Orthopedics Commons^™

Physical Therapy Faculty, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Letter From The Chief Of The Division Of Physical Therapy, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Elbow Injuries In The Throwing Athlete: A Review, Drew K. Newhoff

UNM Orthopaedic Research Journal

Overhand-throwing motions can create supraphysiologic stresses on the elbow. Repeated stresses often result in overuse injuries affecting the elbow, which are commonly seen in throwing athletes. Noted problems include medial epicondylitis, valgus extension overload, olecranon stress fractures, ulnar neuritis, and damage to the ulnar collateral ligament. Symptoms of pain or numbness at presentation vary in location depending on the injury. Successful diagnosis is typically made using results of physical examinations of elbow, wrist, and arm extensions; results of tests for valgus instability; and findings radiographs can all help indicate the problem. However, pathological features of these injuries are not always …

Current Issues In Treatment Of Anterior Shoulder Instability: A Review, Ian Power

UNM Orthopaedic Research Journal

Anterior shoulder instability can be problematic in the young, active population, particularly in athletes and military personnel. The shoulder joint is the most frequently dislocated joint, and there is a high rate of dislocation recurrence in younger patients. The stability of the glenohumeral joint is conferred through the bony anatomy and the static and dynamic stabilizers. Recognizing pathological features, identifying glenoid bone loss, and detecting Bankart and Hill-Sachs lesions are key to formulating an appropriate treatment strategy and improving surgical outcomes. Furthermore, the concept of critical bone loss has been refined by looking at subcritical loss. Recent evidence has shown …

Understanding Radiocarpal Rotation Through In Vivo Pronation And Supination Of The Hand: A Single Case Study, Jorge L. Orbay, Joshua M. Romero, Neal Wostbrock, Deana M. Mercer

UNM Orthopaedic Research Journal

Background: Studies have not clearly defined the motion of the distal radius in relation to the carpus in vivo. We hypothesized that 1) with the hand fixed by grasping a handle to prevent hand and wrist motion, the resulting load in torsion generated by extrinsic muscle in vivo would create motion at the radiocarpal joint; and 2) the motion measured will be between the distal radius and the proximal row of the carpus.

Methods: The data was acquired from the senior author external to our institution; in the current study, we quantify the resulting radiocarpal motion. A K-wire was placed …

Transhumeral Amputation For Treating Necrotizing Fasciitis Infection Of The Upper Extremity: Report Of Two Cases, Drew K. Newhoff, Amber L. Price, Christina Salas, Deana M. Mercer

UNM Orthopaedic Research Journal

Necrotizing fasciitis, an infection of the skin and subcutaneous tissue, can spread rapidly. Studies have emphasized the importance of prompt surgical intervention with aggressive debridement of diseased tissue; however, mortality rates are high despite immediate treatment. We describe two men, aged 44 years (case 1) and 74 years (case 2), presenting with necrotizing fasciitis who underwent aggressive surgical intervention, multiple debridements, and eventual transhumeral amputation of the upper extremity. In each case, the patients were discharged from the hospital to their homes on amoxicillin-clavulanate at postoperative days 15 (case 1) and 32 (case 2). Findings of laboratory studies had normalized. …

Sciatic Nerve Palsy After Operative Treatment Of Subtrochanteric Femur Fracture Resulting From Postoperative Hematoma: A Case Report, Tony G. Pedri, Gehron P. Treme

UNM Orthopaedic Research Journal

Treatment of subtrochanteric femur fractures can be difficult owing to high risk of complications. No cases of sciatic nerve palsy after hematoma following open reduction and intramedullary nailing of a subtrochanteric femur fracture have been reported. We describe a 28-yearold man who presented with a subtrochanteric fracture in the left femur after a motor-vehicle collision, in whom open reduction and intramedullary nailing led to an immediate postoperative hematoma and sciatic nerve palsy. Prompt diagnosis and early wound exploration resulted in complete resolution of the palsy at 1 month postoperatively. Our findings reinforce the importance of prompt diagnosis and treatment in …

A New Diagnosis Of Multiple Sclerosis In A 29-Year-Old Former Collegiate Basketball Player With Initial Symptoms Of Recurrent Bell’S Palsy: A Case Report, Eric R. Reynolds, Andrew D. Ashbaugh, Christopher A. Mcgrew

UNM Orthopaedic Research Journal

Multiple sclerosis (MS) is a demyelinating disorder of the central nervous system, characterized by immunemediated destruction of myelinated axons, which leads to notable physical disability. Although presence among active athletes is extremely low, it can cause considerable lifestyle changes for those athletes affected as they transition into life after competitive athletics. We describe a 29-year-old former collegiate women’s basketball player in whom MS was diagnosed during a visit for recurrent evaluation of Bell palsy. Subsequent neurology consult and magnetic resonance imaging led to the confirmation of the diagnosis of MS, and the patient began treatment for relapsing-remitting MS. During visits …

Taking An Orthopaedic Sabbatical: Mon Année En Lyon, Daniel C. Wascher

UNM Orthopaedic Research Journal

No abstract provided.

Use Of Mesenchymal Stem Cells For The Treatment Of Osteoarthritis, Dennis W. Stewart

Physician Assistant Scholarly Project Posters

• Healthy articular cartilage protects and provides smooth functioning of the joint. The deterioration of the articular cartilage leads to the crippling disease known as osteoarthritis (OA).

• OA is a leading cause of disability in the United States. Although some of the current treatment modalities, along with pharmacological treatment, may offer short term improvement with pain and function, they do not offer long term relief, and are ineffective in preventing the progression of OA.

• In advanced stages, surgery in the form of total knee arthroplasty (TKA), is sometimes needed. This is an invasive procedure and typically requires hospitalization. …

Is The Use Of Kinesio Tape (Kt) Effective In Improving Gross Motor Functionality Throughout The Sit-To-Stand Transfer Activity In Children With Cerebral Palsy (Cp)?, Rachel L. Dodies

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not Kinesio tape (KT) is effective in improving gross motor functionality throughout the sit-to-stand transfer activity in children with cerebral palsy (CP).

Study Design: Review of three English language primary studies published between 2011 and 2015.

Data Sources: One not-blinded randomized controlled trial (RCT), one single-blind RCT, and one cross-sectional study were found using the PubMed database.

Outcomes Measured: The outcomes that were measured were improvement in gross motor function, sitting posture, functional independence, balance, ambulation, and agility from sitting to standing. This …

The Reliability Of The Navicular Drop Test And Its Transferability To Dynamic Movement, Joshua Krispin

College of Graduate Studies: Theses & Dissertations

Background: Navicular drop can be defined as the distance the navicular tuberosity moves from a standing weight bearing to a standing neutral position, as the subtalar joint moves from a relaxed position to a neutral position. Navicular drop is an important measurement for clinicians used to describe foot function, pronation, and excessive movement seen in several pathologies. Objective: The purpose of this study is to see if navicular drop is influenced by mode or speed of locomotion, if it is will there be other influences such as the forefoot and heel soft tissue, and will those factors influence those measures. …

Management Of Simultaneous Bilateral Femur Fractures In A Tertiary Care Hospital: A Retrospective Review, Masood Umer, Syed Zohaib Gulzar Naqvi, Raza Askari, Umair Ashraf

Department of Surgery Docs

Abstract: Introduction: Bilateral long bone fractures are rare and usually are associated with increased risk of complications. These fractures are usually associated with poly traumatic injuries or high impact trauma resulting in shock. Commonest etiology is road traffic accident. Closed diaphyseal fractures are best managed by intramedullary nailing; management becomes difficult if there are open fractures and late arrival. In this study we intend to present our experience of managing these patients. Materials and Methods: Medical records of all adult patients (age more than 16 years of age) admitted at Aga Khan University and Hospital with bilateral femur fractures +/- …

Biomechanical Evaluation Of A Growth-Friendly Rod Construct., Sarah Galvis, Josh Arnold, Erin Mannen, Benjamin Wong, Hadley Sis, Eileen Cadel, John Anderson, Dennis Anderson, Paul Arnold, Elizabeth Friis

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Distraction-type rods mechanically stabilize the thorax and improve lung growth and function by applying distraction forces at the rib, spine, pelvis, or a combination of locations. However, the amount of stability the rods provide and the amount the thorax needs is unknown.

METHODS: Five freshly frozen and thawed cadaveric thoracic spine specimens were tested for lateral bending, flexion/extension, and axial rotation in displacement control (1°/sec) to a load limit of ±5 Nm for five cycles after which a growth-friendly unilateral rod was placed in a simulated rib-to-lumbar attachment along the right side. The specimens were tested again in the …

Rna Sequencing Reveals A Role Of Tonebp Transcription Factor In Regulation Of Pro-Inflammatory Genes In Response To Hyperosmolarity In Healthy Nucleus Pulposus Cells: A Homeostatic Response?, Zariel I. Johnson, Irving M. Shapiro, Makarand V. Risbud

Department of Orthopaedic Surgery Faculty Papers

Transcription factor tonicity-responsive enhancer-binding protein (TonEBP/NFAT5) is critical for osmo-adaptation and extracellular matrix homeostasis of nucleus pulposus (NP) cells in their hypertonic tissue niche. Recent studies implicate TonEBP signaling in inflammatory disease and rheumatoid arthritis pathogenesis. However, broader functions of TonEBP in the disc remain unknown. RNA sequencing was performed on NP cells with TonEBP knockdown under hypertonic conditions. 1140 TonEBP-dependent genes were identified and categorized using Ingenuity Pathway Analysis. Bioinformatic analysis showed enrichment of matrix homeostasis and cytokine/chemokine signaling pathways. C-C motif chemokine ligand 2 (CCL2), interleukin 6 (IL6), tumor necrosis factor (TNF), and nitric oxide synthase 2 (NOS2) …

Near-Complete Humerus Reconstruction In The Pediatric Patient With Vascularized Free Fibula Transfer., John Shuck, Benjamin C Wood, Christopher Zarella, Albert K Oh, Robert M Henshaw, Gary F Rogers

Surgery Faculty Publications

Vascularized free fibula transfer remains the gold standard for reconstruction of large segmental diaphyseal defects of the upper extremity. In the pediatric patient, before skeletal maturity, free fibula transfer with the fibular head provides an active physis for growth and an articular interface for glenohumeral joint reconstruction. Clinical and cadaveric studies have demonstrated that the vascular supply to the fibular head originates, in most cases, from the anterior tibial system. However, anatomical variation exists, and we report a case in which a vascularized fibula autograft including the physis was transferred on the peroneal artery in a 5-year-old patient with Ewing's …

The Development Of A Universally Accepted Sacral Fracture Classification: A Survey Of Aospine And Aotrauma Members., Gregory D. Schroeder, Mark Kurd, Christopher K. Kepler, James C. Krieg, Jefferson R. Wilson, Conor P. Kleweno, Reza Firoozabadi, Carlo Bellabarba, Frank Kandizoria, Klause J. Schnake, S. Rajesekaran, Marcel F. Dvorak, Jens R. Chapman, Luiz R. Vialle, F. C. Oner, Alex R. Vaccaro

Rothman Institute Papers

Study Design Survey study. Objective To determine the global perspective on controversial aspects of sacral fracture classifications. Methods While developing the AOSpine Sacral Injury Classification System, a survey was sent to all members of AOSpine and AOTrauma. The survey asked four yes-or-no questions to help determine the best way to handle controversial aspects of sacral fractures in future classifications. Chi-square tests were initially used to compare surgeons' answers to the four key questions of the survey, and then the data was modeled through multivariable logistic regression analysis. Results A total of 474 surgeons answered all questions in the survey. Overall …

Contribution Of Tactile Dysfunction To Manual Motor Dysfunction In Type Ii Diabetes, Nereyda Ochoa, Gloria R Gogola, Stacey L Gorniak

Faculty, Staff and Student Publications

Introduction:

Changes in sensory and motor functions of the hand in Type II Diabetes (T2D) patients have been reported; there is speculation that these changes are driven by tactile dysfunction. The purpose of this study was to evaluate the effects of tactile feedback on manual function in T2D patients.

Methods:

T2D patients and healthy controls underwent median nerve blocks at the wrist and elbow. All participants underwent traditional timed motor evaluations, force dynamometry, laboratory-based kinetic evaluations, and sensory evaluation.

Results:

Tactile sensation in the T2D group at baseline was found to be equivalent to tactile function of the control group …

Early Experience Of Dynamic Hip Screw With Spiral Blade And Locking Side Plate For The Stabilization Of Trochanteric Fractures., Akbar Jaleel Zubair, Rizwan Haroon Rashid, Marij Zahid, Masood Umer, Pervaiz Hashmi

Department of Surgery Docs

Abstract

OBJECTIVE:

To evaluate early experience with helical hip system in osteoporotic elderly patients with per-trochanteric fractures.

METHODS:

The retrospective study was conducted at Aga Khan University Hospital, Karachi, and comprised records of patients having low-velocity pertrochanteric fractures who were fixed with spiral blade Dynamic Helical Hip Systemfrom July to December 2014 and were followed up for a minimum of 3 months. Demographic variables and clinical outcomes were noted from the medical records whereas operative details were recorded from the operative note. Radiological variables and outcomes were assessed by viewing appropriate pre-operative, post-operative and follow-up radiographs.

RESULTS:

Of the 32 …

Lamina Spreader Technique Improves Debridement Of Loose Bone And Cement In Total Knee Arthroplasty, Sinan E. Ozgur, Ali Oliashirazi, Grant S. Buchanan, Franklin D. Shuler

Marshall Journal of Medicine

Abstract

Loose bone and cement can promote polyethylene wear that may lead to failure in total knee arthroplasty. The authors propose a technique to enhance the debridement of loose bodies by distracting the cemented components with a lamina spreader following standard debridement with pulsatile lavage. Cement and bone/soft tissue debris was recovered from 51 consecutive primary total knee arthroplasty patients. This technique facilitated the removal of hidden debris in 80% of patients (41/51). On average, 2.6 fragments measuring 158 mm³ were removed per patient. The authors advocate that distraction with a lamina spreader be used to reduce potential sources …