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  1. Article: Joint-preserving surgery for idiopathic bilateral osteonecrosis of the distal tibia: A case report.

    Honeine, Mohamad Omar Y / Ghanem, Wendy M / Otayek, Joeffroy N / Dib, Nabil G / Badra, Mohammad I / Moucharafieh, Ramzi S

    Journal of orthopaedic case reports

    2023  Volume 13, Issue 10, Page(s) 47–52

    Abstract: Introduction: Osteonecrosis (ON) is a serious pathological condition that can affect weight-bearing areas of the lower limbs, including the distal tibia. Although trauma is a common cause of ON, the condition has multiple possible etiologies. ON has ... ...

    Abstract Introduction: Osteonecrosis (ON) is a serious pathological condition that can affect weight-bearing areas of the lower limbs, including the distal tibia. Although trauma is a common cause of ON, the condition has multiple possible etiologies. ON has been associated with a range of factors, including trauma, medication use, alcoholism, and vascular disease. Interruption of blood flow to a particular bone region is the first step in the pathophysiology of ON. Conservative management is typically indicated in the early stages of ON, but joint-preserving procedures may be necessary in cases where conservative treatment fails.
    Case report: This article presents a case of bilateral ON of the distal tibia in a 38-year-old female patient without a history of trauma or identifiable risk factors. The patient was initially managed conservatively but ultimately underwent joint-preserving surgery due to treatment failure.
    Conclusion: Joint-preserving procedures should be considered in cases of early-stage distal tibia ON that do not respond to conservative management to prevent joint collapse. This case highlights the importance of considering ON as a possible diagnosis even in the absence of identifiable risk factors or trauma.
    Language English
    Publishing date 2023-10-11
    Publishing country India
    Document type Case Reports
    ZDB-ID 2658169-3
    ISSN 2250-0685
    ISSN 2250-0685
    DOI 10.13107/jocr.2023.v13.i10.3932
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Rectus abdominis free tissue transfer in lower extremity reconstruction: Long term follow up in 58 cases.

    Moucharafieh, Ramzi C / Nehme, Alexandre H / Badra, Mohammad I / Rahal, Mohammad Jawad H

    Injury

    2019  Volume 50 Suppl 5, Page(s) S25–S28

    Abstract: This study evaluates the long-term results of rectus abdominis free-tissue transfer performed for lower extremity reconstruction.: Methods: Over a period of 8 years 58 were available for long term follow-up. Indications for reconstruction included ... ...

    Abstract This study evaluates the long-term results of rectus abdominis free-tissue transfer performed for lower extremity reconstruction.
    Methods: Over a period of 8 years 58 were available for long term follow-up. Indications for reconstruction included acute wounds with soft tissue defects, diabetic foot ulcers, and chronic osteomyelitis.
    Results: At a mean follow-up of 18 years, there were no major complications in the soft tissue defect coverage group except for one patient who continued to have recurrent folliculitis over the weight bearing heel area, which was treated by repeated debridement. Among the diabetic patients, two patients had recurrent ulcerations of the forefoot which were detected early and treated conservatively. In the osteomyelitis group, however, there were no recurrences of the foot infection.
    Conclusions: The rectus abdominis free-tissue transfer provided an excellent method of soft tissue reconstruction with a very minimal long-term complication rate, and a very high rate of success in the treatment of diabetic foot ulcers and chronic osteomyelitis.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Chronic Disease ; Debridement ; Diabetic Foot/surgery ; Female ; Follow-Up Studies ; Free Tissue Flaps ; Humans ; Lower Extremity/surgery ; Male ; Microsurgery/methods ; Middle Aged ; Osteomyelitis/surgery ; Rectus Abdominis/surgery ; Skin Transplantation/methods ; Soft Tissue Injuries/surgery ; Treatment Outcome ; Young Adult
    Language English
    Publishing date 2019-10-19
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 218778-4
    ISSN 1879-0267 ; 0020-1383
    ISSN (online) 1879-0267
    ISSN 0020-1383
    DOI 10.1016/j.injury.2019.10.042
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 778: Show issues Location:
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    Zs.MO 10: Show issues

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  3. Article ; Online: Nerve transfers in the upper extremity: A review.

    Moucharafieh, Ramzi C / Badra, Mohammad I / Boulos, Karl A / Mansour, Jad I / Daher, Jimmy C / Wardani, Hassan M / Nour, Hicham G Abd El / Sayde, Elias G / Nehme, Alexandre H

    Injury

    2020  Volume 51, Issue 12, Page(s) 2804–2810

    Abstract: Injury of the brachial plexus and peripheral nerve often result in significant upper extremity dysfunction and disability. Nerve transfers are replacing other techniques as the gold standard for brachial plexus and other proximal peripheral nerve ... ...

    Abstract Injury of the brachial plexus and peripheral nerve often result in significant upper extremity dysfunction and disability. Nerve transfers are replacing other techniques as the gold standard for brachial plexus and other proximal peripheral nerve injuries. These transfers require an intimate knowledge of nerve topography, a technically demanding Intraneural dissection and require extensive physical therapy for retraining. In this review, we present a summary of the most widely accepted nerve transfers in the upper extremity described in the current literature.
    MeSH term(s) Brachial Plexus/surgery ; Brachial Plexus Neuropathies/surgery ; Humans ; Nerve Transfer ; Peripheral Nerve Injuries/surgery ; Upper Extremity/surgery
    Language English
    Publishing date 2020-05-21
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 218778-4
    ISSN 1879-0267 ; 0020-1383
    ISSN (online) 1879-0267
    ISSN 0020-1383
    DOI 10.1016/j.injury.2020.04.015
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  4. Article ; Online: Thoracic adolescent idiopathic scoliosis: selection of fusion level.

    Badra, Mohammad I / Feldman, David S / Hart, Robert A

    Journal of pediatric orthopedics. Part B

    2010  Volume 19, Issue 5, Page(s) 465–472

    Abstract: Selection of the appropriate fusion levels in thoracic adolescent idiopathic scoliosis has been traditionally a subject of debate among surgeons. Landmarks that have been suggested include the end vertebra, stable vertebra and neutral vertebra. Various ... ...

    Abstract Selection of the appropriate fusion levels in thoracic adolescent idiopathic scoliosis has been traditionally a subject of debate among surgeons. Landmarks that have been suggested include the end vertebra, stable vertebra and neutral vertebra. Various results have been reported with multiple theories proposed to explain them. The clinical appearance of the patient, the type of the curve and its flexibility, the surgical technique and the instrumentation used all seem to play major roles in selecting the appropriate levels of fusion.
    MeSH term(s) Humans ; Orthopedic Procedures/methods ; Scoliosis/classification ; Scoliosis/pathology ; Scoliosis/surgery ; Spinal Fusion/methods ; Thoracic Vertebrae/pathology ; Thoracic Vertebrae/surgery
    Language English
    Publishing date 2010-09
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 1473-5865
    ISSN (online) 1473-5865
    DOI 10.1097/BPB.0b013e32833cb72d
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  5. Article: Use of pelvic incidence as a guide to reduction of H-type spino-pelvic dissociation injuries.

    Hart, Robert A / Badra, Mohammad I / Madala, Alosh / Yoo, Jung U

    Journal of orthopaedic trauma

    2007  Volume 21, Issue 6, Page(s) 369–374

    Abstract: Objective: Describe the use of a radiographic parameter (pelvic incidence) to assess the sagittal plane reduction of H-type sacral fractures associated with spinopelvic dissociation, and assess the relationship between standing lumbar lordosis to pelvic ...

    Abstract Objective: Describe the use of a radiographic parameter (pelvic incidence) to assess the sagittal plane reduction of H-type sacral fractures associated with spinopelvic dissociation, and assess the relationship between standing lumbar lordosis to pelvic incidence after spinopelvic dissociation.
    Design: Retrospective radiographic and clinical review of treatment outcomes for patients with spinopelvic dissociation injuries secondary to H-type sacral fractures.
    Setting: Level I Trauma Center.
    Intervention: Pelvic incidence (PI), a radiographic parameter that measures the orientation of the lumbar spine relative to the pelvis, has been shown to have a correlation with the adequacy of surgical reduction as well as the risk of progression of high-grade spondylolisthesis. We used this parameter as a measure of sagittal plane reduction of spinopelvic dissociation injuries.
    Patients/participants: The clinical records and radiographs of five patients with spinopelvic dissociation injuries were reviewed.
    Main outcome measurements: Radiographic measurements included standing PI and lumbar lordosis (LL). The relationship of lumbar lordosis on pelvic incidence was tested by a regression analysis. Clinical outcome was assessed by the self-reported ability of the patient to comfortably maintain an upright stance.
    Results: The average follow-up period was 32 (range: 12-53) months. The average final PI was 82 (60-115) degrees. The average final lumbar lordosis was 58.2 (42-77) degrees. LL was found to be significantly related to PI (P<0.05). One patient with an abnormally high PI had lumbar fatigue with persistent stance.
    Conclusions: Pelvic incidence is a potentially useful radiographic parameter that can be used to assess the adequacy of sagittal plane reduction in patients with spinopelvic dissociation injuries.
    MeSH term(s) Adult ; Bone Screws ; Female ; Fracture Fixation/instrumentation ; Fracture Fixation/methods ; Humans ; Lordosis/diagnostic imaging ; Lumbar Vertebrae/diagnostic imaging ; Male ; Pelvis/anatomy & histology ; Pelvis/diagnostic imaging ; Posture ; Radiography ; Retrospective Studies ; Sacrum/diagnostic imaging ; Sacrum/injuries ; Spinal Fractures/diagnostic imaging ; Spinal Fractures/surgery ; Treatment Outcome
    Language English
    Publishing date 2007-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639099-7
    ISSN 0890-5339
    ISSN 0890-5339
    DOI 10.1097/BOT.0b013e31806dd959
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    Zs.A 2234: Show issues Location:
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  6. Article: Evaluation of an algorithmic approach to pediatric back pain.

    Feldman, David S / Straight, Joseph J / Badra, Mohammad I / Mohaideen, Ahamed / Madan, Sanjeev S

    Journal of pediatric orthopedics

    2006  Volume 26, Issue 3, Page(s) 353–357

    Abstract: Pediatric patients require a systematic approach to treating back pain that minimizes the number of diagnostic studies without missing specific diagnoses. This study reviews an algorithm for the evaluation of pediatric back pain and assesses critical ... ...

    Abstract Pediatric patients require a systematic approach to treating back pain that minimizes the number of diagnostic studies without missing specific diagnoses. This study reviews an algorithm for the evaluation of pediatric back pain and assesses critical factors in the history and physical examination that are predictive of specific diagnoses. Eighty-seven pediatric patients with thoracic and/or lumbar back pain were treated utilizing after this algorithm. If initial plain radiographs were positive, patients were considered to have a specific diagnosis. If negative, patients with constant pain, night pain, radicular pain, and/or an abnormal neurological examination obtained a follow-up magnetic resonance imaging. Patients with negative radiographs and intermittent pain were diagnosed with nonspecific back pain. Twenty-one (24%) of 87 patients had positive radiographs and were treated for their specific diagnoses. Nineteen (29%) of 66 patients with negative radiographs had constant pain, night pain, radicular pain, and/or an abnormal neurological examination. Ten of these 19 patients had a specific diagnosis determined by magnetic resonance imaging. Therefore, 31 (36%) of 87 patients had a specific diagnosis. Back pain of other 56 patients was of a nonspecific nature. No specific diagnoses were missed at latest follow-up. Specificity for determining a specific diagnosis was very high for radicular pain (100%), abnormal neurological examination (100%), and night pain (95%). Radicular pain and an abnormal neurological examination also had high positive predictive value (100%). Lumbar pain was the most sensitive (67%) and had the highest negative predictive value (75%). This algorithm seems to be an effective tool for diagnosing pediatric back pain, and this should help to reduce costs and patient/family anxiety and to avoid unnecessary radiation exposure.
    MeSH term(s) Algorithms ; Back Pain ; Child ; Child, Preschool ; Decision Support Systems, Clinical ; Decision Support Techniques ; Female ; Humans ; Male ; Pediatrics/methods ; Reproducibility of Results ; Sensitivity and Specificity
    Language English
    Publishing date 2006-05
    Publishing country United States
    Document type Evaluation Studies
    ZDB-ID 604642-3
    ISSN 1539-2570 ; 0271-6798
    ISSN (online) 1539-2570
    ISSN 0271-6798
    DOI 10.1097/01.bpo.0000214928.25809.f9
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  7. Article: Functional outcome in adult patients following Bernese periacetabular osteotomy.

    Badra, Mohammad I / Anand, Ashish / Straight, Joseph J / Sala, Debra A / Ruchelsman, David E / Feldman, David S

    Orthopedics

    2009  Volume 31, Issue 1, Page(s) 69

    Abstract: This study evaluated functional outcome following Bernese periacetabular osteotomy. In 24 patients with mean follow-up of 3.5 years, mean dysfunction score was 15.23 on the Short Musculoskeletal Function Assessment. Eighteen patients (75%) scored = or < ... ...

    Abstract This study evaluated functional outcome following Bernese periacetabular osteotomy. In 24 patients with mean follow-up of 3.5 years, mean dysfunction score was 15.23 on the Short Musculoskeletal Function Assessment. Eighteen patients (75%) scored = or <20, indicating a high functional level. Irrespective of preoperative Shenton line continuity, most patients demonstrated a high functional level. However, a trend toward a poorer outcome was observed in patients with preoperative noncongruent joints and Tonnis osteoarthritis grade 3. These results suggest patients with less than optimal presentation may still benefit from this surgery, delaying or eliminating the need for total hip arthroplasty.
    MeSH term(s) Acetabulum/surgery ; Adolescent ; Adult ; Female ; Hip Dislocation, Congenital/complications ; Hip Dislocation, Congenital/diagnosis ; Hip Dislocation, Congenital/surgery ; Humans ; Male ; Middle Aged ; Osteoarthritis, Hip/diagnosis ; Osteoarthritis, Hip/etiology ; Osteoarthritis, Hip/surgery ; Osteotomy/methods ; Recovery of Function ; Treatment Outcome ; Young Adult
    Language English
    Publishing date 2009-02-25
    Publishing country United States
    Document type Clinical Trial ; Journal Article
    ZDB-ID 424447-3
    ISSN 0147-7447
    ISSN 0147-7447
    DOI 10.3928/01477447-20080101-03
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