Orthopedics Commons^™

3d-Printed Alginate Scaffolds Incorporated With Synergistic Strontium/Magnesium - Doped Bioglass Nanoparticles For Bone Regeneration: An In Vivo Evaluation In Rabbit Cranial Defects, Mehraneh Movahedi Aliabadi, Afsaneh Jahani, Seyed Majdoddin Vahidi Toorchi, Ali Moradi, Mohammad Hossein Ebrahimzadeh, Fatemeh Kalalinia, Farkhonde Sarhaddi, Lobat Tayebi, Nafiseh Jirofti

Electrical & Computer Engineering Faculty Publications

Nonunion fractures remain a major orthopedic challenge, highlighting the need for improved bone tissue engineering (BTE) strategies. This study hypothesized that incorporating Sr/Mg-doped 58S bioglass nanoparticles into 3D-printed alginate (Alg) scaffolds would improve their physicochemical, mechanical, and biological properties and enhance bone regeneration. Structural characterization showed that Sr/Mg-doping reduced bioglass size and produced interconnected porous scaffolds. Under wet conditions, Alg scaffold incorporating 2.5%Sr/Mg-doped 58S bioglass showed the highest Young’s modulus (0.4356 ± 0.0244 MPa), whereas under dry conditions, the Alg scaffold incorporating 5%Sr/Mg-doped 58S bioglass achieved the highest value (0.1945 ± 0.0519 MPa). In vitro studies demonstrated biocompatibility and enhanced …

Distal Adding-On As A Complication Of Posterior Spinal Fusion In Adolescent Idiopathic Scoliosis: A Scoping Review Of Contemporary Evidence, Hussein Hashem, Hassan Abou Adma, Joseph Hayek, Ali Rezazadeh Shirazi, Karim Gaber, Waleed Kishta

Western Journal of Orthopaedics

Distal adding-on (DAO) is a complication of spinal fusion characterized by postoperative deformity progression distal to the fusion construct. DAO after posterior spinal fusion for adolescent idiopathic scoliosis (AIS) is variably defined and inconsistently managed. This scoping review synthesizes evidence on DAO detection, management, and outcomes. A PRISMA-ScR–guided search identified relevant studies. Thirty-one studies (2,998 patients; median follow-up, 30 months) met inclusion criteria. Reported DAO incidence ranged from 3.5% to 62.5%, reflecting heterogeneity in definitions, patient factors, surgical constructs, and follow-up duration. Revision surgery was infrequent and typically delayed. When performed, it was most often prompted by progressive coronal decompensation …

Epidemiology Of Closed Ruptured Tendoachilles, Hesham Mousad Alsakaan, Wael Mansour Wafa, Mohieb Sayed Ahmed, Ahmed El Sayed Magdy Elhawary

Mansoura Medical Journal

Background: To restore tendon function and avoid long-term impairment, early diagnosis and adequate treatment are crucial. The purpose of this study was to ascertain the incidence pattern of ATR and to pinpoint possible variables related to presentation and management approach.

Aim  identifying potential risk factors either patient or environmental related and to assess the incidence rate of ATR

Patients and Methods: This retrospective cross-sectional study was performed on 87 achilles tendon rupture patients. All the patients were subjected to full medical history taking. Clinical examination was performed including thompson test and Matles test and radiological investigations.

Results: The median age …

Fibula Strut Allograft With Proximal Tibia Autograft For Treatment Of Humerus Nonunion: A Case Report And Review Of Oligotrophic Nonunion Management, Paul Wilson, Naomi Kelley, Samer Kakish

Western Journal of Orthopaedics

Due to their high incidence and frequent need for reoperation, nonunions of the humerus present a significant challenge in orthopaedics. Using fibular struts to treat nonunions have demonstrated excellent results. While fibular autografts provide both biologic and structural benefit, high donor site morbidity must be considered. Although their application in midshaft humeral nonunions remains limited, fibular allografts avoid donor site morbidity. Enhancing fibular strut allografts with biological components offers a promising strategy for treating fractures that have failed prior revisions. This case study presents a 36-year-old woman with an aseptic oligotrophic midshaft humeral nonunion who had an unsuccessful revision surgery. …

Front Matter, Arianna Medina

Western Journal of Orthopaedics

No abstract provided.

21st Century Perspective On The Changing Pattern Of Nerve Injuries From Gunshot Wounds In The U.S., Thomas A. Decoster

Western Journal of Orthopaedics

Gunshot wounds (GSWs) with nerve injuries in the 21st century differ significantly from those reported in the 20th century. The vast majority are now low-velocity civilian injuries, in contrast to high-velocity military injuries previously reported. The rate of nerve injury in civilian GSWs is approximately 5%, compared with the 30% reported in military cohorts. However, the most common pattern of nerve injury in the current civilian population is neurotmesis and partial neurotmesis, in contrast to the majority axonotmesis of the military cohorts. In the 20th century, treatment generally consisted of watchful waiting for signs of spontaneous recovery over three months …

Peripheral Nerve Repair And Reconstruction: Current Techniques, Adjuncts, And Emerging Therapies, Niklaus Skipp, Lana Dokic, Christina Wassef, Jazzlyn Gonzalez, Ana Love, Heather Mercer, Deana Mercer

Western Journal of Orthopaedics

Peripheral nerve injuries require reconstruction when direct, tension-free repair is not possible. A range of reconstructive strategies are used to restore continuity and promote axonal regeneration, including graft-based reconstruction, nerve transfers, conduit-based repair, supercharged end-to-side augmentation, and emerging regenerative therapies. Autologous interfascicular nerve grafts and vascularized grafts remain established techniques, whereas processed nerve allografts provide a donor-sparing alternative. Nerve transfers are increasingly used for proximal injuries with long regeneration distances, and conduits are an option for gaps shorter than 5 mm. Nerve-wrapping techniques are used to reduce perineural scarring and preserve gliding in complex or revision cases. Emerging adjunctive therapies, …

The Effect Of Institutional Reputation On Clerkship Grades, Jerry Speight Grimes

Western Journal of Orthopaedics

Background: Clinical rotation scores have been reported to predict resident performance. However, the reporting of clerkship grades varies widely across institutions. The authors explored the correlation of an institution’s reputation and the percentage of students receiving honors. Methods: During the review of applicants for orthopaedic residency, the percentage of students receiving the highest grade in the surgery and internal medicine clerkships was recorded for each institution. The authors then compared published institutional rankings with the proportion of students awarded honors in these clerkships. Results: One hundred nineteen institutions were reviewed. There was poor correlation between the institutional rankings by U.S. …

Increased Mortality And Reduced Survival In Nonagenarians With Hip Fractures: Implications For Geriatric Care, Roman Austin, Julio Avila, Audrey Wassef, Kate Parker, Katherine Gavin

Western Journal of Orthopaedics

Background: Hip fractures in nonagenarians (patients aged ≥ 90 years) are becoming increasingly common as the population ages, yet outcomes in this group remain poorly characterized. This study compared in-hospital mortality and survivorship at three months, six months, and one year after hip fracture surgery in nonagenarians with a younger elderly cohort aged 65 years to 89 years. Secondary outcomes included fracture characteristics, surgical management, and discharge disposition. Methods: A retrospective chart review was conducted on patients who underwent hip fracture surgery at a single Level I Trauma Center from August 2019 to December 2021. Patients were grouped into nonagenarians …

Popliteus Interposition In Metaphyseal Tibial Fractures: The Radiographic Clues That Cannot Be Missed, Lucca Gontijo Giarola, Paulo De Tarso Cardoso Gomes, Robinson Esteves Dos Santos Pires, Guilherme Moreira Abreu E Silva, Marco Antônio Percope De Andrade, Túlio Vinícius De Oliveira Campos

Western Journal of Orthopaedics

High-energy proximal tibia fractures present significant challenges for orthopaedic surgeons, with well-recognized risks including malreduction and nonunion. Although double plating through two mini-open parallel incisions is an established technique for selected patients, nonuion can still occur. One potential contributing factor is entrapment of the popliteus muscle within the distal spike of the posteromedial plateau fragment. This report uses illustrative cases to demonstrate how to identify, address, and prevent this complication. Strategies for managing delayed cases that progress to nonunion are also discussed

Exploring The Interaction Between Cranial Nerves V And Vii In Chronic Eyelid Myokymia: A Case Report, Karina Miramontes, Adam Walsh, Tomas Tafoya

Western Journal of Orthopaedics

Eyelid myokymia involves involuntary contractions of the orbicularis oculi muscle and is commonly associated with stress, fatigue, and craniocervical factors. Emerging evidence suggests that altered trigeminocervical interactions and craniomandibular muscle tension may contribute to symptom persistence; however, the condition remains underrecognized in physical therapy. This report describes a 65-year-old woman with chronic benign eyelid myokymia and cervical pain who completed 12 physical therapy sessions that included suboccipital functional dry needling, temporomandibular soft-tissue mobilization (STM), and cervical stabilization exercises. A reduction in eyelid myokymia was first observed at the fifth visit, coinciding with the initiation of temporomandibular STM. These findings suggest …

Massive Upper Extremity Neurofibroma Treated With Limb-Sparing Debulking: A Case Report, Danielle Cummings, Tomas Holy, Nathan Morrell

Western Journal of Orthopaedics

Surgical management of neurofibromas in Neurofibromatosis type 1 (Von Recklinghausen’s disease), can be challenging because tumor size, location, hypervascularity, and tissue friability pose the risk for significant intraoperative and postoperative blood loss. Despite these risks, surgery is often necessary because of functional losses or cosmetic concerns. The authors present a 31-year-old woman with a massive neurofibroma on her right distal forearm, wrist, and hand, who ultimately underwent surgical resection because of functional impairment of her hand. She required postoperative hospitalization and blood transfusion for management of acute blood loss anemia. Because of concerns regarding blood loss and surgical morbidity, the …

Median Nerve Intraneural Hematoma As An Intraoperative Finding During Carpal Tunnel Release: A Case Report, Ana Silva, Gil Gonrtre, Nikalus Skipp, Ana Love, Deana Mercer

Western Journal of Orthopaedics

Carpal tunnel syndrome (CTS) is the most common compressive neuropathy and typically progresses slowly. Intraoperatively, flexor tenosynovitis, nerve edema, or hourglass deformity may be observed. In rare cases, acute compression symptoms occur due to mass effect on the nerve. Intraneural hematoma of the median nerve is uncommon and has been reported primarily in acute CTS cases associated with trauma. This report describes an 87-year-old patient with a history of mild CTS who underwent carpal tunnel release due to worsening symptoms. After the initial incision, a thickened flexor retinaculum, an hourglass deformity of the median nerve, and an intraneural hematoma were …

Proximal Iliotibial Band Rupture In A 74-Year-Old High-Level, Female Athlete: A Case Report, Jeremiah M. Langsfeld, Joseph Esquibel, Dustin L. Richter

Western Journal of Orthopaedics

A 74-year-old female endurance athlete presented with progressive pain over the left proximal and lateral hip distal to the iliac crest. Symptoms developed over three weeks, impairing weightbearing. Magnetic resonance imaging demonstrated a high-grade tear of the proximal iliotibial band at its iliac crest insertion. The patient was treated nonoperatively and returned to high-level, asymptomatic competition three months after symptom onset. This case offers a nonoperative approach to the rare presentation of a proximal iliotibial band rupture.

Arthroscopic Treatment Of Extensive Synovial Chondromatosis Of The Knee: A Case Report, Gaurav Singh, Bhavna Singh, Rebecca Peebles, Justin Bartley

Western Journal of Orthopaedics

Synovial chondromatosis (SC) is a rare, benign monoarticular disorder characterized by intra-articular cartilaginous loose bodies resulting from synovial metaplasia, most commonly affecting the knee. The authors present the case of a 44-year-old man with progressive, debilitating left knee pain, mechanical symptoms, and functional limitations unresponsive to conservative treatment. Radiographs were unremarkable, but magnetic resonance imaging (MRI) demonstrated multifocal noncalcified intra-articular bodies consistent with SC. The patient underwent arthroscopic debridement of the knee with limited synovectomy. Intraoperative findings included innumerable intra-articular cartilaginous loose bodies throughout the knee, synovial proliferation, and grade II chondromalacia. At three months postoperatively, the patient had regained …

Prosthetic Knee Joint Infection Caused By Gemella Morbillorum, Nataly Echevarria-Castro, Shaleen Duhra, Leonor Echevarria

Western Journal of Orthopaedics

Gemella morbillorum is a gram-positive coccus found in the gastrointestinal tract, and is an uncommon cause of human infections, including prosthetic joint infections (PJI). Reported risk factors include immunosuppression, recent gastrointestinal procedures, and poor dental hygiene. This report describes a case of knee PJI caused by G. morbillorum, likely due to hematogenous seeding following a colonoscopy three months earlier. The patient is a 70-year-old man with well-controlled diabetes mellitus who had undergone total knee arthroplasty three years prior. He presented with three weeks of left knee swelling. Synovial fluid culture revealed G. morbillorum. The patient was treated with debridement, antibiotics, …

Arthroscopic Management Of A Loose Body In The Pisotriquetral Joint: A Case Report, Giovanni Chioda, Tomas Holy, Nicholas Newcomb, Nathan Morrell

Western Journal of Orthopaedics

The pisotriquetral joint is the smallest of the four joints comprising the wrist and is a source of ulnar-sided wrist pain. This condyloid joint connects the pisiform to the triquetrum and is supported by several surrounding ligaments. A variety of pathologies may affect the pisotriquetral joint, including the presence of loose bodies. Because of its small size and the inherent difficulty of visualization, the pisotriquetral joint is often overlooked as an independent joint. Techniques for arthroscopic visualization and loose-body removal have previously been described using the 6R and 4-5 portals. In the following case report, the authors describe successful visualization …

Extradigital Glomus Tumor Mimicking Incisional Neuroma After Total Knee Arthroplasty: A Case Report, James W. Li, Michael J. Sayegh, Heng Hong, Zhongyu Li

This case report describes a patient who was presented with severe incisional pain following an uncomplicated total knee arthroplasty. There was suspicion for an incisional neuroma; however, excisional biopsy revealed an extradigital glomus tumor. The patient had immediate symptom resolution post-operatively. Clinicians should maintain a suspicion for the possibility of extra-digital glomus tumors at sites of prior extremity surgery, causing exquisite tenderness and pain.

Development And Evaluation Of A Modular 3-D Printed Adapter For Hands-Free Tissue Retraction, Fady E. Attia, Vijay A. Chhabra, Vaibhav Tadepalli,, Joseph Attia, Michael M. Hadeed

Fracture fixation procedures typically require precise retraction of soft tissues in order to provide adequate exposure of bone fragments for reduction and fixation. Such procedures require the use of multiple surgical assistants to maintain proper tissue retraction. This manual retraction using traditional instruments, such as Hohmann and Weitlaner retractors, can lead to inefficiencies and poor labor allocation within the operating room (OR). The purpose therefore is to develop and evaluate a three dimensional (3D)-printed Nylon PA12 adapter designed to dock Hohmann retractors onto Weitlaner retractors, enabling hands-free retraction during fracture fixation procedures and potentially improving labor allocation in the OR. …

Association Of Perioperative Steroid Use With Recovery Rate And Postoperative Infection Risk In Spinal Cord Injury, Nathan Zou, Athikur Rahman, Brian Lynch

Background: The purpose of this study is to compare recovery and infection outcomes between teenagers and adults who undergo surgery for traumatic spine injuries and the effect of steroid administration. Steroids are often used in traumatic spine injuries to help recovery, however there is a concern that steroid use could increase the risk of infection due to the suppression of the immune system. We examined the impact of postoperative steroid use on recovery rates and infection rates in both age groups.

Methods: A retrospective cohort study was conducted using the TriNetX Research Network, which includes data from over 100 healthcare …