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Journal of Surgical Orthopaedic Advances

Benjamin C Taylor, Andy R Malarkey, Ryan L Eschbaugh, John Gentile
Volar locked plating has become a standard treatment for operative stabilization of distal radius fractures. It is assumed that volar plating portends a low risk of extensor tendon irritation and rupture, especially when compared with dorsal plating constructs; however, extensor tendon tenosynovitis and rupture is a well-described complication after volar plating of the distal radius. Dorsal cortical penetration of screws may go unnoticed with traditional intraoperative fluoroscopic techniques and may contribute to extensor tendon irritation...
November 2017: Journal of Surgical Orthopaedic Advances
Hale Ersoy, Stephen J Pomeranz
Differential diagnosis of a cystic lesion adjacent to menisci can be a challenge even when the case presents as seemingly straightforward. To "tell the story" as accurately as possible, the radiologist must be familiar with the natural history of these lesions as well as distinctive imaging features and must take all relevant factors into consideration, such as patient's age, activity level, and surgical history. This article presents two cases to illustrate how imaging features affect the report and management plan...
October 2017: Journal of Surgical Orthopaedic Advances
William R Aibinder, Michael E Torchia, Allen T Bishop, Alexander Y Shin
Fractures of the sternum are rare. Persistent nonunions, however, can lead to chronic pain and significant functional limitations. The vascularized medial femoral condyle is a versatile tool in the surgeon's armamentarium. Traditionally, it has been used as a thin corticoperiosteal graft in the treatment of nonunion of tubular bones. Its use as a structural corticocancellous graft has also been expanding. This report presents a case of a patient with a recalcitrant symptomatic nonunion of the manubrium treated with the unique combined corticoperiosteal and corticocancellous vascularized bone graft from the medial femoral condyle and reviews the literature concerning these uncommon nonunions...
October 2017: Journal of Surgical Orthopaedic Advances
Allison Mayfield, Vamsi Singaraju, Afshin A Anoushiravani, Zain Sayeed, Jamal K Saleh, Khaled J Saleh
Extensor mechanism complications involving the patella frequently result in total knee arthroplasty (TKA) failure. Postoperative patellar dislocation may be caused by soft tissue imbalance, improper sizing, and position of the prosthesis. This report describes a case of revision TKA requiring several rounds of soft tissue releases in an effort to treat the patient's chronic patellar dislocation. In the process, a novel surgical approach was developed for the surgical management of refractory chronic patellar dislocations...
October 2017: Journal of Surgical Orthopaedic Advances
Michael M Vosbikian, Constantinos Ketonis, Ronald Huang, James A Costanzo, Asif M Ilyas
Distal radius fractures are among the most common injuries in the upper extremity. While many studies have looked at the maintenance of reduction with volar locking plates, there is a paucity of literature comparing the ability of different plates to maintain reduction over time. This study reviews the ability of various plates to maintain radiographic reduction at union after distal radius fracture treatment. Loss of some aspect of fracture reduction was routinely observed following locked volar plating regardless of implant...
October 2017: Journal of Surgical Orthopaedic Advances
Luke Robinson, Jonathon Spanyer, Zachary Yenna, Patrick Burchell, Andrew Garber, John Riehl
Arthroscopic education research recently has been focused on the use of skills labs to facilitate resident education and objective measure development to gauge technical skill. This study evaluates the effectiveness of three different teaching methods. Medical students were randomized into three groups. The first group received only classroom-based lecture. The second group received the same lecture and 28 minutes of lab-based hands-off arthroscopy instruction using a cadaver and arthroscopy setup. The final group received the same lecture and 7 minutes of hands-on arthroscopy instruction in the lab on a cadaver knee...
October 2017: Journal of Surgical Orthopaedic Advances
Mariano E Menendez, Eric M Greber, Charles S Schumacher, C Lowry Barnes
Although acute ischemic stroke (AIS) is a feared medical complication after total knee arthroplasty (TKA), little is known about its incidence and risk factors. The purpose of this retrospective populationbased study using the Nationwide Inpatient Sample (2008-2011) was to determine the incidence and predictors of AIS following TKA. The rate of perioperative AIS was 0.08%. Patients undergoing bilateral TKA were almost three times more likely to develop AIS compared with unilateral TKA patients. The age group with the highest odds of AIS was ≥85 years...
October 2017: Journal of Surgical Orthopaedic Advances
Eric Grenier, Dave Tennent, Jean Patzkowski, Joseph Hsu, Anthony Johnson
Routine postoperative radiographs are commonly obtained at the initial postoperative visit. The purpose of this study was to demonstrate the clinical utility of routine postoperative radiographs and quantify the radiation exposure and cost to the health care system. All orthopaedic surgeries performed during 2007 at a level I trauma center were retrospectively analyzed. Surgical procedures that were likely to require follow-up radiographs were included. Analysis demonstrated 878 procedures with 471 procedures (54%) receiving initial postoperative radiographs...
October 2017: Journal of Surgical Orthopaedic Advances
J Michael Wiater, Shannon Carpenter, Denise M Koueiter, David Marcantonio, Brett P Wiater
The purpose of this study was to compare reverse total shoulder arthroplasty (RTSA) outcomes in normal weight, overweight, and obese patients. A RTSA outcomes registry was reviewed for rotator cuff-deficient patients with a minimum 2-year follow-up. Fractures, rheumatoid arthritis, and revisions were excluded. Based on World Health Organization body mass index (BMI) classification, there were 29 normal weight, 50 overweight, and 51 obese patients. All groups demonstrated significant improvements from preoperative to most recent follow-up in function scores, pain, and forward elevation...
October 2017: Journal of Surgical Orthopaedic Advances
J Ryan Martin, George Vestermark, Brian Mullis, Jeffrey Anglen
This study details the use of implantable bone stimulators in the setting of nonunion. A retrospective comparative analysis was used to evaluate the efficacy of implantable bone stimulators in achieving union in the setting of atrophic or oligotrophic nonunion by two fellowship-trained orthopaedic trauma surgeons. Initially, 72 patients underwent surgical intervention for nonunion. Twenty-one patients had an implantable bone stimulator placed at the time of nonunion surgery. Thirty-eight patients had a minimum of 1-year follow-up...
October 2017: Journal of Surgical Orthopaedic Advances
Cormac A O'Donovan
No abstract text is available yet for this article.
October 2017: Journal of Surgical Orthopaedic Advances
Hale Ersoy, Stephen J Pomeranz
Plantar fibromatosis, also known as Ledderhose's disease, is a benign fibroblastic disorder of plantar aponeurosis, more specifically the medial side of the foot arch. Magnetic resonance imaging (MRI) has an important role in the diagnosis, staging, and determining the deep extension found in advanced, aggressive forms of plantar fibromatosis, thereby guiding appropriate clinical and surgical management. This case report aims to provide radiologists and clinicians with simple guidelines for the differential diagnosis of the fibroblastic and fibrohistiocytic soft tissue tumors of the foot with the emphasis on the MRI findings...
January 2017: Journal of Surgical Orthopaedic Advances
Tony Locrotando, K Aaron Shaw, Jeremy M Jacobs, John A Bojescul
Anterior knee pain is a common complaint among military members, with a negative impact on operational readiness. A tibial tubercle osteotomy is one treatment option for select etiologies of anterior knee pain and has been reported to result in high rates of return to activity. A retrospective review of active duty service members undergoing a tibial tubercle osteotomy at a single army medical center was performed. Thirteen active duty service members were identified as undergoing a tibial tubercle osteotomy...
January 2017: Journal of Surgical Orthopaedic Advances
David J Ruta, Mark S Morris, Matthew T Pigott, J Sybil Biermann, Todd A Irwin, James R Holmes
The Accreditation Council for Graduate Medical Education (ACGME) orthopaedic milestones require detailed, frequent resident evaluations. This institution desired a cost-effective objective structured clinical examination (OSCE) to facilitate these evaluations. Data were collected as a prospective, uncontrolled observational study. The OSCE was completed by residents entering and exiting the foot and ankle rotation during postgraduate years 2 and 4. Physician assistants functioned as standardized patients. Statistical analyses were performed using paired and independent t tests...
January 2017: Journal of Surgical Orthopaedic Advances
Arnold B Alqueza, Sigrid Fostvedt, W Emerson Floyd, Jesse B Jupiter
This study seeks to determine whether patients with bilateral thumb carpometacarpal osteoarthritis were sufficiently satisfied with their surgeries to choose to undergo surgery again. The null hypothesis is that patients are dissatisfied with the results of the first surgery. Out of 46 living patients meeting enrollment criteria, 41 were enrolled and evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH) score and the Enneking musculoskeletal score. The average DASH score was 17.37. The average Enneking musculoskeletal score was 88...
January 2017: Journal of Surgical Orthopaedic Advances
Emily M Mayekar, Aysel Bayrak, Smiresh Shah, Alfonso Mejia
The purpose of this study was to examine the intraoperative radiation dosage to different body parts and to determine the effectiveness of a new lightweight radiation-attenuating fabric (XPF) versus lead, the current standard. For 51 cases involving fluoroscopy, one attending orthopaedic surgeon wore a set of three dosimeters at various locations. Per each set of three, one dosimeter was shielded with a swatch of XPF, one was placed underneath the lead apron, and one was left exposed. The total dose of radiation was tabulated per body site and the percent attenuation was calculated for both XPF and lead...
January 2017: Journal of Surgical Orthopaedic Advances
Matthew A Napierala, Jaime L Bellamy, Clinton K Murray, Richard K Hurley, Joseph C Wenke, Joseph R Hsu
Treating patients with antibiotics that are selected based on routine cultures obtained from presumed aseptic orthopaedic procedures may lead to an increased risk of antibiotic-related complications without reducing the rate of late deep infection. Routine cultures obtained from 60 of 169 procedures resulted in 23 (38.3%) positive and 37 (61.7%) negative results. Twenty-two patients (13.5%) developed late infections. Seven of 14 patients with positive cultures, who were treated with antibiotics, developed a late infection, while two of nine patients with routine cultures, who received no antibiotic treatment, developed a late infection...
January 2017: Journal of Surgical Orthopaedic Advances
Brian Waterman, Shaunette Davey, Enes Kanlic, Amr Abdelgawad
Autogenous iliac crest bone grating has been the gold standard. Recently, intramedullary bone graft harvest using a reamer-irrigator-aspirator (RIA) had been gaining more interest among orthopedic surgeons. Twenty-four RIA bone graft harvesting procedures in 23 consecutive patients with nonunions were included. The mean age was 37.8 years. Rates of perioperative complications, secondary surgical procedures, and union were assessed for all patients. At mean 10.1 months follow-up, three donor site complications occurred (12...
January 2017: Journal of Surgical Orthopaedic Advances
Jaehon M Kim, Mitchel B Harris, David Zurakowski, Wanjun Liu, Jesse B Jupiter, Joung Heon Kim, Mark S Vrahas
The purpose of this investigation was to determine the incidence and identify the predictors of carpal tunnel release (CTR) after open fractures of the distal radius (DRF). Patients with clinical symptoms of persistent median nerve neuropathy that required CTR were analyzed for risk factors. One hundred thirty-nine open DRFs (107 grade I, 23 grade II, 9 grade III) met the inclusion criteria. The incidence of CTR was 13.7% in all open DRFs (19 out of 139). Multivariable logistic regression analysis identified four predictors: male sex [odds ratio (OR) = 8...
January 2017: Journal of Surgical Orthopaedic Advances
Bradford S Waddell, Neil L Duplantier, Qingyang Luo, Mark S Meyer, Scott F M Duncan
This study compared two popular iPhone-based goniometer applications to the gold standard universal goniometer for the measurement of the hip and knee joints in scenarios mimicking the normal pace of an orthopaedic clinical practice.Three physicians measured hip and knee joint angles 35 times with one of three goniometers: universal 12-inch goniometer, DrGoniometer (iPhone-5 based), and SimpleGoniometer (iPhone-5 based). Data wwere analyzed using Pearson correlation coefficient calculations. Average knee angles measured with the universal goniometer, DrGoniometer, and SimpleGoniometer measured 83...
January 2017: Journal of Surgical Orthopaedic Advances
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