy. Limb salvage has now become the norm in the treatment of musculoskeletal tumours without compromising on the overall survival and recurrence of the disease. In the era of metal, prosthetic reconstruction has become the standard procedure specifically in the large tumours which involve the joints as this method of reconstruction helps in joint mobility and early weight-bearing. …

Inflammatory Arthritis And Mycobacterium Tuberculosis Infection: A Diagnostic And Management Challenge For Knee Arthroplasty In Endemic Areas, Obada Hasan, Riaz Hussain Lakhdawala, Vickash Kumar, Syed Faisal Mahmood, Shahryar Noordin

Section of Orthopaedic Surgery

Tuberculosis continues to be one of the most challenging health problems more prevalent in developing countries. Pakistan ranks 5th in tuberculosis prevalence among the high-burden countries. Prosthetic joint infection of the knee by acid fast bacilli is a rare and distressing complication, occurring in nearly 1% of primary joint arthroplasties requiring prolonged medical treatment and multiple surgeries. A recent publication extensively reviewed English literature from 1952 to 2016, and repor ted only 64 prosthetic joint infec tion with tuberculosis, of which 27 cases involved the knee. Tuberculosis is a global health problem adding to the challenges that arthroplasty surgeons face …

An Evaluation Of Ultrasound-Guided Regional Block Anesthesia In Outpatient Hand Surgery, Daniel Calem, Armen C. Voskeridjian, Md, Michael Rivlin, Md, Pedro Beredjiklian, Md, Mark L. Wang, Md, Phd

Phase 1

Introduction: The utilization of ultrasound-guided peripheral nerve blocks in orthopedic surgery has increased in popularity as the anesthesia of choice for the management of perioperative pain. Peripheral nerve blockade has been shown to increase overall surgical efficiency, improve patient satisfaction, reduce postoperative narcotic use, and decrease the duration of facility admissions, while increasing overall cost-effectiveness. To date, scant literature exists regarding the safety and efficacy of ultrasound-guided supraclavicular blocks used in common hand surgery procedures, and the rate of neurologic and vascular complications remains unknown.

Objective: The purpose of this study was to examine the effectiveness and complication rate of …

Functional And Structural Studies Of Tolloid-Like 1 Mutants Associated With Atrial-Septal Defect 6., Lukasz Sieron, Marta Lesiak, Izabela Schisler, Zofia Drzazga, Andrzej Fertala, Aleksander L. Sieron

Department of Orthopaedic Surgery Faculty Papers

Inactive mammalian tolloid-like 1 (tll1) and mutations detected in tolloid-like 1 (TLL1) have been linked to the lack of the heart septa formation in mice and to a similar human inborn condition called atrial-septal defect 6 (ASD6; OMIM 613087, formerly ASD II). Previously, we reported four point mutations in TLL1 found in approximately 20% of ASD6 patients. Three mutations in the coding sequence were M182L, V238A, and I629V. In this work, we present the effects of these mutations on TLL1 function. Three recombinant cDNA constructs carrying the mutations and one wild-type construct were prepared and then expressed in HT-1080 cells. …

Use Of Intraarticular Injections Of Platelet-Rich Plasma In The Treatment Of Knee Osteoarthritis: A Review Article, Naveed Baloch, Obada Hasan, Zain Baig, Umme-E-Hani Abdullah, Mohammad Atif, Hiroshi Ohuchi

Section of Orthopaedic Surgery

Osteoarthritis is one of the most common degenerative conditions affecting knee joint. As our understanding in the disease pathogenesis is evolving, so do the treatment modalities. One of the postulated mechanisms suggests the production of inflammatory cytokines secondary to repeated micro trauma than in turn lead to cartilage damage overtime. Cartilage being avascular structure has limited potential for repair. Based on this, recent studies have been focusing on stimulating cartilage-healing process by growth factors. This is where platelet-rich plasma comes in to light. Literature is showing promising results of platelet-rich plasma in treating knee osteoarthritis. In this review we have …

Does Surgical Approach Affect Outcome After Fixation Of Intra-Articular Fractures Of Distal Humerus?: Retrospective Cohort Study From A Level-1 Trauma Centre In A Metropolitan City, Muhammad Atif, Obada Hasan, Yasir Mohib, Rizwan Haroon Rashid, Pervaiz Hashmi

Section of Orthopaedic Surgery

Introduction: Fractures around the distal humerus fractures make up to 2% of all fractures. Complex intra-articular distal humerus fractures present as challenge to restore of painless, stable and mobile elbow joint. Surgical exposure to all critical structures is of paramount importance to achieve anatomic reduction. Conflict still persists regarding the choice of ideal approach. In this study we compare the effect of surgical approach triceps lifting vs olecranon osteotomy on the functional outcome after fixation of distal humerus fractures.
Methods: Non-funded, non-commercial, retrospective cohort study was conducted on patients with closed distal humerus intra-articular fractures between 2010 and 2015 at …

Arthroscopic Removal Of Loose Bodies In Synovial Chondromatosis Of Shoulder Joint, Unusual Location Of Rare Disease: A Case Report And Literature Review, Hussain Wahab, Obada Hasan, Ahmed Habib, Naveed Baloch

Section of Orthopaedic Surgery

Introduction: Synovial chondromatosis is a benign mono-articular arthropathy affecting synovial joints. It mostly affects knee joint, followed by hip, elbow and wrist and is rarely reported for shoulder joint. The exact pathogenesis is not known. Usual symptoms are pain, difficulty in movement due to mechanical obstruction. The classic treatment is arthrotomy, removal of chondromatoid loose bodies and synovectomy. With recent advances arthroscopic removal of the chondromatoid loose bodies is a good option with relatively better post op rehabilitation and faster recovery.
Case presentation: 20 years old gentleman presented to clinic with history of pain in right shoulder for 2 years …

Post Surgical Outcomes Following Limited-Open Carpal Tunnel Release Or Endoscopic Carpal Tunnel Release, Keeley Shaye Smith

Online Theses and Dissertations

Carpal Tunnel Syndrome is a neurological condition that may contribute to decreased grip strength, sensory function, activities of daily living, and many other negative impacts on an individual’s life. The purpose of this study was to assess whether patients who received endoscopic carpal tunnel release had better patient reported outcomes than patients who received limited-open carpal tunnel release. This study prospectively assessed patient reported outcomes such as pain, Patient-Specific Functional Score, Quick Disabilities of the Arm Shoulder and Hand Score, two-point discrimination, and hand grip-strength. This study demonstrated that there were significant differences within all subjective data measures (p≤0.017) from …

Transgenic Mice Overexpressing Human Tnf-Α Experience Early Onset Spontaneous Intervertebral Disc Herniation In The Absence Of Overt Degeneration., Deborah J. Gorth, Irving M. Shapiro, Makarand V. Risbud

Department of Orthopaedic Surgery Faculty Papers

There is a well-established link between cytokine expression and the progression of intervertebral disc degeneration. Among these cytokines, interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) are the most commonly studied. To investigate whether systemic hTNF-α overexpression affects intervertebral disc health, we studied the spine phenotype of Tg197 mice, a widely used hTNF-α transgenic line. These mice were studied at 12-16 weeks of age using comprehensive histochemical and immunohistological analysis of the spinal motion segment. Micro-CT analysis was performed to quantify vertebral trabecular bone architecture. The Tg197 mice evidenced spontaneous annular tears and herniation with increased vascularity in subchondral bone and …

Isolated Gonococcal Extensor Tenosynovitis, Cory Lebowitz, Jonas Matzon

Department of Orthopaedic Surgery Faculty Papers

Neisseria gonorrhoeae is a mucosal infection that has the propensity to disseminate, causing symptoms that commonly include arthralgias, skin lesions, fevers, chills, dysuria, genital discharge, septic arthritis, and/or tenosynovitis. Typically, gonococcal tenosynovitis affects the flexor sheath and is associated with arthralgias, skin lesions, or both. To the best of our knowledge, there has not been a documented case of isolated gonococcal extensor tenosynovitis. We report the case of a 16-year-old boy with isolated left upper-extremity gonococcal extensor tenosynovitis who was successfully treated with surgical debridement and antibiotic therapy.

Trends And Costs Of External Electrical Bone Stimulators And Grafting Materials In Anterior Lumbar Interbody Fusion., Anthony D'Oro, Zorica Buser, Darrel Scott Brodke, Jong-Beom Park, Sangwook Tim Yoon, Jim Aimen Youssef, Hans-Joerg Meisel, Kristen Radcliff, Patrick Hsieh, Jeffrey Chun Wang

Rothman Institute Papers

STUDY DESIGN: Retrospective review.

PURPOSE: To identify the trends in stimulator use, pair those trends with various grafting materials, and determine the influence of stimulators on the risk of revision surgery.

OVERVIEW OF LITERATURE: A large number of studies has reported beneficial effects of electromagnetic energy in healing long bone fractures. However, there are few clinical studies regarding the use of electrical stimulators in spinal fusion.

METHODS: We used insurance billing codes to identify patients with lumbar disc degeneration who underwent anterior lumbar interbody fusion (ALIF). Comparisons between patients who did and did not receive electrical stimulators following surgery were …

Femoroacetabular Impingement As A Complication Of Acetabular Fracture Fixation, David A. Zuelzer, Christopher B. Hayes, Raymond D. Wright, Stephen T. Duncan

Orthopaedic Surgery and Sports Medicine Faculty Publications

Case

We present the case of a thirteen-year-old female who sustained a posterior wall acetabular fracture dislocation. She underwent urgent closed reduction and subsequent uncomplicated open reduction and internal fixation. Post reduction computed tomography demonstrated a concentrically reduced hip joint with no evidence of femoroacetabular impingement (FAI). She subsequently healed her fracture and returned to running activities; however, one year later presented with aching pain in her thigh. Radiographs demonstrated the development of a large osseous prominence on her anterolateral femoral neck consistent with femoroacetabular impingement. Based on these findings she was evaluated by a hip preservation specialist. She subsequently …