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Utah peds Attendings

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19 papers 25 to 100 followers Utah Peds Ortho Attending Papers
By David Bennett Pediatric Orthopaedic Surgeon in the United States
David A Stevenson, Holly Zhou, Shadi Ashrafi, Ludwine M Messiaen, John C Carey, Jacques L D'Astous, Stephen D Santora, David H Viskochil
Osseous abnormalities, including long-bone dysplasia with pseudarthrosis (PA), are associated with neurofibromatosis type 1 (NF1). Prospectively acquired tissue from the PA site of two individuals with NF1 was used for immunohistochemical characterization and genotype analysis of the NF1 locus. Typical immunohistochemical features of neurofibroma were not observed. Genotype analysis of PA tissue with use of four genetic markers (D17S1863, GXALU, IN38, and 3NF1-1) spanning the NF1 locus demonstrated loss of heterozygosity...
July 2006: American Journal of Human Genetics
Joel E Holman, Gregory J Stoddard, Daniel S Horwitz, Thomas F Higgins
OBJECTIVE: The prudent use of prescription opiates is a central aspect of current postsurgical pain management, but surgeons have no guidelines on appropriate duration of opiate treatment. Furthermore, there are no established data on the effect of physician counseling on the duration of opiate use postoperatively. DESIGN: Retrospective surgeon-controlled cohort study. SETTING: Level I regional academic trauma center. PATIENTS: All Utah residents admitted to the orthopaedic trauma service with isolated operative musculoskeletal injury...
September 2014: Journal of Orthopaedic Trauma
W Bradford Rockwell, Stephen Daane, Mohammed Zakhireh, Kristen L Carroll
The inversion deformity of club foot is characterized by shortened ligaments and tendons on the medial side of the foot. The condition, when refractory to castings, is treated easily by operative intervention with neutralization of the foot and ankle. Closure of the resulting incision creates tension on the skin that is well tolerated in most children. Correction of severe deformities leaves incisions that will not close primarily, leaving tendons and neurovascular structures exposed on the posteromedial aspect of the foot...
December 2003: Annals of Plastic Surgery
Kristen L Carroll, Jennifer Leiser, Theodore S Paisley
Physical activity and fitness are well recognized as essential to the health of able-bodied people, both young and old. The exact role of athletics and fitness in the lives of people with cerebral palsy is less well defined. In this review we examine the benefits of physical activity and athletics for people of all ages with cerebral palsy. Precautions for safe exercise prescription are discussed. The primary care practitioner will be able to recommend appropriate activities or refer patients to appropriate sources for further evaluation...
December 2006: Current Sports Medicine Reports
Joel Holman, Kristen L Carroll, Kathleen A Murray, Lynne M Macleod, James W Roach
BACKGROUND: We posed 2 questions: what is the long-term result of open reduction surgery in developmental dysplasia of the hip, and is there an age at surgery above which the outcome was too poor to recommend the operation? METHODS: Between 1955 and 1995, 148 patients with 179 dislocated hips had open reduction surgery for developmental dysplasia of the hip (141 anterior and 38 Ludloff medial approaches). We attempted to locate all 148 patients for the follow-up evaluation...
March 2012: Journal of Pediatric Orthopedics
Alison N Schiffern, David A Stevenson, Kristen L Carroll, Richard Pimentel, Geraldine Mineau, David H Viskochil, James W Roach
BACKGROUND: Developmental dysplasia of the hip (DDH) is a familial condition with a wide phenotypic expression. Families with high rates of DDH may have individuals with subtle phenotypic expression that can progress to osteoarthritis and require total hip arthroplasty (THA). This study compares the rates of THA in relatives of individuals with DDH with individuals in control families. METHODS: Probands with a diagnosis of DDH were identified using medical records linked to the Utah Population Database...
September 2012: Journal of Pediatric Orthopedics
Stephanie M Holmes, David Bomback, Michael R Baumgaertner
Coronal fractures of the femoral condyle (Hoffa fractures) are uncommon injuries that have a better outcome when treated surgically. We report a series of five Hoffa fractures (including one nonunion) treated at a Level 1 trauma center by one surgeon employing a protocol of open reduction and internal fixation with lag screws through a formal parapatellar approach. Postoperatively, all patients began immediate unrestricted range of motion. Initial weight bearing was limited, but all patients were permitted full weight bearing by 10 weeks...
May 2004: Journal of Orthopaedic Trauma
Alan K Stotts, Kristen L Carroll, Patrick G Schafer, Stephen D Santora, Timothy D Branigan
STUDY DESIGN: Descriptive case report. OBJECTIVES: To report the case of a child with medial compartment syndrome of the foot following posterior spinal instrumentation and fusion. SUMMARY OF BACKGROUND DATA: No previous study has reported medial compartment syndrome of the foot following spinal surgery. METHODS: A 15-year-old female with progressive idiopathic scoliosis was taken for posterior instrumentation and fusion...
March 15, 2003: Spine
Edward P Junkins, Alan Stotts, Rafael Santiago, Elisabeth Guenther
BACKGROUND: Thoracolumbar spine (TLS) fractures are rare in the pediatric population but may result in significant morbidity, necessitating a prompt diagnosis. No formal recommendations have been made for screening pediatric trauma patients for TLS fractures; early diagnosis has traditionally relied on clinical parameters extrapolated from adult data. METHODS: From March 2004 to April 2005 patients presenting to a level one pediatric trauma center were consecutively enrolled...
November 2008: Journal of Trauma
Alan K Stotts, Peter M Stevens
There are several theoretic advantages of using intramedullary rod fixation for tibial osteotomy fixation. We performed a retrospective review of patients who were treated with a mid-diaphyseal osteotomy of the tibia fixed with an intramedullary rod for isolated, symptomatic tibial torsion. Forty patients (59 tibias) were included in the study and were followed for a minimum of 12 months or until rod removal (average follow-up 22.6 months). Major complication rate was 8.5%, which is comparable to alternative methods of fixation...
December 2009: Strategies in Trauma and Limb Reconstruction
Matthew Bowman, Anna Mackey, Nichola Wilson, Ngaire Susan Stott
AIMS: High referral volumes to paediatric orthopaedic surgeons create long clinic waiting lists. The use of extended scope roles for doctors and health professionals is one strategy to address these wait times. We completed a 6-month trial of a non-surgical paediatric orthopaedic physician role (NSP) to help manage non-urgent referrals to our service from local general practitioners (GPs). METHODS: For a 6-month period, the majority of non-urgent GP referrals were assessed by a US-trained NSP...
February 2015: Journal of Paediatrics and Child Health
John M Rhee, John A Heflin, Takahiko Hamasaki, Brett Freedman
STUDY DESIGN: Prospective case-control study. OBJECTIVE: To determine the prevalence and utility of commonly tested myelopathic signs in surgically treated patients with cervical myelopathy (CM). SUMMARY OF BACKGROUND DATA: Although physical signs are sought in making the diagnosis of CM, their importance remains unclear, as patients with CM may have normal examinations while those without CM can demonstrate "myelopathic" signs. METHODS: Patients presenting with cervical complaints and advanced imaging were evaluated over a 6-month interval in a single surgical practice...
April 20, 2009: Spine
Marcella R Woiczik, Jacques L D'Astous
BACKGROUND: Navajo Familial Neurogenic Arthropathy is a disease identified in Navajo children, primarily residing in Arizona, New Mexico, and Utah. To date, there are no reports in the orthopaedic literature regarding this disorder, particularly the clinical manifestations and treatment considerations. METHODS: We carried out a retrospective chart and radiographic review of 2 patients with Navajo familial neurogenic arthropathy. We present these 2 patients as representative of the orthopaedic manifestations of Navajo familial neurogenic arthropathy...
April 2010: Journal of Pediatric Orthopedics
Kristen L Carroll, Kathleen A Murray, Lynne M MacLeod, Theresa A Hennessey, Marcella R Woiczik, James W Roach
BACKGROUND: Numerous studies underscore the poor intraobserver and interobserver reliability of both the center edge angle (CEA) and the Severin classification using plain film measurements. In this study, experienced observers applied a computer-assisted measurement program to determine the CEA in digital pelvic radiographs of adults who had been previously treated for dysplasia of the hip (DDH). Using a teaching aid/algorithm of the Severin classification, the observers then assigned a Severin rating to these hips...
June 2011: Journal of Pediatric Orthopedics
James O Sanders, Jacques D'Astous, Marcie Fitzgerald, Joseph G Khoury, Shyam Kishan, Peter F Sturm
BACKGROUND: Serial cast correction by using the Cotrel derotation technique is one of several potential treatments for progressive infantile scoliosis. This study reviews our early experience to identify which, if any, patients are likely to benefit from or fail this technique. METHODS: We followed all patients treated at our institutions for progressive infantile scoliosis since 2003 prospectively at 1 institution and retrospectively at the other 2. Data, including etiology, Cobb angles, rib vertebral angle difference, Moe-Nash rotation, and space available for the lung, were recorded over time...
September 2009: Journal of Pediatric Orthopedics
L M Ward, F Rauch, M P Whyte, J D'Astous, P E Gates, D Grogan, E L Lester, R E McCall, T A Pressly, J O Sanders, P A Smith, R D Steiner, E Sullivan, G Tyerman, D L Smith-Wright, N Verbruggen, N Heyden, A Lombardi, F H Glorieux
CONTEXT: Information on the use of oral bisphosphonate agents to treat pediatric osteogenesis imperfecta (OI) is limited. OBJECTIVE: The objective of the investigation was to study the efficacy and safety of daily oral alendronate (ALN) in children with OI. DESIGN AND PARTICIPANTS: We conducted a multicenter, double-blind, randomized, placebo-controlled study. One hundred thirty-nine children (aged 4-19 yr) with type I, III, or IV OI were randomized to either placebo (n = 30) or ALN (n = 109) for 2 yr...
February 2011: Journal of Clinical Endocrinology and Metabolism
G Foley, C E Aubin, H Labelle, J Sanders, J d'Astous, C Johnston, S Parent
The Rib Vertebra Angle Difference (RVAD) as defined by Mehta (1972) is used to predict the progression of early onset scoliosis. No clear physical significance has been established for this measurement. The purpose of this study was to evaluate the RVAD along the thoracic spine and the equivalent measurement on 3D reconstructions of the spine and rib cage of early onset scoliosis patients in order to determine their relationship with the geometry of the chest wall and evolution along the spine. The RVAD was measured on PA radiographs of 42 infantile scoliotic patients (Cobb >20°) from T4 to T10 according to the method described by Mehta...
2012: Studies in Health Technology and Informatics
Bruce A MacWilliams, Barbara A Johnson, Amy L Shuckra, Jacques L D'Astous
AIM: To compare function and gait in a group of children older than most children who received selective dorsal rhizotomy (SDR) with age- and function-matched peers who received either orthopedic surgery or no surgical intervention. METHOD: A retrospective study examined ambulatory children with diplegic cerebral palsy, aged between 10 years and 20 years and categorized in Gross Motor Function Classification System (GMFCS) levels I or II. Three groups were considered: (1) children who had selective dorsal rhizotomy (n=8; two females, six males; mean age 15y 4mo at SDR, 16y 8mo at follow-up); (2) children who had orthopedic surgery (n=9; three females, six males; mean age 14y 6mo at SDR, 15y 1mo at follow-up), and (3) children who had no surgical intervention (n=9; two females, seven males; mean age 15y 6mo at follow-up)...
August 2011: Developmental Medicine and Child Neurology
David A Stevenson, David H Viskochil, Elizabeth K Schorry, Alvin H Crawford, Jacques D'Astous, Kathleen A Murray, J M Friedman, Linlea Armstrong, John C Carey
Neurofibromatosis type 1 is diagnosed clinically based on the presence of two of seven criteria developed by a panel of experts in 1987. The sixth criterion focuses on skeletal findings and is as follows: "A distinctive osseous lesion such as sphenoid dysplasia or thinning of long bone cortex, with or without pseudarthrosis." The wording for this criterion is misleading. In particular, "thinning of long bone cortex" is not the characteristic radiographic presentation, and no mention of long bone bowing is included...
July 2007: Genetics in Medicine: Official Journal of the American College of Medical Genetics
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