A5090541105- Orthopedic Surgery and Rehabilitation
- Elbow and Forearm Trauma Treatment
- Shoulder Injury and Treatment
- Bone fractures and treatments
- Nerve Injury and Rehabilitation
- Shoulder and Clavicle Injuries
- Congenital limb and hand anomalies
- Cardiac Structural Anomalies and Repair
- Reconstructive Surgery and Microvascular Techniques
- Sports injuries and prevention
- Innovations in Medical Education
- Simulation-Based Education in Healthcare
- Surgical Simulation and Training
- Medical Malpractice and Liability Issues
- Muscle and Compartmental Disorders
- Prenatal Screening and Diagnostics
- Musculoskeletal Disorders and Rehabilitation
- Traumatic Ocular and Foreign Body Injuries
- Neurogenetic and Muscular Disorders Research
- Knee injuries and reconstruction techniques
- Peripheral Nerve Disorders
- Tendon Structure and Treatment
- Healthcare cost, quality, practices
- Gynecological conditions and treatments
- Musculoskeletal synovial abnormalities and treatments
Boston Children's Hospital
2015-2024
Harvard University
2015-2024
Orthopedic Center
2013-2023
The Micheli Center for Sports Injury Prevention
2016-2023
Boston Children's Museum
2012-2023
Hartford Hospital
2022
Advisory Board Company (United States)
2010-2014
Palo Alto Institute
2013-2014
American Society for Surgery of the Hand
2011-2014
Children's Hospital of Philadelphia
2014
Background: Several classification systems for the categorization of function in patients with brachial plexus birth palsy have been proposed. The purpose this investigation was to determine intraobserver and interobserver reliability modified Mallet Classification, Toronto Test Score, Hospital Sick Children Active Movement Scale evaluation these patients. Methods: Eighty children were evaluated by two trained examiners on different occasions. Intraobserver determined use kappa statistic....
Background: Closed reduction and percutaneous pin fixation is the treatment of choice for completely displaced (type-III) extension supracondylar fractures humerus in children, although controversy persists regarding optimal pin-fixation technique. The purpose this study was to compare efficacy lateral entry with that medial operative children. Methods: This prospective, randomized clinical trial had sufficient power detect a 10% difference rate loss between two groups. techniques were...
Compartment syndrome can be difficult to diagnose in a child, with delays diagnosis leading disastrous outcomes. Thirty-six cases of compartment 33 pediatric patients were treated at the authors' institution from January 1, 1992, December 31, 1997. There 27 boys and 6 girls, nearly equal upper lower extremity involvement. Approximately 75% these developed setting fracture. Pain, pallor, paresthesia, paralysis, pulselessness relatively unreliable signs symptoms children. An increasing...
Background: Persistent muscle imbalance and soft-tissue contractures can lead to progressive glenohumeral joint deformity in patients with brachial plexus birth palsy. The objective of this investigation was determine the effects correction external rotation weakness internal tendon transfers extra-articular releases on development Methods: Twenty-five palsy who underwent latissimus dorsi teres major rotator cuff—with or without concomitant musculotendinous lengthenings—were evaluated...
Background: Closed reduction and percutaneous pin fixation is the treatment of choice for completely displaced (type-III) extension supracondylar fractures humerus in children, although controversy persists regarding optimal pin-fixation technique. The purpose this study was to compare efficacy lateral entry with that medial operative children. Methods: This prospective, randomized clinical trial had sufficient power detect a 10% difference rate loss between two groups. techniques were...
Compartment syndrome can be difficult to diagnose in a child, with delays diagnosis leading disastrous outcomes. Thirty-six cases of compartment 33 pediatric patients were treated at the authors' institution from January 1, 1992, December 31, 1997. There 27 boys and 6 girls, nearly equal upper lower extremity involvement. Approximately 75% these developed setting fracture. Pain, pallor, paresthesia, paralysis, pulselessness relatively unreliable signs symptoms children. An increasing...
Thirty-four patients were enrolled in a prospective randomized study comparing cast immobilization alone versus percutaneous pin fixation following closed reduction of distal radial metaphyseal fractures. Patients older than 10 years age with greater 30 degrees dorsal angulation or complete fracture displacement eligible for enrollment. Average follow-up was 10.5 weeks. All fractures healed uneventfully without deformity, growth arrest, functional limitations. Overall complication rates...
Background: Derotational humeral osteotomies have been used in older children with brachial plexus birth palsy and glenohumeral joint deformity to place the upper extremity a more functional position. The purpose of this study was determine effects these procedures on shoulder function morphology. Methods: Forty-three patients underwent derotational osteotomy for impairment setting internal rotation contracture and/or at our institution from 1996 2004. Osteotomies were performed proximal...
Persistent muscle imbalance and soft-tissue contractures can lead to progressive glenohumeral joint dysplasia in patients with brachial plexus birth palsy. The objective of the present investigation was determine effects tendon transfers open reduction on shoulder function preexisting deformity secondary palsy.Twenty-three underwent latissimus dorsi teres major rotator cuff concomitant musculotendinous lengthening pectoralis and/or subscapularis for treatment internal rotation contracture...
Background: Historically, scaphoid fractures in children and adolescents have predominantly involved the distal pole, requiring neither surgical care nor extended follow-up. Changing patient characteristics, however, appear to be altering fracture epidemiology treatment. The purpose of this investigation was characterize contemporary patterns identify factors influencing time healing following both nonoperative operative Methods: A retrospective analysis 351 that had been treated from 1995...
Background: Management of pediatric radial neck fractures is controversial regarding acceptable alignment, variable reduction techniques, and suboptimal outcomes. The purpose this study was to assess the characteristics, management, results in a surgical cohort, efforts identify prognostic factors offer treatment suggestions. It hypothesized that less invasive maneuvers would precede open worse correlate with fracture severity, reduction, presence associated injuries. Methods: Retrospective...
Surgical treatment is recommended for patients with unstable osteochondritis dissecans (OCD) of the elbow. However, little information available comparing anticipated results from host techniques. In this investigation, clinical and radiographic resolution as well return to sports rates were assessed in adolescent following loose body (LB) removal drilling/microfracture grade IV lesions.We reviewed 21 adolescents treated LB elbow OCD. Patients additional pathology, prior surgery, or <1 year...
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The normal pattern of daily glucocorticoid production in mammals requires circadian modulation hypothalamicpituitary-adrenal axis activity. To assess both the factors responsible for imparting this diurnal profile and its physiologic importance, we have exploited corticotropin-releasing hormone (CRH)-deficient mice generated by homologous recombination embryonic stem cells. CRH-deficient lost variations plasma ACTH while maintaining locomotor Constant peripheral infusion CRH produced marked...
Background: Persistent muscle imbalance and soft-tissue contractures can lead to progressive glenohumeral joint deformity in patients with brachial plexus birth palsy. The objective of this investigation was determine the effects correction external rotation weakness internal tendon transfers extra-articular releases on development Methods: Twenty-five palsy who underwent latissimus dorsi teres major rotator cuff—with or without concomitant musculotendinous lengthenings—were evaluated...
Background Surgical treatment is often advocated for unstable or severely displaced proximal humerus fractures in older children. The purpose of this study to compare the early radiographic results and complications 2 common methods internal fixation, percutaneous pinning (PP), flexible intramedullary nailing (IMN), used treat these fractures. Methods Fifty skeletally immature patients who underwent surgical reduction PP IMN between 2000 2009 were reviewed. Radiographs assessed maximum...
Background: The purpose of this investigation was to characterize the range Pediatric Outcomes Data Collection Instrument (PODCI) scores in children with brachial plexus birth palsy (BPBP) and determine its correlation 3 published measures active motion function. Methods: One hundred fifty BPBP between ages 2 10 years were evaluated. Active upper-extremity assessed using modified Mallet Classification (MC), Toronto Test score (TTS), Hospital for Sick Children Movement Scale. At time...
Monteggia fractures remain challenging pediatric injuries because of difficulties in diagnosis, propensity for instability, and complexity late reconstruction. The objective this investigation was to assess the efficacy following treatment strategy based upon ulnar fracture pattern: closed reduction (CR) plastic/greenstick fractures, intramedullary (IM) pin fixation transverse/short oblique open internal long oblique/comminuted fractures.A total 112 acute patients were retrospectively...