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Journal of Surgical Orthopaedic Advances

Fiesky A Nunez, Bettina Gyr
Surgical correction of neuromuscular hip dysplasia is a common orthopaedic procedure that carries significant risk of complications. Reducing time of surgery, limiting incisions, and minimizing unnecessary surgical exposure are paramount in reducing complications. This article describes the use of a single-stage, single-surgical approach operation for the correction of neuromuscular hip dysplasia. The operation consists of a modified anterolateral approach to the hip joint (modified Watson-Jones approach) to perform a varus derotational proximal femur osteotomy, hinged acetabuloplasty, and soft tissue releases...
2016: Journal of Surgical Orthopaedic Advances
Todd D Greenberg, Richard Thompson, Stephen J Pomeranz
The technological innovation of magnetic resonance imaging (MRI) is ongoing and necessitates recurring reevaluation of appropriateness standards. As evidenced by current standards, T1 data sets provide an essential role to musculoskeletal imaging. According to a recent survey, T1 data sets are increasingly underutilized. This article discusses common and less commonly recognized T1 data set utility. It is suggested that a single non-fat-suppressed T1 data set (in any plane) continues to be standard in routine MRI musculoskeletal imaging...
2016: Journal of Surgical Orthopaedic Advances
Nikhil K Prasad, Krista A Coleman Wood, Robert J Spinner, Kenton R Kaufman
The assessment of neuromuscular recovery after peripheral nerve surgery has typically been a subjective physical examination. The purpose of this report was to assess the value of gait analysis in documenting recovery quantitatively. A professional football player underwent gait analysis before and after surgery for a peroneal intraneural ganglion cyst causing a left-sided foot drop. Surface electromyography (SEMG) recording from surface electrodes and motion parameter acquisition from a computerized motion capture system consisting of 10 infrared cameras were performed simultaneously...
2016: Journal of Surgical Orthopaedic Advances
Andrew P Hurvitz, Brian T Fitzgerald, Leo T Kroonen
The purpose of this study was to evaluate for ulnar nerve instability following incrementally widened in situ decompression. A standard release of the ulnar nerve was performed in 16 cadaveric elbows, extending from 7cm distal to the medial epicondyle, and then released proximally for a total of 10 cm in 2-cm increments. Eight of the 16 elbows (50%) displayed subluxation of the ulnar nerve following complete in situ decompression. The rate of subluxation was found to increase with increasing length of proximal decompression...
2016: Journal of Surgical Orthopaedic Advances
Brittany E Haws, Benjamin M Braun, Trey B Creech, Eric R Barnard, Anna N Miller
Postoperative surgical wound infections are a significant cause of morbidity in orthopaedic surgical cases. To date, there has been no large, single-institution study evaluating orthopaedic surgical wound infection rates and their correlation with seasonality. The hypothesis of this study was that there would be more infections in the warmer months of the year. A retrospective review of all orthopaedic surgery cases at the authors' institution from 1992 to 2012 was performed of all patients with postoperative wound infections...
2016: Journal of Surgical Orthopaedic Advances
Peter M Formby, Scott C Wagner, Andrew W Mack
This study sought to identify the 50 most-cited articles in the literature pertaining to the surgical treatment of the hip, which has not yet been done to the authors' knowledge. In December 2014, an all-years search of the Thompson Institute for Scientific Information Web of Science was conducted for the term ``hip.'' Articles were sorted from most to least cited. Citations per article ranged from 3176 to 372. The majority of the articles were clinical in nature (64%) and hip arthroplasty was the predominant focus (70%)...
2016: Journal of Surgical Orthopaedic Advances
Vineet K Sarin, William Camisa, Jeremi M Leasure, Alan C Merchant
This study describes a new surgical technique to transfer the tibial tubercle, explains the rationale for its development, and reports the results of initial biomechanical testing. The design goals were to create a tibial tubercle osteotomy that would provide equivalent or better initial fixation compared with traditional techniques, yet would be more flexible, reproducible, accurate, less invasive, and safer. The results of the biomechanical analysis suggest that initial fixation with this novel tubercle transfer technique is as strong as traditional Elmslie-Trillat and anteromedialization procedures...
2016: Journal of Surgical Orthopaedic Advances
Michael A Del Core, Emily Mills, Lisa K Cannada, David E Karges
The purpose of this article is to report midterm follow-up of operatively treated calcaneus fractures. All patients with a calcaneus fracture, treated with open reduction and internal fixation (ORIF) using the extensile lateral approach, were identified. Functional outcomes were assessed using the American Orthopaedic Foot and Ankle Society's (AOFAS) ankle-hindfoot assessment, SF-36, and a questionnaire. There were 20 patients (25 fractures): 16 males and four females. The average age was 42 years (range, 16-73 years) and the mean follow-up time was 40 months (range, 13-73 months)...
2016: Journal of Surgical Orthopaedic Advances
Christopher Bibbo, David Ehrlich, L Scott Levin, Stephen J Kovach
Patients who have undergone a lower extremity amputation may develop an unstable soft tissue envelope of the amputation stump. This envelope may result in pain that prohibits prosthetic use or may become chronically infected. Providing stable soft tissue coverage at the amputation site may provide relief from pain and cure of infection. Additionally, a stable amputation soft tissue envelope may assist with the ability of that patient to maintain his or her existing level of ambulation, overall sense of wellness, and ability to maintain social integration...
2016: Journal of Surgical Orthopaedic Advances
Anil Agarwal, Abbas Shaharyar, Anubrat Kumar, Mohd Shafi Bhat
Ponseti casts for congenital clubfoot are generally removed in the clinics by soaking and unwrapping them. It is often difficult to find the plaster bandage edge for unwrapping it. The use of flags at cast ends can ease this problem.
2016: Journal of Surgical Orthopaedic Advances
B Collier Watson, Benjamin C Taylor, Adam Madsen, Freddie D Persinger, Andy R Malarkey
Volar plating of distal radius fractures was introduced as a means to circumvent some of the issues with dorsal-based plating but has been shown not to be a complete panacea, as other advantages and challenges have subsequently been discovered. Careful attention and proper technique must be utilized to restore and maintain volar tilt. This study reports a technique of using a locking screw as a proximal peg to reliably obtain the volar tilt in a simple fashion.
2016: Journal of Surgical Orthopaedic Advances
Hale Ersoy, Stephen J Pomeranz
Complex regional pain syndrome (CRPS) is a neurological disorder producing peripheral neurogenic inflammatory process in hands and feet distal to injury, which may lead to severe disability. Symptoms are often out of proportion to the initiating event and not limited to a single peripheral nerve. There is no gold standard in diagnosis of this entity, and a multidisciplinary approach is necessary for proper diagnosis. Magnetic resonance imaging (MRI) is one of the most useful diagnostic modalities in early stages of CRPS (when clinical diagnosis is most difficult), the most desirable time to diagnose this disorder to expedite treatment and improve function...
2016: Journal of Surgical Orthopaedic Advances
Fiesky A Nunez, Anastasios Papadonikolakis, Zhongyu Li
The incidence of brachial plexus injury after shoulder dislocation or arthroscopic shoulder surgery is low. Complex regional pain syndrome (CRPS) is an uncommon but painful condition that can develop after nerve injury. Historically, CRPS has been difficult to treat and therapeutic efforts are sometimes limited to ameliorating symptoms. However, if a dystrophic focus can be identified, the condition can be addressed with surgical exploration for potential neurolysis or nerve repair. The present article reports on a case of type II CRPS that developed in the postoperative setting of arthroscopic shoulder surgery complicated with simple shoulder dislocation...
2016: Journal of Surgical Orthopaedic Advances
Andrew Cleveland, Josh Herzog, Pedro Caram
This article evaluates the techniques, results, and complications of hybrid cervical disc arthroplasty in a high-demand military population. Emphasis is on the occupational impact and return to duty outcomes. This article is a case series with prospective follow-up of 30 hybrid cervical disc arthroplasty patients from the authors' institution. Average follow-up was 16.1 months. Average patient age was 39.7 years. Noncommissioned officer was the most common military rank. Cervical disc arthroplasty at C5/6 with fusion at C6/7 was the most common procedure (21/30)...
2016: Journal of Surgical Orthopaedic Advances
Vasanth Sathiyakumar, Dagoberto Estevez-Ordonez, Rachel V Thakore, Young M Lee, Jesse M Ehrenfeld, William T Obremskey, Manish K Sethi
The objective of this study was to determine the clinical factors that are predictors for intraoperative transfusion in orthopaedic trauma patients. A retrospective chart review of patients admitted to a level I trauma center with isolated fractures was conducted. Variables such as gender, height, weight, body mass index, American Society of Anesthesiologists (ASA) classification, and medical comorbidities were assessed to determine likelihood of blood transfusion. A total of 1819 patients with isolated fractures were identified...
2016: Journal of Surgical Orthopaedic Advances
P Maxwell Courtney, Joshua C Rozell, Christopher M Melnic, Neil P Sheth, Charles L Nelson
The purpose of this study is to identify any association between malnutrition and morbid obesity and determine if either independently increases complications following primary total joint arthroplasty (TJA). The study retrospectively reviewed a series of 670 patients who underwent primary TJA at a single institution. Patients were categorized as malnourished if their preoperative serum albumin was <3.5 mg/dL and morbidly obese if their body mass index was >40 kg/m(2). Of the 670 patients in the study, 83 patients were malnourished (12...
2016: Journal of Surgical Orthopaedic Advances
Mitchell J Odom, Young M Lee, Scott L Zuckerman, Rachel P Apple, Theodore Germanos, Gary S Solomon, Allen K Sills
This study evaluated the test-retest reliability of a novel computer-based, portable balance assessment tool, the Equilibrate System (ES), used to diagnose sports-related concussion. Twenty-seven students participated in ES testing consisting of three sessions over 4 weeks. The modified Balance Error Scoring System was performed. For each participant, test-retest reliability was established using the intraclass correlation coefficient (ICC). The ES test-retest reliability from baseline to week 2 produced an ICC value of 0...
2016: Journal of Surgical Orthopaedic Advances
Jessica C Rivera, Renee M Greer, Joseph C Wenke, James R Ficke, Anthony E Johnson
The Military Orthopaedic Trauma Registry (MOTR) orginally began as part of the Department of Defense Trauma Registry (DoDTR) and became a live registry in 2013. As a quality improvement process, this study examined MOTR data for 20 female amputees compared with DoDTR data. The DoDTR provided diagnosis and procedure codes as a list but no details. The MOTR provided additional data, including specific limb, fracture classifications, and associated injuries per limb. The MOTR allowed for construction of a treatment time line for each limb, including number and timing of debridements, antibiotics, and implant types...
2016: Journal of Surgical Orthopaedic Advances
Mark Adam Tait, Cara Petrus, C Lowry Barnes
The purpose of this study was to determine the publication rate of manuscripts presented at the Southern Orthopaedic Association's (SOA) annual meetings. An extensive literature search was performed using Google Scholar and PubMed search engines and all accepted abstracts (posters or podium presentations) presented at an SOA annual meeting from 2005 to 2011 were evaluated. A total of 568 abstracts were presented at SOA meetings between 2005 and 2011. Of these, 234 (41%) were published in the peer-reviewed literature...
2016: Journal of Surgical Orthopaedic Advances
Soham Banerjee, Adam J Starr, Rahul Banerjee
The objective of this study was to develop three-dimensional (3-D) modeling software to generate the optimal individualized starting points and pathways for anterior and posterior column screws. In this cross-sectional study, 95 consecutive patients from a level I trauma center with noncontrast pelvis computed tomography (CT) images without displaced acetabular fractures were studied. A Java-based program was designed that generated a 3-D graph of pelvic bones and a list was compiled of every potential anterograde anterior and posterior column screw that exited distal to the acetabulum, eliminating screws that did not safely remain within the cortex...
2016: Journal of Surgical Orthopaedic Advances
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