Orthopedics Commons^™

Acute Compartment Syndrome Following Lower Leg Vascular Injury: A Big-Data Approach To Estimating Incidence And Risk Factors, Harry Moroz, Edward J. Harvey, Yasser C. Bouklouch

Journal of Shock and Hemodynamics

Acute Compartment Syndrome (ACS) is a limb- and life-threatening complication of lower leg fractures. Rapid recognition and fasciotomy can prevent irreversible ischemic injury, but ACS is often under-recognized. Vascular injury may increase the risk of ACS by impairing perfusion and exacerbating swelling. This study aimed to determine the incidence, risk factors, and outcomes of ACS in patients with lower leg fractures, with particular emphasis on the impact of vascular injury. This retrospective cohort study used data from the 2017 American College of Surgeons Trauma Quality Programs database to perform a multicenter analysis of patients with lower leg fractures. Patients were …

Thoracolumbar Fractures: Historical Systems And Advancements With The Ao Spine Classification, Barry Ting Sheen Kweh, Alex R. Vaccaro, Gregory D. Schroeder, Jose A. Canseco, Maximilian Reinhold, Mohamed M. Aly, Sebastian Bigdon, Mohammad El-Skarkawi, Richard J. Bransford, Andrei Fernandes Joaquim, Harvinder Singh Chhabra, Emiliano Vialle, Rishi M. Kanna, Charlotte Dandurand, Cumhur Öner, Jin Wee Tee

Rothman Institute Papers

Study Design: Systematic Review. Objective: To describe the historical classifications of thoracolumbar injuries and their evolution into the AO Spine Thoracolumbar Injury Classification System. Methods: A systematic review of MEDLINE, EMBASE and Cochrane Databases was performed in keeping with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Results: 445 articles were crystallized to 14 included studies. Simple categorization systems offered by Bohler or Watson-Jones merely identify fracture morphology. Holdsworth and Denis conveyed a sense of the stability of injuries by noting columns of stability, but still failed to take into consideration important factors such as neurological status or …

Decoding A Decade: Evolution In Distal Radius Fracture Techniques From Past To Present, Embracing The Efcr Method, Natasha G. Dark, Ahmed S. Raihane, Laurie G. Wells, Deana Mercer

Western Journal of Orthopaedics

No abstract provided.

A Comprehensive Review Of Bone Remodeling After Trauma And Operative Treatment In Orthopedic Surgery, Sarah E. Rabin, Ian P. Marshall, Benjamin A. Nelson, Justine N. Li, Madison M. Baldauf, Ashley B. Bozzay, Benjamin W. Hoyt

Department of Medicine Faculty Publications

Bone remodeling is a dynamic process involving bone resorption and formation that is regulated on a cellular level and impacted by mechanical stress. A variety of Orthopedic surgery treatment strategies can affect bone remodeling, which can in turn may have long-term impacts on skeletal stress tolerance and function. This review provides a comprehensive overview of bone remodeling involved in Orthopedic surgery. Materials related to bone remodeling principles across Orthopedic surgery domains were selected and compiled using databases including PubMed, MEDLINE, AccessMedicine, and CINAHL; case studies were not included. Relevant literature was summarized for a general review of bone remodeling and …

Are Orthopaedic Trauma Surgeons At Risk Of Occupational Noise-Induced Hearing Loss?, Vincent W. Lau, Stephanie A. Kwan, Jack Graham, Gregory K. Deirmengian

Rothman Institute Papers

OBJECTIVES: Orthopaedic surgeons are at risk of occupational, noise-induced hearing loss due to exposure to instruments in the operating room. The primary objective of this study was to determine whether orthopaedic trauma procedures exceed recommended decibel (dB) limits. The secondary objective was to demonstrate which actions during a case create the highest sound levels.

METHODS: Intraoperative recordings were taken during orthopaedic trauma surgeries and classified into open reduction internal fixation (ORIF), intramedullary nailing, closed reduction percutaneous pinning, external fixation, soft tissue procedures, or a combination thereof. Recordings were taken of drilling, screw insertion, suctioning, saw use, and mallet striking. Decibel …

Epidemiology Of Shoulder Dislocations In The United States From 1990 To 2019: A Temporal Study Using The Global Burden Of Disease Database., Gabrielle Dykhouse, Ambrose Loc T Ngo, Phillip C Mckegg, Peter B Spencer, Arsalaan Sayyed, Taylor J Manes, Morgan Turnow, Nathaniel Long

Surgery Articles

Introduction The shoulder joint is a common site for joint dislocation, with many individuals suffering from recurrent dislocations following treatment. The purpose of this study was to evaluate the epidemiology of shoulder dislocations in the United States from 1990 to 2019. Methods The Global Burden of Disease database was utilized to collect epidemiological data on shoulder dislocations in the United States (U.S.) from 1990 to 2019. These data included age-standardized rates of years lived with disability (YLDs), prevalence rates, and incidence rates per 100,000 people. Using the U.S. Census Bureau definitions, the data were stratified into four regions: the Northeast, …

Use Of Intraoperative Vancomycin Powder And Its Effects On The Incidence Of Surgical Site Infection In Orthopaedic Trauma: A Systematic Review And Meta-Analysis, Troy Puga, Mckenna Box, Alan Lam, Claire Ferguson, Mason Poffenbarger, Cornelis Potgieter, John Riel

North Texas Research Forum 2025

Introduction Surgical site infection (SSI) in orthopaedic trauma can have devastating consequences for patients. Many risk factors for SSI exist and many strategies are employed to prevent SSI. The use of intraoperative powdered vancomycin is one such strategy used in orthopaedic trauma surgery, however, evidence and guidelines remain unclear. The aim of this systematic review is to evaluate the evidence for the use of powdered vancomycin in orthopaedic trauma surgery for the prevention of SSI. Methods A search was conducted across Pubmed/Medline, Cochrane, and Embase databases to evaluate for the use of powdered vancomycin in orthopaedic trauma surgery for the …

Introducing The University Of New Mexico 12-Level Functional Scale: A Novel Approach For Assessing Functional Recovery In Orthopaedic Trauma Patients, Devin A. Maez, Rick J. Gehlert, Thomas A. Decoster

Western Journal of Orthopaedics

The University of California at Los Angeles (UCLA) Activity Scale and other common activity scales are primarily used for patients undergoing joint reconstructive surgery. However, no such scale exists for musculoskeletal trauma patients. The authors propose The University of New Mexico (UNM) 12-Level Functional Activity Scale to address this gap in assessing functional activity and managing postoperative care for orthopaedic trauma patients. A comprehensive review of existing scales led to the development of the UNM Scale, emphasizing simplicity, objectivity, and potential benefits in patient education and interdisciplinary collaboration. The UNM Scale provides a structured approach to assess and monitor functional …

An Experience With A Concurrent Bilateral Tibia Interlocking Nailing: Its About Dancing With The Rhythm, Hoh Wee Liam Dr, Eyrique Goh Boay Heong, Hanif Azman

Manipal Journal of Nursing and Health Sciences

Tibial shaft fractures are the most common injuries resulting from high energy trauma such as motor vehicle accident or fall from height. Operative management options of tibia shaft fractures include intramedullary nailing, plating or external fixation or conservative by casting. Interlocking nail of tibia remains favorite among other type of surgical fixation as patient can rehabilitate post op earlier.

Interlocking nail of bilateral tibia are usually performed sequentially in view of patient needing to be properly positioned to allow easy entry and reaming of interlocking nail. Hence, this will prolong operative time, thus increasing risk of general anaethesia and surgical …

To Manipulate Or Not? Management Of Pediatric Knee Arthrofibrosis Following Operative Fixation Of Tibial Spine Fractures, Matthew J Folkman, Neeraj M Patel, Alexandra C Stevens, Aristides I Cruz, R Jay Lee, Indranil Kushare, Theodore J Ganley, Henry Ellis, Peter Fabricant, Daniel Green, Benjamin Johnson, Scott Mckay, Gregory Schmale, Yi-Meng Yen, R Justin Mistovich

Faculty, Staff and Students Publications

Background: Knee arthrofibrosis is a common complication after surgical fixation of tibial spine fractures. However, there is no standardized treatment modality for resultant arthrofibrosis, with some surgeons electing for nonoperative management, while others prefer manipulation under anesthesia with a possible arthroscopic lysis of adhesions, if indicated. To better understand indications and outcomes from these treatment modalities for arthrofibrosis, we examined patients treated by both approaches.

Methods: We performed a multicenter retrospective case series of patients with arthrofibrosis after tibial spine fracture surgery. Arthrofibrosis was defined as loss of knee extension ≥10.0° and/or knee flexion ≥25.0° compared to the contralateral, uninjured …

Risk Factors For Loss To Follow Up In Pediatric Supracondylar Humerus Fractures, Nathaniel Grey Loyd, David Hsiou, Armando Martinez, Pablo Coello, Lon Kai Pang, Muhammad Hamza Shamim, Jessica Mcgraw-Heinrich, Scott B Rosenfeld

Faculty, Staff and Students Publications

Background: This study seeks to analyze risk factors associated with loss to follow up (LTF) after pin pull in pediatric patients with operatively treated supracondylar humerus fractures (SCHF).

Methods: A retrospective cohort study of patients under 18 years with operative SCHF from 2010 to 2020 was conducted. Factors of interest included LTF, age, race, language, distance to the hospital, Gartland fracture type, and Social Deprivation Index (SDI) by ZIP code. Univariate logistic regression was performed for each independent variable and significant variables were additionally analyzed with multivariate logistic regression analysis.

Results: Six hundred ninety-eight patients were included in the study. …

Construct Length Analysis Of Type B And C Cervical And Thoracolumbar Fractures, Jeremy C. Heard, Mark J. Lambrechts, Yunsoo Lee, Teeto Ezeonu, Delano R. Trenchfield, Nicholas D. D'Antonio, Azra N. Dees, Bright M. Wiafe, John J. Mangan, Jose A. Canseco, Barrett I. Woods, Ian David Kaye, Alan S. Hilibrand, Alex R. Vaccaro, Christopher K. Kepler, Gregory D. Schroeder

Rothman Institute Papers

Objectives:

The purpose of this study is to identify if construct length affects the rate of surgical complications and instrumentation revision following surgical fixation of subaxial and thoracolumbar Type B and C fractures. This study evaluates the effect of ankylosing spondylitis/diffuse idiopathic skeletal hyperostosis (AS/DISH) within this population on outcomes.

Methods:

Retrospective review of 91 cervical and 89 thoracolumbar Type B and C fractures. Groups were divided by construct length for analysis: short-segment (constructs spanning two or less segments adjacent to the fracture) and long-segment (constructs spanning more than two segments adjacent to the vertebral fracture).

Results:

For cervical fractures, …

Nail-Plate Combination Treatment Of Ipsilateral Humeral Shaft And Distal Humerus Fractures - A Case Report., Mark Lagreca, Yash P Chaudhry, Thomas Falconiero, Thomas Muzzonigro, Daniel Lippe, Mitesh Shah

Orthopedic Surgery Resident Research

INTRODUCTION: Humeral shaft and distal humerus fractures have several different treatment options, including plate fixation and intramedullary nailing. Each has its own benefits, but typically, they are not used in conjunction. While nail-plate combinations (NPCs) have become more common in the lower extremity, literature on their use in upper extremity fractures remains scarce.

CASE REPORT: A 74-year-old right-hand dominant male presented after a fall with a closed left transverse midshaft humerus fracture and an associated supracondylar distal humerus fracture with intercondylar extension through a medial column. Due to the segmental nature of his injury, medial column plating was used in …

Masquelet Technique Promotes Osteogenesis In Traumatic Open Tibial Plateau Fracture, Melanie Valencia, Paul C. Baldwin

South Atlantic Division GME Research Day 2024

No abstract provided.

Pelvic Fractures - An Overview, Shashank Cheemalapati

Digital Journal of Clinical Medicine

Pelvic fractures are injuries commonly caused by high-energy trauma, such as motor vehicle accidents and falls from a height. Understanding the anatomy, mechanisms of injury, classification, diagnosis and the management of these fractures is crucial to improve patient outcomes. This short article aims to provide a comprehensive overview of the current state of knowledge regarding pelvic fractures.

The Effect Of Graft Selection On Patients’ Subjective Readiness To Return To Sport After Acl Reconstruction, Adeeb Hanna, William Johns, Emma Johnson, Bryson Kelmer, Gabriel Onor, Kevin Freedman, Christopher Dodson, Michael Ciccotti

Rowan-Virtua Research Day

Background: Patients who undergo ACL reconstruction with allografts may have an easier functional recovery compared to autograft patients. This is due to decreased donor site morbidity and less muscle atrophy compared to autograft patients. This “easier” recovery may be perceived by patients and may result in a subjective earlier readiness for return to sports.

Hypothesis/Purpose: To determine if there is a difference in perceived readiness to return to sport (RTS) in the first year postoperative period between individuals who undergo ACL reconstruction utilizing bone-patellar tendon-bone (BTB) autografts or allografts.

Study Design: Prospective Cohort Study, Level II Methods: This was a …

Do Lower Extremity Injuries Of Nfl Players Affect Their Yearly Income?, Abdullah Sahyouni, Robert De La Torre, Gautham Pavar, Kinan Sawar, Yasmeen Alcodray, Bohdan Matsko, Justin Bennie, Nicole Xu, Harika Bollineni

Medical Student Research Symposium

Introduction: Injuries are arguably the most daunting career setbacks professional sports players have to face. To better understand the drawbacks of sports injuries, we decided to examine players’ annual income before and after sports injuries. Income is arguably the most important metric of success for professional athletes. To make the study more relevant for the US, we collected data on one of the most viewed professional sports leagues in the country: the National Football League (NFL).

Methods: We examined the NFL’s weekly injury reports for seasons from 2016 to 2020, and recorded players with lower extremity injuries (LEI) (Hamstring, Calves, …

'Empty Toe' Phenomenon: A Unique Trauma Case, Sadaf Sheikh, Junaid Khan, Rizwan Haroon Rashid

Section of Orthopaedic Surgery

No abstract provided.

Evolution Of The Ao Spine Sacral And Pelvic Classification System: A Systematic Review, Barry Ting Sheen Kweh, Jin W. Tee, F. Cumhur Oner, Klaus J. Schnake, Emiliano N. Vialle, Frank Kanziora, Shanmuganathan Rajasekaran, Marcel Dvorak, Jens R. Chapman, Lorin M. Benneker, Gregory Schroeder, Alexander R. Vaccaro

Rothman Institute Papers

OBJECTIVE: The purpose of this study was to describe the genesis of the AO Spine Sacral and Pelvic Classification System in the context of historical sacral and pelvic grading systems.

METHODS: A systematic search of MEDLINE, EMBASE, Google Scholar, and Cochrane databases was performed consistent with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify all existing sacral and pelvic fracture classification systems.

RESULTS: A total of 49 articles were included in this review, comprising 23 pelvic classification systems and 17 sacral grading schemes. The AO Spine Sacral and Pelvic Classification System represents both the evolutionary …

Survivorship, Complications, And Outcomes Following Distal Femoral Arthroplasty For Non-Neoplastic Indications., Keenan Rhys Sobol, Brianna R Fram, John T Strony, Scot A Brown

Department of Orthopaedic Surgery Faculty Papers

AIMS: Endoprosthetic reconstruction with a distal femoral arthroplasty (DFA) can be used to treat distal femoral bone loss from oncological and non-oncological causes. This study reports the short-term implant survivorship, complications, and risk factors for patients who underwent DFA for non-neoplastic indications.

METHODS: We performed a retrospective review of 75 patients from a single institution who underwent DFA for non-neoplastic indications, including aseptic loosening or mechanical failure of a previous prosthesis (n = 25), periprosthetic joint infection (PJI) (n = 23), and native or periprosthetic distal femur fracture or nonunion (n = 27). Patients with less than 24 months' follow-up …

Does Minimally Invasive Spine Surgery Reduce Surgical Site Infection Rates In The Trauma Patient? A Southeast Asian Experience., Chenghan Wu, Kelvin Kah Ho Lor, Eugene Weiren Yang, Allan Shao Hui Ng

BioMedicine

Abstract

Introduction:

The trauma patient has an increased susceptibility to postoperative surgical site infection (SSI). There is a lack of studies in the literature investigating the rates of SSI in minimally invasive spine (MIS) surgery for trauma patients with thoracolumbar fractures with other concomitant injuries. We aim to investigate if MIS surgery for trauma patients reduces the incidence of SSI through a less invasive approach and smaller surgical incision.

Methods:

A case series of 30 trauma patients who underwent MIS surgery for thoracolumbar spine fractures at our center were followed up for a year. The primary outcome measured was the …

Effect Of Patient-Surgeon Orientation On Plunge Depth During Plate Fixation Of Clavicle Fractures, Aaron Mullane, Layla A. Haidar, Adam Kozemchak, Colton Wayne

Western Journal of Orthopaedics

Background: Operative management of clavicle fractures indicated for open reduction internal fixation poses significant risk to critical anatomic structures. The associated risks to the underlying neurovascular structures during clavicle fixation as a result of plunge depth for patients in the supine position in comparison to patients in the beach-chair position is currently unknown. The purpose of this study was to compare plunge depth measurements between the supine and beach-chair positions during plate fixation of clavicle fractures. Methods: The participant population at this single institution was comprised of residents, fellows, and fellowship-trained, attending orthopaedic surgeons. The participants drilled three bicortical holes …

The University Of New Mexico Orthopaedics Research Journal 2021, Unm Department Of Orthopaedic Surgery

Western Journal of Orthopaedics

No abstract provided.

Comparison Of Short-Leg And Long-Leg Casts For The Treatment Of Distal Third Tibial Shaft Fractures In Children, Scott A. Barnett, Bailli Fontenot, Claudia Leonardi, Joseph A. Gonzales, Dominic Gargiulo, Michael J. Heffernan

School of Medicine Faculty Publications

Background:Long-leg casts (LLCs) are an established treatment for pediatric tibial shaft fractures including fractures involving the distal third. There is a paucity of literature assessing the use of short-leg cast (SLC) for tibial shaft fractures. The purpose of this study was to determine if SLC were as effective as LLC for the treatment of pediatric distal third tibial shaft fractures.Methods:A retrospective review was conducted on consecutive distal third tibial shaft fractures treated at a tertiary pediatric hospital from 2013 to 2018. Exclusion criteria included midshaft and proximal fractures of the tibia, distal fractures that violated the tibial physis or plafond, …

Change In The Spectrum Of Orthopedic Trauma: Effects Of Covid-19 Pandemic In A Developing Nation During The Upsurge; A Cross-Sectional Study, Pervaiz Mahmood Hashmi, Marij Zahid, Syed Arif Ali, Hammad Naqi Khan, Anum Sadruddin Pidani, Alizah Pervaiz Hashmi, Shahryar Noordin

Section of Orthopaedic Surgery

Background: The COVID-19 pandemic has caused a great impact on orthopedic surgery with a significant curtailment in elective surgeries which is the major bread and butter for orthopedic surgeons. It was also observed that the spectrum of orthopedic trauma injuries has shifted from more severe and frequent road traffic accidents (high energy trauma) to general, low energy house-hold injuries like low energy fractures in the elderly, pediatric fractures, house-hold sharp cut injuries and nail bed lacerations. The aim of this study is to appraise the effect of the COVID-19 pandemic on orthopedic surgical practice, both inpatient and outpatient facility.
Materials …

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

Western Journal of Orthopaedics

No abstract provided.

Sustaining The National Spinal Cord Injury Registry Of Iran (Nscir-Ir) In A Regional Center: Challenges And Solutions, Zahra Azadmanjir, Zahra Mohtasham-Amiri, Seyed-Mahdi Ziabari, Leila Kochakinejad, Hamid Haidari, Guilan University Of Medical Sciences, Hadis Sabour, Zahra Khazaeipour, Mahdi Sharif-Alhoseini, Zahra Ghodsi, Abbas Amirjamshidi, Farshad Akbarzadeh, Kazem Zendehdel, Amir Azarhomayouon, Khatereh Naghdi, Gerard Oreilly, Ellen Merete, Alexander Vaccaro, Edward C. Benzel, Seyed Behzad Jazayeri, Vafa Rahimi-Movaghar

Department of Orthopaedic Surgery Faculty Papers

Background: The National Traumatic Spinal Cord Injury Registry in Iran (NSCIR-IR), was implemented initially in three hospitals as a pilot phase from 11 Oct 2015 to 19 Jun 2016 and has been active in eight centers from 19 Jun 2016. Poursina Hospital, a trauma care referral center in Rasht, Guilan Province of Iran is one of the registry sites, and has been involved in registering eligible patients since 1 Jan 2016. This study aimed to identify the challenges and solutions for sustaining the NSCIR-IR in a regional center.

Methods: This was a mixed-methods study. For the quantitative analysis, a retrospective …

Staged Management Of High-Energy Complex Tibial Pilon Fractures, Gan Golshteyn Dpm, Gina Nguyen Dpm, Bradley Roth Do, Marie Williams Dpm

Podiatry

No abstract provided.

Functional And Clinical Outcomes Of Open Versus Closed Radius And Ulna Shaft Fractures In Adults: A Prospective Cohort Study, Tashfeen Ahmad, Zehra Abdul Muhammad, Pervaiz Hashmi

Section of Orthopaedic Surgery

Objective: To compare functional and clinical outcomes of open versus closed radius ulna shaft fractures in adults treated by internal fixation.
Methods: A prospective cohort study was conducted on patients presenting with traumatic radius and ulna shaft fractures to Aga Khan University and undergoing internal fixation between July 2015 to June 2019. Data was extracted from an ongoing orthopaedic trauma registry. Functional and clinical outcomes were assessed by Price et al. criteria at 6 weeks, 3, 6 and 12 months follow-up. Outcome scores of open versus closed fractures were compared.
Results: Twenty-nine adult patients with isolated radius and ulna shaft …

Comparison Of Intraarticular Distal Humerus Fracture Outcomes Treated With Or Without Olecranon Osteotomy - A Case Series, Naveed Baloch, Tashfeen Ahmad, Zehra Abdul Muhammad

Section of Orthopaedic Surgery

A case series was extracted from the trauma registry at Aga Khan University Hospital from the period June 2015 to June 2019. Included were 16 adult patients who presented with intra-articular distal humerus fracture type C2. The functional, clinical and radiological outcomes of fractures treated with or without olecranon osteotomy up to 12 months follow-up were compared. Outcomes were assessed at 6 weeks, 3, 6 and 12 months re-visits. Among the 16 studied patients, 9 (56%) were males and 7 (44%) were females. In the group without osteotomy, there was a good functional and clinical outcome with a mean Quick …