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Alumni Map, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Primary Fusion For Treating High-Energy Intraarticular Fractures Of The Distal Tibia: A Review, Tony G. Pedri

UNM Orthopaedic Research Journal

Orthopaedic surgeons on-call often see patients with fractures of the distal tibia involving the articular surface, with extension proximal into the metaphysis, or intraarticular distal tibia fractures. These injuries pose unique challenges owing to the typical highenergy mechanism, articular-surface involvement, high degree of comminution, and typically large soft-tissue injury. Treatment has evolved greatly with the advent of modern fracture-fixation techniques and implants. However, a large percentage of patients continue to report poor subjective outcomes. Nearly all of these patients develop posttraumatic arthritis, with the most severe often requiring further reconstructive or fusion procedures once healed to treat the symptoms. Recent …

Controversies In Treatment Of Pediatric Supracondylar Humerus Fractures: A Review, Brielle Payne Plost

UNM Orthopaedic Research Journal

Although supracondylar humerus fractures are one of the most common fractures in children, there remains notable controversy regarding several treatment aspects. Controversial topics include fixation of ipsilateral forearm fractures, treatment of type II supracondylar humerus fractures, pin configuration, timing of operative intervention, and treatment of supracondylar humerus fractures with a vascular injury. Studies have supported both closed and open reduction for treating ipsilateral forearm fractures associated with supracondylar humerus fractures. For type II supracondylar humerus fractures, some studies support nonoperative treatment owing to risks associated with operative treatment such as pin-site infections. However, other studies support operative fixation because of …

Retrograde Nailing For Treating Femoral Shaft Fractures: A Review, Thomas A. Decoster, Brianna N. Patti

UNM Orthopaedic Research Journal

Rigid intramedullary nailing is an effective procedure for treating fractures of the femoral shaft. Although antegrade nailing is the traditionally used technique, retrograde nailing offers various advantages. A companion article published in the seventh volume of The University of New Mexico Orthopaedics Research Journal addressed antegrade femoral nailing. This review will describe retrograde nailing of femoral shaft fractures, including a brief history, indications, detailed technique, outcomes, advice (or “pearls”), and common failures (or “pitfalls”). Retrograde nailing for treating femoral shaft fractures can provide successful results similar to those of antegrade nailing in general and advantages in particular situations such as …

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 …

Clinical And Radiographic Comparison Between Patients With Achilles Midsubstance Ruptures And Achilles Sleeve Avulsions, Christopher L. Shultz, Matthew G. Wharton, Katherine J. Gavin, Richard A. Miller

UNM Orthopaedic Research Journal

No abstract provided.

Midterm Results Of An Anatomical Radial Head Arthroplasty For Treating Fractures And Degenerative Joint Diseases Of The Radial Head, Gabriel Pertierra, Lauren L. Vernon, Francisco Rubio

UNM Orthopaedic Research Journal

Background: Radial head arthroplasty (RHA) is typically performed to restore elbow stability or function in patients with fractures or degenerative joint diseases. The procedure requires a specific operating technique to avoid complications such as overstuffing, capitellar erosion, stiffness, instability, micro motion, and loosening. It is difficult to restore native radial head function reliably.

Methods: We reviewed the medical records of 45 patients who underwent radial head arthroplasty using the ALIGN radial head implant (ALIGN Radial Head System, Skeletal Dynamics, Miami, FL) at our institution. A total of 15 patients met inclusion criteria and were contacted to complete a QuickDASH questionnaire, …

Simulated Method To Perform The Coleman Block Test In Educating Orthopaedic Residents Outside Of The Clinic, Taylor J. Polander, Erika L. Garbrecht, Amber L. Price, Paul J. Johnson, Richard A. Miller

UNM Orthopaedic Research Journal

No abstract provided.

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 …

Brachial Artery Vasculitis And Associated Stenosis Presenting As Elbow Pain In A 16-Year-Old Soccer Player: A Case Report, Eric R. Reynolds, Andrew D. Ashbaugh, James P. Toldi, Deana M. Mercer, Mark Langsfeld, Christopher A. Mcgrew

UNM Orthopaedic Research Journal

Chronic vascular occlusion in the upper extremity can result from repetitive trauma, atherosclerosis, proximal embolic events, hypercoagulable states, and systemic diseases such as collagen vascular disease and vasculitis. Considerable functional impairment can result from these maladies; however, sometimes the condition develops slowly with minimal effect on the patient. We describe a 16-year-old soccer player with slow-progressing elbow pain and loss of range in motion caused by brachial artery vasculitis and resultant brachial arterial stenosis. Although vascular insults and lesions rarely cause chronic vascular occlusion, physicians should consider this possibility in patients with localized pain or atrophy, especially if the condition …

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.

Simultaneous Avulsion Fractures Of The Tibial Tuberosity Of Both Knees In A 14-Year-Old Boy: A Case Report, Margaret E. Pusateri, Selina R. Silva, Christopher A. Mcgrew

UNM Orthopaedic Research Journal

Fractures of the tibial tuberosity are uncommon injuries in adolescents, representing an estimated 0.4% to 2.7% of all pediatric fractures. Most of these injuries occur in young, active males commonly between the ages of 12 to 17 years. Sports, particularly those involving jumping or sudden starts and stops, are most often implicated. Injuries of the tibial tuberosity of both knees are especially rare, with little more than 30 cases reported in the past 60 years. We present a 14-year-old male football player with simultaneous avulsion fractures of the tibial tuberosity of both knees. We reviewed the anatomy, mechanisms of injury, …

Letter From The Residency Director, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Below-Knee Amputations: A Review, Erika L. Garbrecht

UNM Orthopaedic Research Journal

At our institution, physicians from the orthopaedic department perform a considerable proportion of below-knee amputations. These amputations are performed to treat non-traumatic and traumatic injuries. However, the outcomes of amputation are not discussed as often in our educational experience as those of other procedures. The current review examines the current and relevant studies for indications and outcomes of patients with non-traumatic and traumatic conditions treated with below-knee amputations.

Chronic Tenosynovitis Caused By Mycobacterium Avium-Intracellulare Of The Flexor Tendons In A 65-Year-Old Man: A Case Report, Kourosh M. Kolahi, Moheb S. Moneim

UNM Orthopaedic Research Journal

We report a rare case of Mycobacterium aviumintracellulare flexor tenosynovitis in the hand of a 65-year-old man. The patient reported no history of penetrating trauma but was an avid gardener and presented nearly 2 years after the onset of symptoms. Our case highlights the difficulty in diagnosing mycobacterial infections owing to their lack of classic clinical and laboratory findings. Our patient underwent successful surgical debridement followed by oral antibiotic therapy, initiated 4 weeks after the culture was positive for a slow-growing organism.

Volume Vi (2017), Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.