A5103013270- Bone fractures and treatments
- Hip and Femur Fractures
- Pelvic and Acetabular Injuries
- Orthopedic Surgery and Rehabilitation
- Trauma and Emergency Care Studies
- Orthopaedic implants and arthroplasty
- Orthopedic Infections and Treatments
- Foot and Ankle Surgery
- Opioid Use Disorder Treatment
- Diversity and Career in Medicine
- Pregnancy-related medical research
- Pain Management and Opioid Use
- Cardiac, Anesthesia and Surgical Outcomes
- Abdominal Trauma and Injuries
- Anesthesia and Pain Management
- Musculoskeletal pain and rehabilitation
- Spinal Fractures and Fixation Techniques
- Sports injuries and prevention
- Elbow and Forearm Trauma Treatment
- Muscle and Compartmental Disorders
- Shoulder Injury and Treatment
- Musculoskeletal Disorders and Rehabilitation
- Surgical site infection prevention
- Emergency and Acute Care Studies
- Health and Medical Research Impacts
Florida Orthopaedic Institute
2016-2025
University of South Florida
2015-2024
Orthopedic Institute
2018-2024
Tampa General Hospital
2012-2023
Boston University
2021
University of Vermont
2021
Orthopaedic Trauma Association
2016-2021
Zimmer Biomet (Switzerland)
2021
Baylor College of Medicine
2021
Clinical Orthopaedics and Related Research
2020
The past few decades have seen an alarming rise in opioid use the United States, and negative consequences from diversion of opioids for nontherapeutic are dramatically increasing. A significant number orthopaedic patients at risk repercussions both therapeutic use. Orthopaedic surgeons third highest prescribers prescriptions among physicians States. Thus, it is important to understand detrimental effects abuse on individuals society recognize objective measures identify These include...
Management of vertical femoral neck fractures in young adults has been a challenging clinical problem, resulting mixed outcomes. A thorough understanding the fracture morphology for this injury pattern is lacking, which may contribute to frequent failures treatment. This study designed produce detailed description pathoanatomy these fractures, ultimately be helpful developing more informed reduction and fixation strategies.Retrospective patient records, plain radiographs, computed tomography...
To report on the immediate postoperative alignment of distal tibia fractures (within 5 cm tibial plafond) treated with suprapatellar intramedullary nail (IMN) insertion compared infrapatellar technique. Primary outcomes include both anteroposterior and lateral radiographic views.Retrospective cohort study.Two urban level I trauma centers.A total 266 skeletally mature patients a fracture were an IMN. One hundred thirty-two underwent this procedure through technique.Intramedullary...
The diagnosis of quadriceps and patellar tendon ruptures requires a high index suspicion thorough history-taking to assess for medical comorbidities that may predispose patients degeneration. Radiographic assessment with plain films supplemented by ultrasound magnetic resonance imaging when the work-up is equivocal further aids diagnosis; however, advanced often unnecessary in functional extensor mechanism deficits. Acute repair preferred, transpatellar bone tunnels serve as primary form...
The COVID-19 pandemic has presented challenges to healthcare systems, including the cancellation and then staged resumption of elective procedures. orthopaedic trauma community continued provide care patients with acute musculoskeletal injuries that cannot be delayed in all scenarios. This article summarizes provides relevant information (orthopaedic service, outpatient fracture clinic, inpatient surgery) practicing traumatologist on maximizing outcomes while limiting exposure during...
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...
While internet search engines have been the primary information source for patients' questions, artificial intelligence large language models like ChatGPT are trending towards becoming new source. The purpose of this study was to determine if can answer patient questions about total hip (THA) and knee arthroplasty (TKA) with consistent accuracy, comprehensiveness, easy readability.
Objectives: The aim of this study was to evaluate the level comprehension in an orthopedic trauma patient population regarding injury, surgery, and postoperative instructions determine if educational background is associated with inadequate comprehension. Design: This involved a prospective observational cohort. Setting: conducted at Academic Level 1 center. Patients: From April June 2011, 248 patients operatively fixed isolated fracture were found be eligible for inclusion. One hundred...
To determine the optimal fixation method [intramedullary nail (IMN) vs. plate (PF)] for treating critical bone defects with induced membrane technique, also known as Masquelet technique.Retrospective cohort study.Four Level 1 Academic Trauma Centers.All patients treated or between January 1, 2005, and 31, 2018.Operative treatment a temporary cement spacer to induce formation, followed by removal grafting at 6-8 weeks.Time union, number/reason reoperations, time full weight-bearing, any...
To investigate the biomechanical properties of a lateral locked plate alone or in combination with supplemental medial an intramedullary nail (IMN).Intra-articular distal femur fractures metaphyseal comminution (OTA/AO 33-C) were simulated standardized model 28 synthetic femora and divided into 4 groups. Group I was instrumented 4.5-mm femoral alone, group II plus low-profile precontoured 3.5-mm tibial plate, III reconstruction IV retrograde IMN. Specimens then axially loaded cycled to...
Objectives: To assess the operative results of femoral neck fractures (FNFs) in young adults a large multicenter series, specifically focusing on risk factors for treatment failure. Design: Large retrospective cohort series. Setting: Twenty-six North American Level 1 trauma centers. Patients: Skeletally mature patients younger than 50 years with displaced and nondisplaced FNFs treated between 2005 2017. Intervention: Operative repair FNF. Main outcome measurements: The main measure is...
Objectives Fracture is a common injury after traumatic event. The efficacy and safety of non-steroidal anti-inflammatory drugs (NSAIDs) to treat acute pain related fractures not well established. Methods Clinically relevant questions were determined regarding NSAID use in the setting trauma-induced with clearly defined patient populations, interventions, comparisons appropriately selected outcomes (PICO). These centered around (pain control, reduction opioid use) (non-union, kidney injury)....
To determine if preoperative fever and leukocytosis without an established source of untreated infection are independent risk factors for the development deep postoperative wound (DPWI) after surgical treatment pelvic acetabular fractures.Retrospective chart radiographic review; matched case-control comparison.: Level 1 regional referral trauma center.Five hundred ninety-seven skeletally mature patients with and/or fractures requiring operative fixation (353 acetabular, 170 pelvic, 74...
Surgical site infections (SSI) continue to be a significant source of morbidity despite the introduction perioperative intravenous antibiotics. Our objective was assess efficacy local vancomycin powder on lowering deep SSI rates in high-energy tibial plateau and pilon fractures. A retrospective review all fractures treated 2012 at our level I trauma center identified 222 patients. Of these, 107 patients sustained injuries that required staged fixation, 93 had minimum 6 month follow-up. Ten...
Background: Biomechanical studies suggest that augmenting anterior fixation of the pelvic ring with posterior increases stability. Prior clinical have assessed radiographic outcomes following plate symphysis. However, to our knowledge, none directly compared and alone such addition percutaneous screw in treatment a partially disrupted hemipelvis. We attempted determine whether use an symphyseal is adequate control sagittal coronal plane rotation prevent malunion anteroposterior compression...
The negative consequences of narcotic use and diversion for nonmedical are on the rise. A growing number abusers obtain prescriptions from multiple providers ("doctor shopping"). This study sought to determine effects postoperative prescriptions, duration narcotics, morphine equivalent dose per day in orthopaedic trauma population.Our prospective cohort used state-controlled substance monitoring database identify all filled three months prior admission six following discharge enrolled...
To analyze radiographic changes in intertrochanteric (IT) fracture alignment after treatment with either a single sliding lag screw or an integrated compressed and locked, dual screw, cephalomedullary nail construct.Retrospective comparative study.Level 1 regional trauma center.1004 OTA/AO 31A, 31B2.1 fractures treated (Gamma 3) (InterTAN) between February 1, 2005, June 30, 2013. Four hundred thirteen remained exclusion criteria; 130 were device (79 stable 51 unstable), 283 (155 128...
To evaluate the prehospital use of direct oral anticoagulant (DOAC) agents on outcomes early surgical fixation a geriatric hip fracture.Case control study.Two academic Level 1 trauma centers.Early (<48 h) proximal femur fracture.Nineteen patients receiving Pradaxa (dabigatran), Eliquis (apixaban), or Xarelto (rivaroxaban) who underwent surgery between 2010 and 2015 74 patients.Time to surgery, transfusion rates, changes in hemoglobin levels, postoperative complications, readmission survival...
To evaluate the rate of, and reasons for, conversion of closed treatment humeral shaft fractures using a fracture brace, to surgical intervention.Multicenter, retrospective analysis.Nine Level 1 trauma centers across United States.A total 1182 patients with initially managed nonoperatively functional brace from 2005 2015 were reviewed retrospectively 9 institutions.Functional brace.Conversion surgery.A 344 (29%) ultimately underwent intervention. Reasons for included nonunion (60%),...
To evaluate rates of nonunion repair, osseous healing, and outcomes in femoral nonunions with contemporary healing. Retrospective review. Five academic level 1 trauma centers. This study includes adult patients (age older than 18) seen at one the participating institutions between 2012 2019 who sustained a femur fracture (OTA/AO 31, 32, 33) initially treated intramedullary fixation that developed were exchange nailing for index surgery. Seventy-nine met inclusion criteria. Exchange treatment...
Introduction: To report the incidence of lower leg fasciotomies in tibial shaft and plateau fractures explore potential missed acute compartment syndrome (ACS) with widespread, selective, or no invasive monitoring (IM). Methods: This is a retrospective review adult patients diaphyseal (Orthopaedic Trauma Association 42A-C), proximal 41A-C) treated surgically at Level 1 trauma center from 2001 to 2020. Main outcomes interest include extremity fasciotomy rates ACS (abnormal neurovascular...