Orthopedics Commons^™

Measurement Of Femoral Notch Type Show Low Inter-Rater Reliability, Evan D. Boyd, Michael S. Barnum, James R. Saluterbeck, Pamela M. Vacek

Western Journal of Orthopaedics

Background: Preventing first time anterior cruciate ligament (ACL) injury and the devastating sequela of post-traumatic osteoarthritis in the young athlete has attracted efforts to identify risk factors for development of ACL injury. Femoral notch type has been related to risk of ACL injury in previous studies. However, little data exists to support the reliability of assessing this qualitative measurement amongst independent investigators. Methods: Femoral notch type was measured from magnetic resonance imaging sections of 344 injured ACL and control knees by three investigators with different levels of professional experience. Inter-rater reliability was assessed using Cohen’s kappa statistic. Results: The simple …

Alumni Map 2020, Unm Department Of Orthopaedic Surgery

Western Journal of Orthopaedics

No abstract provided.

Prevalence Of Prolonged Sitting Among Orthoapedic Residents, Benjamin D. Packard, Richard A. Miller

Western Journal of Orthopaedics

Background: There is a plethora of data regarding the negative health consequences of sitting, including increased cardiometabolic risk factors and all-cause mortality. Correctable actions should be identified. Methods: A literature review was performed to examine articles that identified sitting prevalence and health consequences. A survey querying average hours per day spent sitting was distributed to orthopaedic residents at a single institution. Statistical analysis of the data was performed using a 2-tailed t test. Results: A total of 25 orthopaedic residents were surveyed, and 20 responses were received. The average time spent sitting was 5.38 hours per day. There was equal …

Pronator Quadratus Rotational Muscle Flap Technique For Coverage Of Hardware After Distal Radius Orif, Camille Aubin-Lemay, Henry Ran, Deana Mercer

Western Journal of Orthopaedics

Flexor tenosynovitis and tendon rupture are rare. Yet these occurrences can be serious complications after treatment of a fractured distal radius with a volar plate. The highest incidents of rupture are associated with the plate on or distal to the watershed line of the radius. Although studies have shown that reattachment of the pronator quadratus (PQ) following plating does not lead to improved measures in grip strength or range of motion, it is possible that doing so may reduce the incidence of flexor tendon irritation or rupture. Reattachment of the PQ after a standard approach does not often capture the …

Hallus Rigidus: A Technique For Reliable, Safe, And Reproducible Cheilectomy Excision, Jory Wasserburger, Amber Price, Matthew Wharton, Richard Miller

Western Journal of Orthopaedics

Hallux rigidus is a common cause of foot pain involving the hallux; however, the etiology is yet to be elucidated. There are many different treatments that have been described, including cheilectomy. Taking too much bone can cause joint instability and altered joint mechanics, whereas taking too little bone may not relieve pain. We present a reliable, safe, and reproducible technique for cheilectomy in the hallux rigidus.

Foreign Bodies In The Hand: A Case Report, Review Of Literature, And Guidance For Acute Management, Jessica Avila, Griffin Biedron, Jordan Carter, Gilberto A. Gonzalez

Western Journal of Orthopaedics

No abstract provided.

Isolated Proximal Fibula Fractures In Young Athletes Mimic Lateral Collateral Ligament Injury, Aaron M. Gray, Jason H. Nielson

Western Journal of Orthopaedics

Lateral knee injury is common among adolescent athletes in both contact and non-contact sports. Injuries in this population deserve special consideration regarding diagnosis and treatment due to the presence of open, closing, or recently closed physes. We describe two cases of isolated proximal fibula fractures with knee pain and laxity to varus stress in young athletes. Isolated proximal fibula fractures can mimic lateral collateral ligament injuries in the knee. Treatment for these injuries is conservative with bracing, protected weight bearing, and delayed or protected return to activity.

Femoral Diaphysis Fracture In A Collegiate Male Hockey Player: A Case Report, Matthew Bain, James Slauterbeck

Western Journal of Orthopaedics

Femoral diaphysis fractures represent a small subset of sports-related orthopaedic trauma, accounting for less than 1% of all sports fractures. We describe a 22-year-old male ice hockey player who slid and crashed into the boards during practice. Radiographs revealed fracture of the femoral diaphysis, necessitating surgical intervention to insert an intermedullary nail. Rehabilitation was a hybrid of an anterior cruciate ligament reconstruction and hip labrum repair protocols. There was emphasis on rotator cuff strengthening and lower-extremity rehabilitation owing to a pre-existing shoulder dislocation that occurred during the same season. He returned to skating at 16 weeks, and at 20 weeks …

A Case Of Osteosarcoma And Its Presentation In A Division I Collegiate Athlete, Alec Sundet, Allison Shepherd, James Slauterbeck

Western Journal of Orthopaedics

Primary bone and soft-tissue tumors may present by mimicking common sports injuries. Their diagnosis is contingent on maintaining a broad differential. We report a case of a 20-year-old male athlete who sustained a twisting injury to his planted right knee while playing college lacrosse. He was unable to bear weight or fully extend his knee. The team’s orthopaedic surgeon was concerned for a locked knee secondary to a possible flipped meniscal tear. Radiographs and magnetic resonance imaging were performed that led to the discovery of an expansile, sclerotic lesion arising from the posteromedial aspect of the distal femur. Biopsy of …

Treatment Of Both Column Acetabular Bone Loss In Multiple Myeloma Patient With Custom Triflange Acetabular Component: A Case Report, Scott Plaster, Kyle Stephen, David Chafey

Western Journal of Orthopaedics

Massive acetabular bone loss with pelvic discontinuity remains a challenging obstacle with few arthroplasty solutions. We present a case of a 61-year-old man with multiple myeloma who suffered a pathologic acetabular fracture resulting in acetabular protrusio and eventually extensive acetabular bone loss. His prognosis was initially poor; however, he ultimately responded to his radiation and chemotherapy and was limited in his mobility by his extensive acetabular bone loss. Given his complex presentation, it was decided to go forward with total hip arthroplasty utilizing the Zimmer-Biomet custom triflange acetabular component. His outcome at 9 months is fair

Tibial Lengthening Using A Magnetic Lengthening Intramedullary Nail In An Hiv-Positive Patient: A Case Report And Review Of Literature, Rami Khalifa, Christopher Gerzina, Amr Abdelgawad, Ahmed M. Thabet

Western Journal of Orthopaedics

Limb lengthening can be affected by poor bone healing in patients with human immunodeficiency virus. This is a case report of a 56-year-old man with 6.1 cm leg length discrepancy and end-stage arthritis in the hip. The patient had total hip arthroplasty prior to his lengthening procedure. The patient was human immunodeficiency virus positive. This case report describes the experiences of using a motorized intramedullary magnetic lengthening nail in equalization of limb length discrepancy. Treatment for the patient included tibial lengthening with a motorized nail to correct the limb length discrepancy, with adequate bone healing in a patient with an …

Intra-Articular Osteoid Osteoma Of The Elbow: A Case Report, Catherine M. Westbom, John E. Nolan, Nathan T. Morrell

Western Journal of Orthopaedics

A 24-year-old woman, with 5 years of left elbow pain, was given a preliminary diagnosis of focal pigmented villonodular synovitis based on magnetic resonance imaging. She underwent arthroscopic debridement and was found to have an intra-articular bony mass. Histopathology was consistent with an intra-articular osteoid osteoma. The mass was removed arthroscopically with excellent symptomatic improvement. There was no recurrence of symptoms at 1 year follow-up.

Arthroscopic Management Of Focal Pigmented Villonodular Synovitis In The Scaphotrapeziotrapezoidal Joint, John E. Nolan, Brian W. Gross, Nathan T. Morrell

Western Journal of Orthopaedics

A 43-year-old man presented with persistent wrist pain and loss of range of motion after nonoperative therapy. Magnetic resonance imaging showed features consistent with pigmented villonodular synovitis (PVNS) of the scaphotrapeziotrapezoidal joint. He underwent arthroscopic excision and synovectomy. At 2 years postoperatively, he had no symptomatic recurrence. This case shows the importance of considering PVNS for chronic pain of small joints, and it highlights the viability for arthroscopic synovectomy as a treatment option.

Predicting Running Ability After Lower Extremity Amputation: A Review, Rebecca Dutton

Western Journal of Orthopaedics

The ability to ambulate with a prosthesis after lower extremity limb loss is an important determinant of functional independence and quality of life. Some individuals may be capable of achieving higher levels of mobility (eg, running) that can further improve function, physical health, and mental health. Thus, a fundamental understanding of the variables that help predict ambulation ability after lower limb loss is important. Particular attention should be given to modifiable predictors, as interventions directed at these conditions can help facilitate optimal mobility and function. This article reviews various factors that influence the ability

Malreductions Following Intramedullary Nail Fixation Of Femur Shaft Fractures, Jory Wasserburger, Christopher Kurnik, Thomas A. Decoster

Western Journal of Orthopaedics

Femur shaft fractures are common injuries frequently treated with intramedullary fixation. Although satisfactory alignment is usually achieved, malreductions can happen in sagittal and coronal planes, as well as along the longitude axis. The causes of malposition with femoral nailing include fracture location, comminution, and suboptimal technique. We identify the most common patterns of malreduction of nailed femu

Cost Analyses Of Nonoperative Treatment Of Sports-Medicine Conditions Are Lacking, Casey Slattery, Jai Yao, Amy Cizik, Mia S. Hagen

Western Journal of Orthopaedics

The purpose of this study was to qualitatively review existing studies that examined cost data within sports medicine. A literature search was conducted for all economic studies related to sports-medicine conditions from 2000 to 2017 within the United States. Area of analysis, data source utilized, and the type of collected cost data was identified. There were 29 studies that met criteria, with the majority of studies (60%) focused on rotator cuff repair and anterior cruciate ligament reconstruction. Substantial variability in data source, practice setting, data metrics, and reported measures makes interpretation of existing reports challenging. Greater diversity in topics and …

Can The Contralateral Knee Effectively Estimate Pre-Injury Patellar Height? A Control Study, Benjamin Albertson, Andrew Ockuly, Ian Fletcher, Daniel Wascher

Western Journal of Orthopaedics

Introduction: Patellar height abnormalities have been associated with patellar instability, which is common among adolescents and young adults. Pre-injury patellar height is often unknown in patients with a patellar instability episode. The purpose of this study was to determine whether patellar height of one knee could effectively estimate patellar height of the contralateral knee in control patients between the ages of 13 and 25 years. Methods: A retrospective chart review was conducted to identify 40 patients who obtained bilateral knee radiographs with no prior surgical intervention or diagnosis of injury to the extensor mechanism. CatonDeschamps Index (CDI) was measured by …

The Vulcan Sign: A Radiographic And Clinical Indicator Of Plantar Plate And Collatoeral Ligament Injury, Katherine Gavin

Western Journal of Orthopaedics

Introduction: There is no consensus on terminology used to describe the radiographic and clinical findings commonly encountered in second metatarsophalangeal (MTP) instability. We propose the use of a consensus term, the Vulcan sign, to describe the deformity commonly seen in second MTP instability and verify its utility as an adjunct in the diagnosis and treatment of plantar plate and collateral ligament pathology. Methods: We retrospectively evaluated preoperative anteroposterior weight-bearing x-rays of 156 feet of patients who underwent operative intervention for second MTP instability and the presence of a Vulcan sign at the second webspace, defined as more than 50% medial …

The Importance Of The Screening Anteroposterior Pelvis Radiograph In Trauma Patients: A Level-1 Trauma Center's Experience With Traumatic Hip Dislocations, Ansab Khwaja, Brad Askam, Matt Morin, Aditya Manoharan

Western Journal of Orthopaedics

Background: Advanced Trauma Life Support guidelines strongly recommend obtaining anteroposterior (AP) pelvis radiographs when evaluating patients with traumatic injuries. Recently, there has been a trend at our institution to forego AP pelvis radiographs, and to obtain computed tomography (CT) scans as the initial imaging modality of the pelvis instead. Lifesaving interventions, such as the application of a pelvic binder, can be delayed due to the time it takes to complete a primary survey and a CT scan. This study aims to evaluate the effects of bypassing an AP pelvis radiograph on the management of acute traumatic dislocations of the hip. …

Inter- And Intra-Observer Differences In Proximal Fifth Metatarsal Fractures, Benjamin Packard, Kathryn Yeagar, Richard A. Miller, Katherine Gavin

Western Journal of Orthopaedics

Introduction: Proximal fifth metatarsal fractures are common. When using the Lawrence and Botte Classification for these injuries, they are classified as type 1, 2, and 3. Identifying the zone of injury is crucial to guide treatment. The authors hypothesize that interand intra-observer reliability of these fractures is low. Methods: Anteroposterior (AP), lateral, and oblique x-rays of 60 patients with isolated fifth metatarsal base fractures were reviewed. Five physicians evaluated the radiographs and classified the fractures as type 1,2, or 3. Each of the three radiographic views were examined separately. Results were then analyzed for inter- and intra-observer reliability. Results: Sixty …

Quantifying Coverage Of A Distal Radius Volar Plate Using A Novel Pronator Quadratus Rotational Muscle Flap Technique, Christina Salas, Leslie Neher, Joshua Romero, Camille Aubin-Lemay

Western Journal of Orthopaedics

Background: Flexor tenosynovitis and tendon rupture are rare, yet serious complications after treatment of a fractured distal radius with a volar plate. The highest incidents of rupture are associated with the plate on or distal to the watershed line of the radius. While studies have shown that reattachment of the pronator quadratus (PQ) following plating does not lead to improved measures in grip strength or range of motion, it may reduce the incidence of these complications. Reattachment of the PQ after a standard approach does not often capture the distal edge of the plate. We report results of a new …

Aspetic Nonunion Of Long Bones In Children: A Report Of Twelve Cases, Rami Khalifa, Amr Abdelgawad, Ahmed M. Thabet

Western Journal of Orthopaedics

Background: There are very few reports in the literature that directly address nonunion in children. The current study aimed to present a series of long bones nonunion in children following fractures and corrective osteotomies. Methods: This was a retrospective study that included pediatric patients diagnosed with nonunion following long bone fractures or corrective osteotomies. Patients with nonunion following femoral neck or lateral humeral condyle fractures were excluded. The clinical and radiological records were retrospectively analyzed. Results: Eight patients developed nonunion after fractures, while four patients had nonunion after corrective osteotomies. The mean age at the time of surgical procedure for …

The Versatility Of Taylor Spatial Frame In Treating Comple Posttraumatic Deformities Of The Lower Extremity, Rami Khalifa, Amr Abdelgawad, Ahmed M. Thabet

Western Journal of Orthopaedics

Background: The Taylor Spatial Frame (TSF) is a multiplanar external fixator with a computerized web-based program to provide accurate fractures reduction and deformity correction. This study aimed to evaluate our results after the treatment of complex lower extremity injuries with the external fixators including TSF. Methods: This retrospective case series included eight patients with complex lower extremity injuries treated with TSF. The medical records and radiographs were reviewed. The ASAMI score was used as an outcome measure. Statistical analysis used Microsoft Excel descriptive statistics. No inferential statistical tests were done owing to the small sample size. Results: The mean age …

The University Of New Mexico Orthopaedics Research Journal 2020, Unm Department Of Orthopaedic Surgery

Western Journal of Orthopaedics

No abstract provided.

Combined Open Calcaneocuboid, Naviculocuneiform And Subtalar Dislocation: A Case Report And Literature Review, Khai Phang Wong, Zhi Hao Tang, Gek Meng Tan

BioMedicine

Open dislocations of the midfoot and subtalar joints are extremely rare injuries. Understanding the anatomy of these joints and the various injury patterns is imperative to obtain stable concentric reduction and provide good functional outcome. We present a report of a 26- year old male who was involved in a road traffic accident and sustained open dislocations of the calcaneocuboid, naviculocuneiform and subtalar joints. He initially underwent external fixation in view of the severe soft tissue injury. After improvement of the soft tissue condition, he underwent K-wiring of the calcaneocuboid joint, buttress plating of the talonaviculocuneiform joint, peroneal tendon reconstruction …

Acute Opioid Withdrawal Mimicking Postoperative Joint Infection Following Anterior Cruciate Ligament (Acl) Reconstruction: A Case Report., Qingwu Kong, Martin Griffis, Brandon J Shallop, Amrit S Khalsa, Kyle Brougham, Paul A Marchetto

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND A short course of opioid narcotics is often prescribed for postoperative anterior cruciate ligament (ACL) reconstruction pain management. Unfortunately, there is a well-documented incidence of opioid withdrawal syndrome (OWS) following short-term use of these medications. OWS can present with symptoms such as influenza-like illness. It is important to differentiate OWS from infectious illnesses, especially after surgery. CASE REPORT We present a case of OWS in a patient who underwent ACL reconstruction 7 days prior. The patient's OWS symptoms were similar to symptoms of a postoperative infection. The knee was aspirated, and the analysis of the aspirate was not concerning …

Seasonal Influence On Postoperative Hip Fracture Complications: Retrospective Cohort Of More Than 1000 Patients From A Tertiary-Care University Hospital, Obada Hasan, Mashal Amin, Fatima Mahmood, Amna Rabbani, Umar Rabbani, Shahryar Noordin

Department of Paediatrics and Child Health

Background: Hip fractures account for one of the most debilitating conditions affecting the general population amongst the developed and developing nations. Investigators aimed to study the influence of the ongoing season i.e. whether patients operated upon in summer or winter, on post-operative complications occurring within 30 days of surgical procedure for hip fractures at a tertiary care hospital and level 1 trauma center.
Materials and methods: Investigators conducted a non-funded, non-commercialized retrospective cohort of 1045 patients with hip fractures managed surgically. Primary exposure was surgical procedures undertaken during the summer months (April-September). Our primary outcome was determining post-operative complication rates …

The Effect Of Critical Shoulder Angle On Functional Compensation In The Setting Of Cuff Tear Arthropathy., Jeffrey Lu, Manan Patel, Joseph A. Abboud, John G. Horneff

Rothman Institute Papers

Introduction: Critical shoulder angle (CSA) has been shown to influence rates of rotator cuff tears and glenohumeral arthritis with a larger CSA associated with rotator cuff tears and a smaller CSA associated with glenohumeral arthritis. There has been no study to determine whether such radiographic measurement influences the function of patients with demonstrated cuff tear arthropathy (CTA). The purpose of this study was to examine whether smaller CSAs were associated with greater range of motion (ROM) in patients diagnosed with CTA.

Materials and methods: Ninety-three patients with a diagnosis of CTA with adequate anteroposterior shoulder radiographs were included in the …

Effectiveness Of Home-Based Rehabilitation Program In Minimizing Disability And Secondary Falls After A Hip Fracture: Protocol For A Randomized Controlled Trial, Anum Sadruddin Pidani, Saniya Sabzwari, Khabir Ahmad, Ata Khan, Shahryar Noordin

Department of Surgery Docs

Introduction: Hip fractures are a major health problem globally and are associated with increased morbidity, mortality, and substantial economic costs. Successful operative treatment of hip fracture patients is necessary for the optimization of post-op mobility and functional recovery of the patient. Rehabilitation after surgical stabilization of a hip fracture is crucial in order to restore pre-fracture function and to avoid long-term institutionalization. In particular ongoing exercise which targets balance can prevent up to 40% of falls. Therefore, we have designed a post-discharge home-based physical rehabilitation intervention program to minimize disability and falls in this high-risk elderly population.
Methods and analysis: …

Do New Trainees Pose A Threat To Postoperative Complications After Hip Fracture Surgeries? Retrospective Cohort Of 1045 Patients Over A Decade At A University Hospital, Obada Hasan, Mashal Amin, Umar Rabbani, Amna Rabbani, Fatima Mahmood, Shahryar Noordin

Department of Paediatrics and Child Health

Introduction: Induction of new residents and surgical trainees in most institutes occurs once a year. Fresh residents with no experience, may pose a threat to the surgical procedure outcome and there can be a potential increase in patients' morbidity and mortality as a result of this turnover. Literature is inconclusive about this effect. Our aim was to study the "new residents' induction effect" on postoperative complications after hip fracture surgeries.
Methodology: This is non funded non commercialized study from a university hospital. Investigators studied a retrospective cohort of 1045 adult hip fracture patients who were operated at our tertiary care …