A5067989173- Pelvic and Acetabular Injuries
- Bone fractures and treatments
- Trauma and Emergency Care Studies
- Surgical site infection prevention
- Innovations in Medical Education
- Diversity and Career in Medicine
- Heterotopic Ossification and Related Conditions
- Orthopedic Infections and Treatments
- Cardiac, Anesthesia and Surgical Outcomes
- Musculoskeletal Disorders and Rehabilitation
- Surgical Simulation and Training
- Abdominal Trauma and Injuries
- Pregnancy-related medical research
- Foot and Ankle Surgery
- Healthcare cost, quality, practices
- Spinal Fractures and Fixation Techniques
- Orthopedic Surgery and Rehabilitation
- Lower Extremity Biomechanics and Pathologies
- Ureteral procedures and complications
- Hospital Admissions and Outcomes
- Tendon Structure and Treatment
- Hip and Femur Fractures
- Muscle and Compartmental Disorders
- Parathyroid Disorders and Treatments
- Vascular Procedures and Complications
Brooke Army Medical Center
2017-2022
San Antonio Uniformed Services Health Education Consortium
2017-2022
Joint Base San Antonio
2022
Urology San Antonio
2022
Military Health System
2020
United States Air Force
2019
Wilford Hall Ambulatory Surgical Center
2019
Womack Army Medical Center
2018
Portsmouth Hospitals NHS Trust
2018
Denver Health Medical Center
2005-2008
Background: The current management of pelvic fracture patients who are hemodynamically unstable in the United States consists aggressive resuscitation, mechanical stabilization, and angioembolization. Despite this multidisciplinary approach, our recent analysis confirms an alarming 40% mortality these high-risk patients. Therefore, we pursued alternate therapies to improve patient outcomes. European trauma groups have suggested technique packing via laparotomy directly address venous...
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...
Smith, Wade R. MD; Moore, Ernest E. Osborn, Patrick Agudelo, Juan F. Morgan, Steven J. Parekh, Anand A. MRCS(Eng); Cothren, Clay MD Author Information
Background: Traumatic injuries to the tarsometatarsal or Lisfranc joints can be complex problems associated with long-term morbidity. Currently there is no clear consensus regarding optimal fixation methods. The purpose of this study was evaluate association between time from injury treatment and method outcome. It hypothesized that patients who underwent open reduction internal (ORIF) more acutely would have higher return duty rates. Methods: This a retrospective review 171 low-energy...
The risk of developing a surgical site infection after extremity fracture repair is nearly 5 times greater than in most elective orthopedic procedures. For all procedures, it standard practice to prepare the operative with an antiseptic solution; however, there limited evidence guide choice solution used for repair.To compare effectiveness iodophor vs chlorhexidine solutions reduce infections and unplanned fracture-related reoperations patients who underwent repair.The PREP-IT (Program...
The Major Extremity Trauma and Rehabilitation Consortium the American Academy of Orthopaedic Surgeons have developed Appropriate Use Criteria (AUC) for Diagnosis Management Acute Compartment Syndrome (ACS). Evidence-based information, in conjunction with clinical expertise physicians, was used to develop criteria improve patient care, aid decision-making, obtain best possible outcomes while considering subtleties distinctions necessary making decisions. AUC ACS were derived by identifying...
Abstract Introduction Physical exam and angiography have important roles in the diagnosis of traumatic lower extremity vascular injury with similar reported high rates sensitivity specificity. It has been previously shown that CTA is not universally indicated setting acute trauma when a reliable physical examination obtained. As such, purpose this study was to determine if obtaining following altered clinical care patients high-energy generalizability military population. Materials Methods...
Multi-planar transverse, U-type, and vertical sacral fractures occur from high energy trauma or as pathologic often have associated neurologic extremity injuries. Modern treatment algorithms fall into two broad categories: 1) percutaneous posterior pelvic fixation (iliosacral transiliac-transsacral screws) 2) lumbopelvic fixation. Posterior screw is minimally invasive but typically requires restricted weight bearing until fracture union. In many cases, allows for a closed reduction provides...
Racial disparities in treatment benchmarks have been documented among older patients with hip fractures. However, these studies were limited to patient-level evaluations.To assess whether meeting fracture care time-to-surgery exist at the patient level or hospital institutional using high-quality multicenter prospectively collected data; study hypothesis was that hospital-level reflecting structural health systems issues would be detected.This cohort a secondary analysis of data PREP-IT...
Heterotopic ossification (HO) is a significant problem for wounded warriors surviving high-energy blast injuries; however, currently, there no biomarker panel capable of globally characterizing, diagnosing, and monitoring HO progression. The aim this study was to identify biomarkers using proteomic techniques blood serum.Isobaric tags relative absolute quantitation (iTRAQ) used generate semi-quantitative global proteomics survey serum from patients with without heterotopic ossification....
Talus fractures are infrequent injuries that often associated with poor clinical outcomes. Literature reviewing talus is limited to a civilian population, few studies characterizing these sustained in active duty personnel. The aim of this study was characterize combat trauma by reporting their surgical outcomes.The Department Defense Trauma Registry (DoDTR) queried identify US service members who battle conditions between 2001 and 2014. These patients underwent retrospective chart review....
The observation of decreased resident autonomy, ultimately influencing the readiness a new graduate to practice, has been supported with number recent surveys. This perceived lack autonomy is felt be due, in part, many reasons, including duty-hour regulations, increased supervision requirements, patient safety measures, concern for complication rates, and other performance measures. Pressure on faculty members have clinical productivity may not allow more autonomy.Increased exposure improve...
Osteochondral lesions of the talus (OLTs) are common injuries in young, active patients. Microfracture is an effective treatment for less than 150 mm2 size. Most commonly employed postoperative protocols involve delaying weightbearing 6 to 8 weeks (DWB), though one study suggests that early (EWB) may not be detrimental patient outcomes. The goal this research compare outcomes following EWB and DWB after microfracture OLTs.We performed a prospective, randomized, multicenter clinical trial...
With the institution of Next Accreditation System (NAS), case log procedures fundamentally changed. Unless multiple entries are made, only one procedure per is credited for counts. We hypothesized that NAS caused notable changes in national data.Accreditation Council Graduate Medical Education Orthopaedic Surgery Case Logs National Data Reports from 2008 to 2016 were analyzed calculate differences data before and after implementation.In first academic year post-NAS, average total decreased...
ABSTRACT Introduction Decay of military surgeons’ critical wartime skills is a persistent and growing concern among leaders in the health system (MHS). The Knowledge, Skills Abilities (KSA) Clinical Readiness Program was developed to quantify readiness clinicians MHS; however, utility data questionable due lack focus on operative expeditionary skillset original methodology. A revised methodology emphasizing most relevant orthopedic surgery procedures described. Materials Methods All Current...
As we transition to an interwar period, combat-related injuries are at their lowest levels in over a decade, yet must continue maintain our surgical skills and train new surgeons. During the recent wars, importance of treatment care for amputations complex extremity became apparent. This study compares number these procedures performed during civilian military orthopaedic trauma patients Department Defense Level I center past 9 years. The need evaluate this unique system is further...