Orthopedics Commons^™

Intra-Articular Tranexamic Acid During Total Knee Arthroplasty, Ahmed F. Khan

Clinical Research in Practice: The Journal of Team Hippocrates

An informed consent conversation regarding bleeding risk prior to total knee arthroplasty in an elderly patient with chronic kidney disease.

Management Of Elbow Dislocations In The National Football League., Edward S. Chang, Meghan Bishop, Christopher C. Dodson, Peter F. Deluca, Michael G. Ciccotti, Steven B. Cohen, Matthew L. Ramsey

Department of Orthopaedic Surgery Faculty Papers

Background: Although much literature exists regarding the treatment and management of elbow dislocations in the general population, little information is available regarding management in the athletic population. Furthermore, no literature is available regarding the postinjury treatment and timing of return to play in the contact or professional athlete.

Purpose: To review the clinical course of elbow dislocations in professional football players and determine the timing of return to full participation.

Study Design: Case series; Level of evidence, 4.

Methods: All National Football League (NFL) athletes with elbow dislocations from 2000 through 2011 who returned to play during the season were …

Natural Progress Of D-Dimer Following Total Joint Arthroplasty: A Baseline For The Diagnosis Of The Early Postoperative Infection., Yong Seuk Lee, Young-Kyun Lee, Seung Bum Han, Chang Hyun Nam, Javad Parvizi Md, Kyung-Hoi Koo

Rothman Institute Papers

BACKGROUND: Early detection followed by prompt intervention is essential for the treatment of periprosthetic joint infection (PJI). D-dimer, a fibrin degradation product, characteristically changes rapidly during early postoperative period and has a short half-life. The aim of this prospective study was to measure postoperative change of D-dimer level after joint arthroplasty in conjunction with ESR and CRP.

METHODS: ESR, CRP, and D-dimer levels were measured on the day before surgery, postoperative days 1, 2, 3, and 5 and weeks 2 and 6 in 65 patients who underwent elective primary total hip arthroplasty (38 hips in 38 patients) or total knee …

Muscle Activity During Maximal Isometric Forearm Rotation Using A Power Grip, Joseph Scott Bader, Michael R. Boland, Desney Greybe, Arthur J. Nitz, Timothy L. Uhl, David A. Pienkowski

Biomedical Engineering Faculty Publications

This study aimed to provide quantitative activation data for muscles of the forearm during pronation and supination while using a power grip. Electromyographic data was collected from 15 forearm muscles in 11 subjects while they performed maximal isometric pronating and supinating efforts in nine positions of forearm rotation. Biceps brachii was the only muscle with substantial activation in only one effort direction. It was significantly more active when supinating (µ = 52.1%, SD = 17.5%) than pronating (µ = 5.1%, SD = 4.8%, p < .001). All other muscles showed considerable muscle activity during both pronation and supination. Brachioradialis, flexor carpi radialis, palmaris longus, pronator quadratus and pronator teres were significantly more active when pronating the forearm. Abductor pollicis longus and biceps brachii were significantly more active when supinating. This data highlights the importance of including muscles additional to the primary forearm rotators in a biomechanical analysis of forearm rotation. Doing so will further our understanding of forearm function and lead to the improved treatment of forearm fractures, trauma-induced muscle dysfunction and joint replacements.

In-Home Delivery Of Constraint-Induced Movement Therapy Via Virtual Reality Gaming, Alexandra L. Borstad, Roger Crawfis, Kala Phillips, Linda Pax Lowes, David Maung, Ryan Mcpherson, Amelia Siles, Lise Worthen-Chaudhari, Lynne V. Gauthier

Journal of Patient-Centered Research and Reviews

Purpose: People with chronic hemiparesis are frequently dissatisfied with the recovery of their hand and arm, yet many lack access to effective treatments. Constraint-induced movement therapy (CI therapy) effectively increases arm function and spontaneous use in persons with chronic hemiparesis. The purpose of this study was to determine the feasibility and measure safety and outcomes of an in-home model of delivering CI therapy using a custom, avatar-based virtual reality game.

Methods: Seventeen individuals with chronic hemiparesis participated in this pretest/posttest quasi-experimental design study. The 10-day intervention had three components: 1) high-repetition motor practice using virtual reality gaming; 2) constraint of …

A Case Review Of A Morel Lavellee Lesion With Delayed Presentation, Ammar Qureshi, Pradeep Monoot

Marshall Journal of Medicine

A Morel Lavellee lesion is a relatively rare post traumatic condition which is missed at the time of early presentation. It involves a closed internal degloving injury where the subcutaneous tissue is torn away from the underlying fascia and thus creating a cavity containing hematoma and necrotic fat. It occurs most commonly over the greater trochanter. The lesion can be treated conservatively and surgically. Here we report an unusually delayed presentation of a Morel Lavellee lesion that was treated by incisions, drainage and primary closure.

2016 Sosort Guidelines: Orthopaedic And Rehabilitation Treatment Of Idiopathic Scoliosis During Growth., Stefano Negrini, Sabrina Donzelli, Angelo Gabriele Aulisa, Dariusz Czaprowski, Sanja Schreiber, Jean Claude De Mauroy, Helmut Diers, Theodoros B. Grivas, Patrick Knott, Tomasz Kotwicki, Andrea Lebel, Cindy Marti, Toru Maruyama, Joe O'Brien, Nigel Price, Eric Parent, Manuel Rigo, Michele Romano, Luke Stikeleather, James Wynne, Fabio Zaina

Manuscripts, Articles, Book Chapters and Other Papers

Background: The International Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) produced its first guidelines in 2005 and renewed them in 2011. Recently published high-quality clinical trials on the effect of conservative treatment approaches (braces and exercises) for idiopathic scoliosis prompted us to update the last guidelines' version. The objective was to align the guidelines with the new scientific evidence to assure faster knowledge transfer into clinical practice of conservative treatment for idiopathic scoliosis (CTIS).

Methods: Physicians, researchers and allied health practitioners working in the area of CTIS were involved in the development of the 2016 guidelines. Multiple literature …

Front Matter, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Faculty, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Residents, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Mid-Level Providers, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Physical Therapy Faculty, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Division Of Research, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Fellows And Chiefs, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Letter From The Chair, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Letter From The Co-Editors, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

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 …

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 …