A5075241970- Bone fractures and treatments
- Hip and Femur Fractures
- Trauma and Emergency Care Studies
- Pelvic and Acetabular Injuries
- Orthopedic Infections and Treatments
- Orthopaedic implants and arthroplasty
- Surgical site infection prevention
- Total Knee Arthroplasty Outcomes
- Spinal Fractures and Fixation Techniques
- Cardiac, Anesthesia and Surgical Outcomes
- Orthopedic Surgery and Rehabilitation
- Sports injuries and prevention
- Opioid Use Disorder Treatment
- Muscle and Compartmental Disorders
- Musculoskeletal Disorders and Rehabilitation
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Disaster Response and Management
- Shoulder Injury and Treatment
- Scoliosis diagnosis and treatment
- Ethics in Clinical Research
- Hip disorders and treatments
- Musculoskeletal pain and rehabilitation
- Knee injuries and reconstruction techniques
- Cardiac Arrest and Resuscitation
- Healthcare cost, quality, practices
Carolinas Medical Center
2015-2025
Carolina Musculoskeletal Institute
2021-2024
OrthoCarolina
2023
Atrium Medical Cente
2021-2022
Brigham and Women's Hospital
2021
Harvard University
2021
American Academy of Orthopaedic Surgeons
2011-2021
Baylor College of Medicine
2018
Phelps Hospital
2018
Orthopaedic Trauma Association
1998-2016
Background: High-energy trauma to the lower extremity presents challenges with regard reconstruction and rehabilitation. Failed efforts at limb salvage are associated increased patient mortality high hospital costs. Lower-extremity injury-severity scoring systems were developed assist surgical team initial decision amputate or a limb. The purpose of present study was prospectively evaluate clinical utility five lower-extremity systems. Methods: Five hundred fifty-six high-energy injuries...
Background: Currently, the treatment of diaphyseal tibial fractures associated with substantial bone loss often involves autogenous bone-grafting as part a staged reconstruction. Although this technique results in high healing rates, donor-site morbidity and potentially limited supply suitable some patients are commonly recognized drawbacks. The purpose present study was to investigate benefit safety osteoinductive protein recombinant human morphogenetic protein-2 (rhBMP-2) when implanted on...
Objectives: Current data show smoking is associated with a number of complications the fracture healing process. A concern, however, potential confounding effect covariates smoking. The present study first to prospectively examine time union, as well major process, while adjusting for confounders. Setting: Eight Level I trauma centers. Patients: Patients unilateral open tibia fractures were divided into 3 baseline categories: never smoked (n = 81), previous smoker 82), and current 105)....
Recent reports have suggested that functional outcomes are similar following either amputation or reconstruction of a severely injured lower extremity. The goal this study was to compare two-year direct health-care costs and projected lifetime associated with these two treatment pathways.Two-year were estimated for 545 patients unilateral limb-threatening lower-extremity injury treated at one eight level-I trauma centers. Included in the calculation related (1) initial hospitalization, (2)...
Objective: To examine the association between antibiotic timing and deep infection of type III open tibia fractures. Design: Retrospective prognostic study. Setting: Level 1 Trauma Center. Patients: The study population included 137 patients after exclusions for missing data (13), nonreconstructible limbs (9), and/or absence 90-day outcome (3). Intervention: An observational timing. Main Outcome Measurement: Deep within 90 days. Results: Age, smoking, diabetes, injury severity score, IIIA...
Background: The principal aims of this study were to examine functional outcomes following trauma-related lower-extremity amputation and compare according the levels. We hypothesized that above-the-knee amputations would result in less favorable than through-the-knee or below-the-knee amputations. A secondary aim was factors, addition level, influence outcome, including type soft-tissue coverage, selected patient characteristics, technological sophistication prosthetic device. Methods:...
Background Factors thought to influence the decision for limb salvage include injury severity, physiologic reserve of patient, and characteristics patient their support system. Methods Eligible patients were between ages 16 69 with Gustilo type IIIB IIIC tibial fractures, dysvascular limbs resulting from trauma, ankle or severe open midfoot hindfoot injuries. Data collected at enrollment relevant decision-making process included its treatment, nature severity other Logistic regression...
Background: The development of a deep wound infection in the presence hardware after open reduction and internal fixation presents clinical dilemma, there is scant literature to aid decision-making. purpose present study was determine prevalence osseous union with maintenance postoperative within six weeks fracture. Methods: included 121 patients from three level-I trauma centers, retrospectively identified billing registries, whom 123 infections positive intraoperative cultures had...
Background: In health care, increased emphasis has been placed on patient-centered but to our knowledge little work conducted understand the influences patient satisfaction after surgery for treatment of severe lower-extremity injury. Our purpose was analyze how patient's with outcome correlates other measures (clinical, functional, physical impairment, psychological and pain) sociodemographic characteristics patient, nature injury, decisions. Methods: Four hundred sixty-three patients...
Trauma to the extremities is disproportionately represented in casualties of recent conflicts, accounting for >50% injuries sustained during operations Iraq and Afghanistan. Infectious complications have been reported >25% those evacuated trauma, 50% such patients were treated intensive care unit (ICU). Osteomyelitis has 9% (14% patients), deep-wound infection 27% type III open-tibia fractures. Infections complicating extremity trauma are frequently caused by multidrug-resistant bacteria...
Eighty-five legs in forty-four cadavera were dissected to determine the course of superficial peroneal nerve from its origin termination as dorsal cutaneous nerves foot. Particular attention was paid relationship with intermuscular septum between anterior and lateral compartments leg. In sixty-two (73 per cent) legs, coursed within muscle compartment exit through crural fascia. twelve (14 had a variable compartment, crossed into passed ten (12 divided two, branches both compartment. one leg,...
To determine the effectiveness of exchange reamed nails for treatment aseptic femoral delayed unions and nonunions.Retrospective chart review.Nineteen patients admitted to Carolinas Medical Center Level I trauma center from 1990 1996 repair shaft fracture nonunion following contemporary locked nailing performed at least six months previously. These showed no radiographic evidence progression healing three had clinical symptoms nonunion.Exchange treat ununited fracture.Radiographic union or...
Objectives: The purpose of this study is to report the clinical and functional results a cohort patients with knee dislocations associated vascular injury. Methods: Patients dislocation injury were prospectively assessed for outcome severe lower extremity trauma during 2 years. Sickness Impact Profile was used assess recovery patient. Surgeon therapist assessments documented metrics treatment, including salvage or amputation, neurologic recovery, stability, motion. Results: Eighteen...
Objectives: To determine healing outcomes of open diaphyseal tibial shaft fractures treated with reamed intramedullary nailing (IMN) a bone gap 10–50 mm on ≥50% the cortical circumference and to better define “critical defect” based outcome. Design: Retrospective cohort study. Patients: Forty patients, age 18–65, as measured standard anteroposterior lateral postoperative radiographs IMN. Intervention: IMN an fracture gap. Setting: Level-1 trauma center. Main Outcome Measurements: Healing...
Objectives The biomembrane (induced membrane) formed around polymethylmethacrylate (PMMA) spacers has value in clinical applications for bone defect reconstruction. Few studies have evaluated its cellular, molecular or stem cell features. Our objective was to characterise induced membrane morphology, features and osteogenic characteristics. Methods Following Institutional Review Board approval, specimens were obtained from 12 patient surgeries management of segmental bony defects (mean age...
Fracture-related infection is one of the most challenging complications in orthopaedic trauma surgery. However, effect on functional and pain-related outcomes has not been well established. The aims this study were to evaluate recovery for patients with fracture a deep surgical site compared without whether pain severity, social support, preinjury mental health have moderating magnitude direction relationship between recovery.
Our study was designed to compare the effect of indometacin with that a placebo in reducing incidence heterotopic ossification prospective, randomised trial. A total 121 patients displaced fractures acetabulum treated by operation through Kocher-Langenbeck approach receive either (75 mg) sustained release, or once daily for six weeks. The extent evaluated on plain radiographs three months after operation. Significant Brooker grade III IV occurred nine 59 (15.2%) group and 12 62 (19.4%)...
The purpose of this study was to characterize demographics, healing time, and complications a large series operatively treated atypical femur fractures.Retrospective multicenter review.Seventeen academic medical centers.Bisphosphonate-related fractures as defined by American Society Bone Mineral Research. Fractures had be followed for at least 6 months or union revision.Operative treatment bisphosphonate-related fracture.Union time treatment, well information about the contralateral...
To describe and enumerate surgeries for patients who underwent reconstruction or amputation after severe distal tibia, ankle, mid to hindfoot injuries. Design: Secondary analysis of a multicenter prospective observational study. 31 U.S. level-I trauma centers 3 military treatment facilities. Participants aged 18 60 with Gustilo type-III pilon (OTA 43B 43C), IIIB C ankle fracture 44A, 44B, 44C), talar calcaneal 81B, 82B, 82C), open closed crush blast injuries the midfoot limb from 2012 2017....
Objective To determine the biomechanical characteristics of four different fixation constructs for split depression fractures lateral tibial plateau (OTA classification 41B3.1). Design Laboratory investigation using a cadaveric simulated fracture model. Setting Split were created, reduced, and instrumented in matched pair design. Specimens tested stiffness materials testing machine. Intervention Tibias with an L-buttress plate, 3.5-millimeter subchondral raft screws antiglide plate...