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  1. Article: A cortical screw based tension band construct for transverse patella fractures: An evolving strategy for addressing common modes of failure.

    Paziuk, Taylor / Chang, Gerard / Henry, Tyler / Krieg, James

    Journal of orthopaedics

    2022  Volume 30, Page(s) 66–71

    Abstract: Introduction: Displaced patella fractures represent a clinical challenge. We evaluate the effectiveness of an alternative fixation construct to address common modes of fixation failure.: Methods: A retrospective review of 49 patients who underwent ... ...

    Abstract Introduction: Displaced patella fractures represent a clinical challenge. We evaluate the effectiveness of an alternative fixation construct to address common modes of fixation failure.
    Methods: A retrospective review of 49 patients who underwent fixation via the specific construct at a single institution between 2013 and 2019.
    Results: Median follow-up was 52.7 weeks (Mean: 75.4 weeks; SD: 54.9; range: 27-267.7 weeks). Construct failure rate was 6.1% (3/49). This included two mechanical hardware failures, one the result of trauma and the other due to noncompliance.
    Conclusions: The modified construct represents a safe and effective means of treating transverse patella fractures.
    Level of evidence: Level 4.
    Language English
    Publishing date 2022-02-17
    Publishing country India
    Document type Journal Article
    ZDB-ID 2240839-3
    ISSN 0972-978X
    ISSN 0972-978X
    DOI 10.1016/j.jor.2022.02.018
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  2. Article ; Online: Posterior Wall Acetabulum Fracture with a Persistent Sciatic Artery: A Case Report.

    Chang, Gerard / Chip Routt, Milton L / Warner, Stephen

    JBJS case connector

    2021  Volume 11, Issue 3

    Abstract: Case: We report the case of a patient who sustained a left posterior wall acetabular fracture with an ipsilateral persistent sciatic artery (PSA). The PSA was diagnosed preoperatively on lower extremity computed tomography angiogram. He was treated with ...

    Abstract Case: We report the case of a patient who sustained a left posterior wall acetabular fracture with an ipsilateral persistent sciatic artery (PSA). The PSA was diagnosed preoperatively on lower extremity computed tomography angiogram. He was treated with open reduction internal fixation through a Kocher-Langenbeck approach. The PSA and sciatic nerve were identified and protected throughout the case. There were no neurovascular complications.
    Conclusion: PSA in the setting of posterior wall acetabulum fractures has not been reported previously. Orthopaedic surgeons who treat these injuries should be aware of PSA anatomic variants so that they can be identified and protected during surgery.
    MeSH term(s) Acetabulum/diagnostic imaging ; Acetabulum/injuries ; Acetabulum/surgery ; Arteries/injuries ; Fracture Fixation, Internal/methods ; Hip Fractures/surgery ; Humans ; Male ; Spinal Fractures
    Language English
    Publishing date 2021-07-15
    Publishing country United States
    Document type Case Reports ; Journal Article
    ISSN 2160-3251
    ISSN (online) 2160-3251
    DOI e21.00156
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  3. Article ; Online: Dogs can detect an odor profile associated with

    Ramos, Meghan T / Chang, Gerard / Wilson, Clara / Gilbertie, Jessica / Krieg, James / Parvizi, Javad / Chen, Antonia F / Otto, Cynthia M / Schaer, Thomas P

    Frontiers in allergy

    2024  Volume 5, Page(s) 1275397

    Abstract: Introduction: The study investigated the utilization of odor detection dogs to identify the odor profile of : Methods: Dogs were trained on pure : Results: The results demonstrated that dogs achieved a high degree of sensitivity and specificity in ...

    Abstract Introduction: The study investigated the utilization of odor detection dogs to identify the odor profile of
    Methods: Dogs were trained on pure
    Results: The results demonstrated that dogs achieved a high degree of sensitivity and specificity in detecting the odor profile associated with
    Discussion: Training odor detection dogs on
    Language English
    Publishing date 2024-02-13
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2673-6101
    ISSN (online) 2673-6101
    DOI 10.3389/falgy.2024.1275397
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  4. Article ; Online: Radial Nerve Palsy After Humeral Shaft Fractures: The Case for Early Exploration and a New Classification to Guide Treatment and Prognosis.

    Chang, Gerard / Ilyas, Asif M

    Hand clinics

    2018  Volume 34, Issue 1, Page(s) 105–112

    Abstract: Radial nerve palsies are a common complication associated with humeral shaft fractures. The authors propose classifying these injuries into 4 types based on intraoperative findings: type 1 stretch/neuropraxia, type 2 incarcerated, type 3 partial ... ...

    Abstract Radial nerve palsies are a common complication associated with humeral shaft fractures. The authors propose classifying these injuries into 4 types based on intraoperative findings: type 1 stretch/neuropraxia, type 2 incarcerated, type 3 partial transection, and type 4 complete transection. The initial management of radial nerve palsies associated with closed fractures of the humerus remains a controversial topic, with early exploration reserved for open fractures, fractures that cannot achieve an adequate closed reduction requiring fracture repair, fractures with associated vascular injuries, and polytrauma patients. Outside of these recommendations, expectant observation for spontaneous recovery is recommended.
    Language English
    Publishing date 2018-02
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1315374-2
    ISSN 1558-1969 ; 0749-0712
    ISSN (online) 1558-1969
    ISSN 0749-0712
    DOI 10.1016/j.hcl.2017.09.011
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    Se 989: Show issues Location:
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  5. Article ; Online: Short Term Complications in Geriatric Ankle Fractures Using a Protocolized Approach to Surgical Treatment: Is Early Weight Bearing Safe?

    Chang, Gerard / Henry, Tyler / Sobol, Keenan / Krieg, James

    The Iowa orthopaedic journal

    2020  Volume 40, Issue 1, Page(s) 159–165

    Abstract: Background: Surgical management of geriatric ankle fractures requires unique considerations in addressing operative risks. Prior studies have reached varying conclusions regarding optimal treatment strategies. The primary aim of this study was to ... ...

    Abstract Background: Surgical management of geriatric ankle fractures requires unique considerations in addressing operative risks. Prior studies have reached varying conclusions regarding optimal treatment strategies. The primary aim of this study was to determine if surgical fixation following a predetermined treatment protocol was safe and effective. The secondary aim was to determine if immediate weight bearing as tolerated (IWBAT) in a subset of patients was safe or conferred any short-term benefits.
    Methods: This retrospective study included all patients over the age 65 treated surgically for an ankle fracture by a single surgeon over a five-year period. A protocol was used including: augmented fixation techniques, IWBAT for select patients, and specific strategies to minimize soft tissue damage. Complications associated with operative treatment were analyzed. A subgroup analysis of patients with isolated ankle injuries was carried out to compare patients made IWBAT to patients made non-weight bearing (NWB) postoperatively.
    Results: Thirty-four patients were included in the study. Fracture types were predominantly OTA 44B2 (18/34, 53%) and 44B3 (8/34, 24%). Union rate was 100%. Augmented fixation techniques were used in 14/34, 41% of patients. Twenty-one of 34, 62% of patients were allowed IWBAT. There were 4 complications, 12%: 1 malunion, 1 superficial infection, and 2 wound dehiscence. Two patients returned to the operating room for removal of hardware and irrigation and debridement. In the subgroup analysis, the IWBAT group was discharged to a rehabilitation facility at a significantly lower rate than the NWB group, 25% (4/16) vs 90% (9/10; p=0.0036). There were no differences in the complication rates between the two groups.
    Conclusion: Acceptable outcomes can be reliably obtained when following a standardized approach to geriatric ankle fracture management. In addition, immediate weight bearing in select patients does not seem to increase complications and may benefit patients by increasing rate of discharge to home.
    MeSH term(s) Aged ; Aged, 80 and over ; Ankle Fractures/surgery ; Female ; Fracture Fixation, Internal ; Health Services for the Aged ; Humans ; Male ; Postoperative Complications/etiology ; Retrospective Studies ; Weight-Bearing
    Language English
    Publishing date 2020-07-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1204065-4
    ISSN 1555-1377 ; 1541-5457
    ISSN (online) 1555-1377
    ISSN 1541-5457
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    In stock of ZB MED Cologne/Königswinter

    Se 1381: Show issues Location:
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  6. Article ; Online: Single-Incision 4-Compartment Fasciotomy of the Lower Leg: Safe, Effective, and Advantageous.

    Chang, Gerard / Fram, Brianna / Krieg, James C

    Orthopedics

    2020  Volume 43, Issue 4, Page(s) e225–e230

    Abstract: The optimal surgical approach for acute compartment syndrome (ACS) of the lower leg remains debatable. Although a majority of surgeons tend to use a 2-incision approach to 4-compartment fasciotomies, the authors have used a single-incision technique ... ...

    Abstract The optimal surgical approach for acute compartment syndrome (ACS) of the lower leg remains debatable. Although a majority of surgeons tend to use a 2-incision approach to 4-compartment fasciotomies, the authors have used a single-incision technique followed by protocolized, staged skin closure. The purpose of this study was to determine the safety, efficacy, and complication rate of this strategy. This retrospective study included all patients treated for ACS by a single surgeon during a 3-year period. A protocol was used including a single-incision technique followed by vacuum-assisted wound-closure dressing, periodic return to the operating room at 48- to 72-hour intervals, and sequential wound closure with vertical mattress sutures. Complications associated with this protocol were analyzed. Eleven patients were included in the study. Average length of follow-up was 12 months (range, 2-35 months). There were no instances of malunion, deep or superficial infection, intraoperative neurovascular injury, or progressive neurologic deficits-indicating adequate release of all 4 compartments through a single incision. All patients were closed primarily without need for skin grafting. Average time to primary closure was 4.5 days. One patient had a tibial fracture nonunion and 1 had distal wound breakdown, which healed by secondary intention. A single-incision approach to 4-compartment fasciotomies followed by protocolized skin closure is safe and effective and may reduce the need for skin grafting. [Orthopedics. 2020;43(4):e225-e230.].
    MeSH term(s) Adult ; Compartment Syndromes/surgery ; Fasciotomy/adverse effects ; Fasciotomy/methods ; Female ; Follow-Up Studies ; Fractures, Ununited/etiology ; Humans ; Male ; Middle Aged ; Patient Safety ; Retrospective Studies ; Skin Transplantation ; Sutures/adverse effects ; Tibia/surgery ; Tibial Fractures/surgery ; Time Factors ; Treatment Outcome ; Wound Healing
    Language English
    Publishing date 2020-04-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 424447-3
    ISSN 1938-2367 ; 0147-7447
    ISSN (online) 1938-2367
    ISSN 0147-7447
    DOI 10.3928/01477447-20200404-03
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    Zs.A 1487: Show issues Location:
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  7. Article: Reinforced reconstruction: A technique for the treatment of periacetabular metastases.

    Chang, Gerard / Paziuk, Taylor / Henry, Tyler / Krieg, James / Brown, Scot

    Journal of orthopaedics

    2021  Volume 27, Page(s) 63–68

    Abstract: Purpose: To describe a single-stage reconstruction of intraarticular periacetabular metastases that utilizes a cemented acetabular liner reinforced with percutaneous screws oriented along various osseous fixation pathways.: Methods: A retrospective ... ...

    Abstract Purpose: To describe a single-stage reconstruction of intraarticular periacetabular metastases that utilizes a cemented acetabular liner reinforced with percutaneous screws oriented along various osseous fixation pathways.
    Methods: A retrospective evaluation of all patients with intraarticular periacetabular metastases who underwent the procedure outlined.
    Results: 16 procedures (1 bilateral) were included. There were no intraoperative complications or postoperative mechanical failures to date despite allowing the patients to immediately weight bear in the postoperative setting.
    Discussion: Utilizing osseous fixation pathways to reinforce a cemented acetabular cup represents a safe and effective strategy to allow for immediate weightbearing in patients with periacetabular metastases.
    Language English
    Publishing date 2021-09-01
    Publishing country India
    Document type Journal Article
    ZDB-ID 2240839-3
    ISSN 0972-978X
    ISSN 0972-978X
    DOI 10.1016/j.jor.2021.08.013
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  8. Article ; Online: Open Reduction and Internal Fixation of Pediatric Scapula Fractures: A Report of 2 Cases.

    Schultz, Blake J / Davis, Elizabeth P / Chang, Gerard / Ward, Norman H / Berkes, Marschall / Choo, Andrew M

    JBJS case connector

    2022  Volume 12, Issue 1

    Abstract: Case: Two pediatric patients with displaced, extra-articular scapula fractures who underwent surgery because of concerns for persistent deformity and decreased function with continued nonoperative management.: Conclusion: We advocate careful ... ...

    Abstract Case: Two pediatric patients with displaced, extra-articular scapula fractures who underwent surgery because of concerns for persistent deformity and decreased function with continued nonoperative management.
    Conclusion: We advocate careful consideration of all patient factors and treatment options when addressing pediatric scapula fractures. Specific fracture patterns with altered shoulder girdle mechanics may warrant surgical intervention to restore anatomic alignment and stability.
    MeSH term(s) Child ; Fracture Fixation, Internal ; Humans ; Open Fracture Reduction ; Scapula/diagnostic imaging ; Scapula/surgery ; Shoulder Fractures/surgery
    Language English
    Publishing date 2022-02-10
    Publishing country United States
    Document type Case Reports ; Journal Article
    ISSN 2160-3251
    ISSN (online) 2160-3251
    DOI e21.00725
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  9. Article: Upper-Extremity Deep Venous Thrombosis following a Fracture of the Proximal Humerus: An Orthopaedic Case Report.

    Strony, John / Chang, Gerard / Krieg, James C

    Case reports in orthopedics

    2019  Volume 2019, Page(s) 6863978

    Abstract: Deep venous thrombosis of the lower extremities following orthopaedic surgery is well-documented. Though less common than its lower extremity counterpart, upper extremity deep venous thrombosis (UEDVT) has been documented in the literature as well, ... ...

    Abstract Deep venous thrombosis of the lower extremities following orthopaedic surgery is well-documented. Though less common than its lower extremity counterpart, upper extremity deep venous thrombosis (UEDVT) has been documented in the literature as well, largely in the context of arthroscopic shoulder surgery. However, there is a paucity of literature documenting UEDVT following surgical fixation of upper extremity fractures, specifically fractures involving the proximal humerus. We present a case of UEDVT following a fracture to the proximal humerus and subsequent surgery. Though UEDVT is considered a rare complication following this type of surgery based on a lack of documentation within the literature, we believe a high-index of suspicion is required to prevent potentially life-threatening sequelae, such as pulmonary embolism (PE) and post-thrombotic syndrome.
    Language English
    Publishing date 2019-11-04
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2684648-2
    ISSN 2090-6757 ; 2090-6749
    ISSN (online) 2090-6757
    ISSN 2090-6749
    DOI 10.1155/2019/6863978
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  10. Article ; Online: Treatment of Distal Fibular Malunion with Corrective Osteotomy: Yablon Revisited.

    Chang, Gerard / Buckley, Patrick S / Krieg, James C

    The Iowa orthopaedic journal

    2019  Volume 39, Issue 1, Page(s) 167–172

    Abstract: Yablon originally described that late posttraumatic degenerative ankle arthritis was due to ongoing tibio-talar joint incongruity, and more importantly that anatomic reduction of the lateral malleolus was key to anatomic reduction of the ankle joint, as ... ...

    Abstract Yablon originally described that late posttraumatic degenerative ankle arthritis was due to ongoing tibio-talar joint incongruity, and more importantly that anatomic reduction of the lateral malleolus was key to anatomic reduction of the ankle joint, as the talus "faithfully followed that of the lateral malleolus." Ankle fractures involving the lateral malleolus, left unreduced, can lead to malunion and posttraumatic degenerative arthritis. Treatment of this often includes a fibular osteotomy to restore length and rotation. We revisit Yablon's original principles and present a review of the literature pertaining to techniques and outcomes of lateral malleolus malunions treated with distal fibular osteotomies as well as a case report highlighting the challenges and considerations when facing this problem.
    MeSH term(s) Ankle Fractures/diagnostic imaging ; Ankle Fractures/surgery ; Arthroscopy/methods ; Female ; Fibula/injuries ; Fibula/surgery ; Fluoroscopy/methods ; Follow-Up Studies ; Fracture Fixation, Internal/adverse effects ; Fracture Fixation, Internal/methods ; Fractures, Bone/diagnostic imaging ; Fractures, Bone/surgery ; Fractures, Malunited/diagnostic imaging ; Fractures, Malunited/surgery ; Humans ; Injury Severity Score ; Middle Aged ; Osteotomy/methods ; Reoperation/methods ; Treatment Outcome
    Language English
    Publishing date 2019-08-05
    Publishing country United States
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 1204065-4
    ISSN 1555-1377 ; 1541-5457
    ISSN (online) 1555-1377
    ISSN 1541-5457
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