A5079413905- Bone fractures and treatments
- Hip and Femur Fractures
- Trauma and Emergency Care Studies
- Cardiac, Anesthesia and Surgical Outcomes
- Bone health and osteoporosis research
- Surgical site infection prevention
- Orthopedic Infections and Treatments
- Vitamin C and Antioxidants Research
- Vitamin D Research Studies
- Pelvic and Acetabular Injuries
- Frailty in Older Adults
- Health Systems, Economic Evaluations, Quality of Life
- Chronic Disease Management Strategies
- Knee injuries and reconstruction techniques
- Bariatric Surgery and Outcomes
- Congenital Heart Disease Studies
- Medication Adherence and Compliance
- Atrial Fibrillation Management and Outcomes
- Musculoskeletal pain and rehabilitation
- Venous Thromboembolism Diagnosis and Management
- Intensive Care Unit Cognitive Disorders
- Balance, Gait, and Falls Prevention
- Spine and Intervertebral Disc Pathology
University of Maryland, Baltimore
2017-2022
Eastern Virginia Medical School
2022
University of Maryland Medical Center
2017
Cornell University
2015
Despite the widespread use of systemic antibiotics to prevent infections in surgically treated patients with fracture, high rates surgical site infection persist.To examine effect intrawound vancomycin powder reducing deep infections.This open-label randomized clinical trial enrolled adult an operatively tibial plateau or pilon fracture who met criteria for a risk from January 1, 2015, through June 30, 2017, 12 months follow-up (final assessments completed April 2018) at 36 US trauma...
Objectives: To determine factors predictive of postoperative surgical site infection (SSI) after fracture fixation and create a prediction score for risk at time initial treatment. Design: Retrospective cohort study. Setting: Level I trauma center. Patients/Participants: Study group, 311 patients with deep SSI; control 608 patients. Intervention: We evaluated 27 theorized to be associated infection. Bivariate multiple logistic regression analyses were used build model. A composite reflecting...
Orthopedic trauma patients are often treated with venous thromboembolism (VTE) chemoprophylaxis aspirin or low molecular weight heparin (LMWH) after discharge from their index admission, but adherence patterns not known. We hypothesized that overall would be moderate and greater compared to LMWH.We conducted a randomized controlled trial of adult an operative extremity fracture any pelvic/acetabular requiring VTE prophylaxis. Patients were receive either LMWH 30 mg BID 81 BID. prescribed...
Objective: To compare the magnitude of knee pain between suprapatellar (SP) and infrapatellar (IP) approach for tibial nailing in patients who are more than 1 year after injury. Design: Retrospective cohort study. Setting: Academic Level I trauma center. Patients/Participants: All tibia fracture 18-80 years age treated with an intramedullary nail during a 5-year period were retrospectively reviewed inclusion. The surgical was determined by surgeon preference, 3 9 surgeons routinely using SP...
To develop a clinically useful prediction model of success at the time surgery to promote bone healing for established tibial nonunion or traumatic defects.Retrospective case controlled.Level 1 trauma center.Adult patients treated with tibia fracture defects from 2007 2016. Two hundred three met inclusion criteria and were available final analysis.Surgery segmental defect plate screw construct, intramedullary nail fixation, multiplanar external fixation.Failure that was defined as unplanned...
Nearly half of adult fracture patients are vitamin D deficient (serum 25-hydroxyvitamin [25(OH)D] levels <20 ng/mL). Many surgeons advocate prescribing supplements to improve healing outcomes; however, data supporting the effectiveness D3 acute lacking. We tested supplementation for improving tibia and femur healing. conducted a single-center, double-blinded phase II screening randomized controlled trial with 12-month follow-up. Patients aged 18-50 years receiving an intramedullary nail or...
Vitamin D is often prescribed as an adjuvant therapy to aid fracture healing due its biological role in bone health. However, the optimal frequency, dosage and duration of vitamin supplementation for non-osteoporotic has not been established. The objective this study was determine patient preferences relative hypothetical dosing options.Discrete choice experiment.Level 1 trauma centre Baltimore, Maryland, USA.199 adult (18-60 years) patients with a fracture.Parameter estimates utility...
Abstract Background This study aimed to address the current limitations of use composite endpoints in orthopaedic trauma research by quantifying relative importance clinical outcomes common patients and those values develop a patient-centered endpoint weighting technique. Methods A Best-Worst Scaling choice experiment was administered 396 adult surgically-treated fracture patients. Respondents were presented with ten sets, each consisting three out plausible outcomes. Hierarchical Bayesian...
To evaluate rates of complications in patients with bilateral femur fractures treated intramedullary nailing (IMN) during either 1 single procedure or 2 separate procedures.A multicenter retrospective review sustaining fractures, IMN 2-stage procedure, from 1998 to 2018 was performed at 10 Level-1 trauma centers.Ten centers.Two hundred forty-six fractures.Intramedullary nailing.Incidence complications.A total 246 were included, 188 single-stage and 58 two-stage patients. Gender, age, injury...
Abstract Background Observational studies have found that 75% of healthy adult fracture patients (ages 18–50) serum 25-hydroxyvitamin D (25(OH)D) levels < 30 ng/mL. Although lower 25(OH)D yet to be correlated healing complications or poor outcomes, many orthopedic surgeons are routinely prescribing vitamin supplements improve in non-osteoporotic patients. To address this gap the literature, we propose a phase II exploratory randomized controlled trial comparing three 3 dosing regimens for...
PurposeFemoral neck fractures in young patients are typically managed with internal fixation using either cancellous screws or a sliding hip screw (SHS). Although preserves the joint, still at risk of complications and poor clinical outcomes which lead to diminished function health related quality life (HRQL). The Fixation Alternative Implants for Treatment Hip Fractures (FAITH-2) pilot randomized controlled factorial trial evaluated effect surgical (cancellous vs. SHS) vitamin D...
Falls are a significant source of morbidity, mortality, and health care spending in the elderly. The objective was to identify whether race, insurance status, median income by zip code were associated with discharge disposition, readmission within 90 days, or mortality 1 year ground-level falls patients aged 60-90.We conducted retrospective chart review 926 60-90 treated for falls. We created binomial linear regression model predictors 90-day readmission, discharge.Length stay (P < .01),...
A retrospective case-control study was conducted at a level I trauma center to assess whether radiographic details of tibial plateau fixation can predict symptomatic implant removal. Nine hundred fifty-one fractures were treated with open reduction and internal from 2007 2016. Eighty-two (9%) removal for localized pain over the implant. control group selected remaining patients using cumulative sampling. Records radiographs reviewed predictors hypothesized be associated Based on authors'...
Objectives: To compare the volume of embolic load during intramedullary fixation femoral and tibial shaft fractures. Our hypothesis was that nails (IMNs) would be associated with less intravasation marrow than IM nailing femur Design: Prospective observational study. Setting: Urban Level I trauma center. Patients/Participants: Twenty-three patients consented for study: 14 fractures 9 Intervention: All underwent continuous transesophageal echocardiography, evaluated 5 distinct stages:...