Pub Date : 2023-04-13DOI: 10.2106/JBJS.JOPA.22.00030
T. Taros, Alina Syros, Christopher T Zoppo, Ronald M. Swonger, Joseph S. Geller, Byron Chen
With over 8,000 and counting, varying in origin from people to cities to animals, eponyms are everywhere in medicine. The fields of radiology and orthopedics both have an especially rich history regarding the usage of eponyms. A variety of eponymous fractures from head to toe were identified to show their ubiquity throughout the body. It is our hope that readers gain an appreciation not just for the medical facets of these fractures but for the characters who make their names worth remembering as well. Orthopedic and radiological perspectives on 11 eponymous fractures (Barton, Bennett/Rolando, Galeazzi, Monteggia, Duverney, Segond, Bosworth, Tillaux, Chopart, and Lisfranc) were reviewed. The historical impact and biographical information of those fractures are named for was discussed. Although eponyms are losing popularity, they remain ubiquitous in radiology and orthopedics. There exists, however, a disparity in gender of eponyms in orthopedics especially. It is likely that as more women enter orthopedics, this disparity will disappear.
{"title":"Who’s Who in Eponymous Fractures","authors":"T. Taros, Alina Syros, Christopher T Zoppo, Ronald M. Swonger, Joseph S. Geller, Byron Chen","doi":"10.2106/JBJS.JOPA.22.00030","DOIUrl":"https://doi.org/10.2106/JBJS.JOPA.22.00030","url":null,"abstract":"With over 8,000 and counting, varying in origin from people to cities to animals, eponyms are everywhere in medicine. The fields of radiology and orthopedics both have an especially rich history regarding the usage of eponyms. A variety of eponymous fractures from head to toe were identified to show their ubiquity throughout the body. It is our hope that readers gain an appreciation not just for the medical facets of these fractures but for the characters who make their names worth remembering as well. Orthopedic and radiological perspectives on 11 eponymous fractures (Barton, Bennett/Rolando, Galeazzi, Monteggia, Duverney, Segond, Bosworth, Tillaux, Chopart, and Lisfranc) were reviewed. The historical impact and biographical information of those fractures are named for was discussed. Although eponyms are losing popularity, they remain ubiquitous in radiology and orthopedics. There exists, however, a disparity in gender of eponyms in orthopedics especially. It is likely that as more women enter orthopedics, this disparity will disappear.","PeriodicalId":93583,"journal":{"name":"Journal of orthopedics for physician assistants","volume":"11 1","pages":"e22.00030"},"PeriodicalIF":0.0,"publicationDate":"2023-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47275265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-07DOI: 10.2106/JBJS.JOPA.22.00027
Seikai Toyooka, O. Villanger, Vibeke Røstad Kristiansen, L. Engebretsen
Case: A 17-year-old male tennis player presented with persistent and increasing posterior neck pain. An overuse of tennis stroke motion resulted in a clay-shoveler fracture at the first thoracic vertebra. The patient was able to fully return to tennis after discontinuation of the causative motion and conservative treatment. Conclusions: This report presents a clay-shoveler fracture occurring in a tennis player. Although this fracture is rare in the modern era, it is characterized by its causative motion and site of occurrence. Knowing these characteristics, care should be taken not to miss it.
{"title":"Clay-Shoveler Fracture of an Adolescent Tennis Player","authors":"Seikai Toyooka, O. Villanger, Vibeke Røstad Kristiansen, L. Engebretsen","doi":"10.2106/JBJS.JOPA.22.00027","DOIUrl":"https://doi.org/10.2106/JBJS.JOPA.22.00027","url":null,"abstract":"Case: A 17-year-old male tennis player presented with persistent and increasing posterior neck pain. An overuse of tennis stroke motion resulted in a clay-shoveler fracture at the first thoracic vertebra. The patient was able to fully return to tennis after discontinuation of the causative motion and conservative treatment. Conclusions: This report presents a clay-shoveler fracture occurring in a tennis player. Although this fracture is rare in the modern era, it is characterized by its causative motion and site of occurrence. Knowing these characteristics, care should be taken not to miss it.","PeriodicalId":93583,"journal":{"name":"Journal of orthopedics for physician assistants","volume":"11 1","pages":"e22.00027"},"PeriodicalIF":0.0,"publicationDate":"2023-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47282478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-16DOI: 10.2106/JBJS.JOPA.22.00026
Daniel A. Cornejo
Distal radius fractures are the most common fracture in children younger than 16 years. A common pattern of distal radius fractures is the buckle or torus fracture. Traditional treatment of these injuries involved casting with serial x-ray imaging to evaluate for proper healing and maintained alignment. Studies of these injury patterns, however, suggest that these fractures are inherently stable and have a very low incidence of displacement. These studies posit that torus fractures can be treated definitively in a removable brace that can be discontinued by the patient's caregiver without the need for follow-up examinations or imaging. A review of pertinent literature from the past 5 years concluded that, in pediatric patients with acute radial torus fractures, clinical outcomes were equivalent between patients treated with removable braces and no scheduled follow-up and those treated with hard casting and repeat clinical evaluation. Implementation of this evidence-based treatment can significantly improve patient care by reducing unneeded follow-ups and imaging while minimizing the cost of treatment and missed school/work days by patients and their caregivers.
{"title":"Evidence-Based Management of Pediatric Distal Radius Buckle Fractures","authors":"Daniel A. Cornejo","doi":"10.2106/JBJS.JOPA.22.00026","DOIUrl":"https://doi.org/10.2106/JBJS.JOPA.22.00026","url":null,"abstract":"Distal radius fractures are the most common fracture in children younger than 16 years. A common pattern of distal radius fractures is the buckle or torus fracture. Traditional treatment of these injuries involved casting with serial x-ray imaging to evaluate for proper healing and maintained alignment. Studies of these injury patterns, however, suggest that these fractures are inherently stable and have a very low incidence of displacement. These studies posit that torus fractures can be treated definitively in a removable brace that can be discontinued by the patient's caregiver without the need for follow-up examinations or imaging. A review of pertinent literature from the past 5 years concluded that, in pediatric patients with acute radial torus fractures, clinical outcomes were equivalent between patients treated with removable braces and no scheduled follow-up and those treated with hard casting and repeat clinical evaluation. Implementation of this evidence-based treatment can significantly improve patient care by reducing unneeded follow-ups and imaging while minimizing the cost of treatment and missed school/work days by patients and their caregivers.","PeriodicalId":93583,"journal":{"name":"Journal of orthopedics for physician assistants","volume":"11 1","pages":"e22.00026"},"PeriodicalIF":0.0,"publicationDate":"2023-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47956441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-16DOI: 10.2106/JBJS.JOPA.22.00017
J. Weis, Kristofer S. Matullo
Introduction: With participation in outdoor and remote activities rising, it is essential for wilderness medicine clinicians to be aware of the hand, wrist, and forearm injuries that commonly occur. From mountain biking to rock climbing to dog walking, hand and wrist injuries are ubiquitous, and knowledge of them can improve preparedness. Methods: This was a retrospective study that evaluated hand, wrist, and forearm injuries, sustained during recreational outdoor activities, that then presented to orthopaedics. Data were recorded over the course of 1 calendar year for activity, body part, injury type, sex, age, and the need for surgery. This was then analyzed to highlight trends. Results: Of 436 hand, wrist, and forearm injuries, the wrist was the most frequently injured upper extremity body part with 253 injuries. The most common type of injury was fracture with 336, and of these fractures, 170 were of the distal radius. Biking, skateboarding, and dog walking were the most common causes of injury, and the most frequently injured patients were young men and older women. Conclusion: This study underscores the importance of clinician preparation for evaluation and management of hand, wrist, and forearm injuries, including distal radius fractures. It also highlights the importance of recognizing patients at risk for osteoporosis. Having knowledge of the leading injuries, most common mechanisms, and most at-risk patients helps with clinician training, provider and kit preparedness, and participant education.
{"title":"Epidemiology of Hand and Wrist Injuries in Outdoor Recreational Activities","authors":"J. Weis, Kristofer S. Matullo","doi":"10.2106/JBJS.JOPA.22.00017","DOIUrl":"https://doi.org/10.2106/JBJS.JOPA.22.00017","url":null,"abstract":"Introduction: With participation in outdoor and remote activities rising, it is essential for wilderness medicine clinicians to be aware of the hand, wrist, and forearm injuries that commonly occur. From mountain biking to rock climbing to dog walking, hand and wrist injuries are ubiquitous, and knowledge of them can improve preparedness. Methods: This was a retrospective study that evaluated hand, wrist, and forearm injuries, sustained during recreational outdoor activities, that then presented to orthopaedics. Data were recorded over the course of 1 calendar year for activity, body part, injury type, sex, age, and the need for surgery. This was then analyzed to highlight trends. Results: Of 436 hand, wrist, and forearm injuries, the wrist was the most frequently injured upper extremity body part with 253 injuries. The most common type of injury was fracture with 336, and of these fractures, 170 were of the distal radius. Biking, skateboarding, and dog walking were the most common causes of injury, and the most frequently injured patients were young men and older women. Conclusion: This study underscores the importance of clinician preparation for evaluation and management of hand, wrist, and forearm injuries, including distal radius fractures. It also highlights the importance of recognizing patients at risk for osteoporosis. Having knowledge of the leading injuries, most common mechanisms, and most at-risk patients helps with clinician training, provider and kit preparedness, and participant education.","PeriodicalId":93583,"journal":{"name":"Journal of orthopedics for physician assistants","volume":"11 1","pages":"e22.00017"},"PeriodicalIF":0.0,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47132034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-07DOI: 10.2106/JBJS.JOPA.22.00023
Ryan Desgrange
{"title":"Battle Royale","authors":"Ryan Desgrange","doi":"10.2106/JBJS.JOPA.22.00023","DOIUrl":"https://doi.org/10.2106/JBJS.JOPA.22.00023","url":null,"abstract":"","PeriodicalId":93583,"journal":{"name":"Journal of orthopedics for physician assistants","volume":"11 1","pages":"e22.00023"},"PeriodicalIF":0.0,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45940665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-19DOI: 10.2106/JBJS.JOPA.22.00018
Tom Gocke
Hand-related trauma is a common injury accounting for nearly a million emergency department visits annually. Fractures involving the metacarpals comprise approximately 40% of all hand injuries. Sports-related injuries are seen most often in children and young adults; middle-aged workers suffer more motor vehicle accident or work-related/industrial injuries; and the elderly seems to injure their hands from ground-level falls. The most commonly reported hand fracture involves the fifth metacarpal neck. Metacarpal fractures are described by their bone location in which they occur (head-neck-shaft-base). Fracture patterns are referred to as transverse, oblique (short/long), or comminuted based on fracture line configuration. The predominance of metacarpal fractures is closed injuries. However, open metacarpal fractures can result from severe bone and soft-tissue trauma caused by bone fragment(s) lacerating the skin. Small finger metacarpal neck fractures have the highest probability of being associated with an open fracture because of their injury mechanism. The primary goals of metacarpal fracture treatment are to achieve acceptable alignment, stable reductions, bony union, and full motion. Bone fracture location, fragment(s) size, and fracture pattern will influence treatment decisions. Most metacarpal fractures can be treated nonoperatively with closed reduction maneuvers and splinting. Metacarpal fractures associated with open injuries can be treated effectively with early detection, copious irrigation, antibiotic therapy, appropriate wound coverage, and fracture immobilization. Surgical considerations of metacarpal fractures include malunion, failure to maintain fracture reduction, polytrauma, and open fractures resulting in severe soft-tissue trauma.
{"title":"Metacarpal Fractures","authors":"Tom Gocke","doi":"10.2106/JBJS.JOPA.22.00018","DOIUrl":"https://doi.org/10.2106/JBJS.JOPA.22.00018","url":null,"abstract":"Hand-related trauma is a common injury accounting for nearly a million emergency department visits annually. Fractures involving the metacarpals comprise approximately 40% of all hand injuries. Sports-related injuries are seen most often in children and young adults; middle-aged workers suffer more motor vehicle accident or work-related/industrial injuries; and the elderly seems to injure their hands from ground-level falls. The most commonly reported hand fracture involves the fifth metacarpal neck. Metacarpal fractures are described by their bone location in which they occur (head-neck-shaft-base). Fracture patterns are referred to as transverse, oblique (short/long), or comminuted based on fracture line configuration. The predominance of metacarpal fractures is closed injuries. However, open metacarpal fractures can result from severe bone and soft-tissue trauma caused by bone fragment(s) lacerating the skin. Small finger metacarpal neck fractures have the highest probability of being associated with an open fracture because of their injury mechanism. The primary goals of metacarpal fracture treatment are to achieve acceptable alignment, stable reductions, bony union, and full motion. Bone fracture location, fragment(s) size, and fracture pattern will influence treatment decisions. Most metacarpal fractures can be treated nonoperatively with closed reduction maneuvers and splinting. Metacarpal fractures associated with open injuries can be treated effectively with early detection, copious irrigation, antibiotic therapy, appropriate wound coverage, and fracture immobilization. Surgical considerations of metacarpal fractures include malunion, failure to maintain fracture reduction, polytrauma, and open fractures resulting in severe soft-tissue trauma.","PeriodicalId":93583,"journal":{"name":"Journal of orthopedics for physician assistants","volume":"11 1","pages":"e22.00018"},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41525837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-13DOI: 10.2106/JBJS.JOPA.22.00022
Joshua K. Radi, Morgan E Hasegawa, K. S. Min
The scapula serves as the transition point at which the energy from the lower body and core transmits through the scapulothoracic articulation and the upper extremity. Spinal accessory nerve palsy leads to lateral winging of the scapula and abnormal scapulothoracic motion. Resultant abnormal motion and asynchrony of the scapulothoracic articulation can disrupt the upper extremity kinetic chain, leading to pain, atrophy, and dysfunction of the shoulder. Disruption of this kinetic chain can severely impair patients and athletes who engage in physically demanding activities. Conservative management alone with anti-inflammatories, lifestyle changes, and physical therapy has not produced encouraging results. Surgical management options include a tendon transfer (Eden-Lange, triple tendon transfer) or nerve repair. We present a case of an active duty service member with idiopathic spinal accessory nerve palsy treated with triple tendon transfer. After the triple tendon transfer, this patient experienced improvements in pain, range of motion, and function at 1-year postoperatively, also maintaining enough strength and function to pass their physical fitness assessments and remain on active duty. As such, these findings may suggest the triple tendon transfer procedure offers a viable option in the treatment of spinal accessory nerve palsy in the active patient populations who require a high level of physical function.
{"title":"Modified Eden-Lange Triple Tendon Transfer Procedure for Idiopathic Spinal Accessory Nerve Palsy and Scapular Winging","authors":"Joshua K. Radi, Morgan E Hasegawa, K. S. Min","doi":"10.2106/JBJS.JOPA.22.00022","DOIUrl":"https://doi.org/10.2106/JBJS.JOPA.22.00022","url":null,"abstract":"The scapula serves as the transition point at which the energy from the lower body and core transmits through the scapulothoracic articulation and the upper extremity. Spinal accessory nerve palsy leads to lateral winging of the scapula and abnormal scapulothoracic motion. Resultant abnormal motion and asynchrony of the scapulothoracic articulation can disrupt the upper extremity kinetic chain, leading to pain, atrophy, and dysfunction of the shoulder. Disruption of this kinetic chain can severely impair patients and athletes who engage in physically demanding activities. Conservative management alone with anti-inflammatories, lifestyle changes, and physical therapy has not produced encouraging results. Surgical management options include a tendon transfer (Eden-Lange, triple tendon transfer) or nerve repair. We present a case of an active duty service member with idiopathic spinal accessory nerve palsy treated with triple tendon transfer. After the triple tendon transfer, this patient experienced improvements in pain, range of motion, and function at 1-year postoperatively, also maintaining enough strength and function to pass their physical fitness assessments and remain on active duty. As such, these findings may suggest the triple tendon transfer procedure offers a viable option in the treatment of spinal accessory nerve palsy in the active patient populations who require a high level of physical function.","PeriodicalId":93583,"journal":{"name":"Journal of orthopedics for physician assistants","volume":"11 1","pages":"e22.00022"},"PeriodicalIF":0.0,"publicationDate":"2023-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49048173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.2106/jbjs.jopa.22.00024
Taylor Sares, Renee Andreeff
{"title":"Effect of Diabetes Mellitus on Patient Outcomes After Arthroscopic Rotator Cuff Repair","authors":"Taylor Sares, Renee Andreeff","doi":"10.2106/jbjs.jopa.22.00024","DOIUrl":"https://doi.org/10.2106/jbjs.jopa.22.00024","url":null,"abstract":"","PeriodicalId":93583,"journal":{"name":"Journal of orthopedics for physician assistants","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67754028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.2106/jbjs.jopa.23.00013
D. Cloutier
{"title":"JBJS JOPA Writing Awards","authors":"D. Cloutier","doi":"10.2106/jbjs.jopa.23.00013","DOIUrl":"https://doi.org/10.2106/jbjs.jopa.23.00013","url":null,"abstract":"","PeriodicalId":93583,"journal":{"name":"Journal of orthopedics for physician assistants","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67753623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.2106/jbjs.jopa.22.00021
Julia L. Hale, Jacquelyn N. Valenzuela-Moss, V. Tolo
{"title":"Chemotherapy-Induced Peripheral Neuropathy Leading to Foot Deformity","authors":"Julia L. Hale, Jacquelyn N. Valenzuela-Moss, V. Tolo","doi":"10.2106/jbjs.jopa.22.00021","DOIUrl":"https://doi.org/10.2106/jbjs.jopa.22.00021","url":null,"abstract":"","PeriodicalId":93583,"journal":{"name":"Journal of orthopedics for physician assistants","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67754017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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