Mount Carmel, OH, United States
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Formaini N.,Grant Medical Center | Taylor B.C.,Grant Medical Center | Backes J.,Mount Carmel Medical Center | Bramwell T.J.,Grant Medical Center
Orthopedics | Year: 2013

Plate fixation of displaced clavicle fractures has proven to be reliable and reproducible, leading to high union rates and a low rate of associated complications. However, the decision of whether to place the plate superiorly or anteroinferiorly on the clavicle has remained controversial. The authors performed a retrospective review on a consecutive series of patients who underwent plate fixation for a displaced midshaft clavicle fracture at a Level I urban trauma center. A review of surgical records identified 138 patients with a displaced midshaft clavicle fracture requiring operative stabilization. A total of 105 patients who met the inclusion criteria were included in the analysis. Both superior and anteroinferior techniques resulted in a similar time to radiographic union (12.6±4.8 vs 11.3±5.2 weeks, respectively) and identical union rates (95%). At final follow-up, patient-reported implant prominence was nearly double in patients with a retained superior plate (54% vs 29%, respectively; P=.04). No significant difference existed in mean visual analog scale score at a mean of 2.77 years postoperatively, although a significant difference existed in the Oxford Shoulder Score questionnaire, with a mean score of 41.4 in the superior group and 44.4 in the anteroinferior group (P=.008). Implant removal occurred more frequently after superior plating but was not significant. Both superior and anteroinferior clavicle plating are safe treatment methods for displaced clavicle fractures. Superior plating leads to an increased rate of patient-reported implant prominence and may prompt more requests for implant removal.


Boyles A.D.,Doctors Hospital | Taylor B.C.,Grant Medical Center | Ferrel J.R.,Mount Carmel Medical Center
Injury Extra | Year: 2013

Multiple rib fractures are common in blunt thoracic trauma, and while indicative of the severity of injury, are rarely implicated as the solitary cause of death. Significant chest wall injury and the presence of flail chest is associated with substantial dysfunction and morbidity, including the need for respiratory support, pneumonia or septicemia, and prolonged hospitalization and pain medication requirements [12]. Posterior rib fractures are commonly associated with flail segments, but are often minimally displaced due to surrounding soft tissue attachments and support. However, if associated with intrathoracic displacement, the risks of significant morbidity and even mortality increase exponentially, and surgical intervention is indicated to minimize this risk. © 2013 Elsevier Ltd.


Taylor B.C.,Grant Medical Center | Poka A.,Grant Medical Center | French B.G.,Grant Medical Center | Fowler T.T.,Mount Carmel Medical Center | Mehta S.,Grant Medical Center
Journal of Bone and Joint Surgery - Series A | Year: 2012

Background: The Gritti-Stokes amputation procedure is a modification of the traditional transfemoral amputation, with resection of the bone at a supracondylar femoral level and fixation of the patella to the distal part of the femur as an endcap. Although well-established in patients with vascular compromise, no evidence exists on its use in the trauma setting. Methods: Fourteen consecutive patients who underwent Gritti-Stokes amputation and fifteen consecutive patients who underwent traditional transfemoral amputation by fellowship-trained orthopaedic traumatologists at a level-I trauma center were evaluated at more than fourteen months postoperatively. The Sickness Impact Profile (SIP) questionnaire was also administered to both patient groups at more than thirty-six months postoperatively to assess patient-reported functional outcomes. Results: Despite the two groups not having significant differences in preoperative variables or demographics, the Gritti- Stokes group had significantly improved SIP questionnaire overall and domain scores. This procedure also left the patients with a significantly longer residual limb (an average of 46.1 cm of residual femoral length versus 34.6 cm for the transfemoral group). The Gritti-Stokes group also had a significantly increased rate of walking without assistive devices (five patients versus none in the transfemoral amputation group). Conclusions: The Gritti-Stokes amputation appears to be safe and beneficial when utilized in the trauma population. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2012 by The Journal of Bone and Joint Surgery Incorporated.


Taylor B.C.,Grant Medical Center | French B.G.,Grant Medical Center | Ty Fowler T.,Mount Carmel Medical Center | Russell J.,Grant Medical Center | Poka A.,Grant Medical Center
Journal of the American Academy of Orthopaedic Surgeons | Year: 2012

Multiple surgeries are often required to manage segmental bone loss because of the complex mechanics and biology involved in reconstruction. These procedures can lead to prolonged recovery times, poor patient outcomes, and even delayed amputation. A twostage technique uses induced biologic membranes with delayed placement of bone graft to manage this clinical challenge. In the first stage, a polymethyl methacrylate spacer is placed in the defect to produce a bioactive membrane, which appears to mature biochemically and physically 4 to 8 weeks after spacer placement. In the second, cancellous autograft is placed within this membrane and, via elution of several growth factors, the membrane appears to prevent graft resorption and promote revascularization and consolidation of new bone. Excellent clinical results have been reported, with successful reconstruction of segmental bone defects >20 cm.


Taylor B.C.,Grant Medical Center | French B.G.,Grant Medical Center | Fowler T.T.,Mount Carmel Medical Center
Journal of Orthopaedic Trauma | Year: 2013

Operative management of thoracic injuries is an increasingly accepted technique, with multiple reports of improved patient outcomes as compared with nonoperative treatment. Despite the evolving support of rib fracture fixation, descriptions of surgical approaches and tactics remain limited. We present this information to allow surgeons to begin or improve treatment of these injuries. In addition, we present the initial treatment results of a series of 21 patients treated with the approaches described within. Copyright © 2013 by Lippincott Williams & Wilkins.


Fowler T.T.,Mount Carmel Medical Center | Taylor B.C.,Grant Medical Center | Bellino M.J.,Stanford University | Althausen P.L.,Reno Orthopaedic Clinic
Journal of the American Academy of Orthopaedic Surgeons | Year: 2014

Despite significant advances in critical care management, flail chest remains a clinically significant finding, with a mortality rate of up to 33%. Nonsurgical management is associated with prolonged ventilator support, pneumonia, respiratory difficulties, and lengthy stays in the intensive care unit, as well as chronic pain from nonunion and malunion of the bony thorax. Treatment with aggressive pulmonary toilet, ventilator support, and different modalities of pain control remains the benchmark of care. However, several recent randomized controlled studies of surgical intervention of flail chest have demonstrated an improvement in the number of ventilator days, intensive care unit and hospital stays, incidence of pneumonia, and respiratory function and hospital costs, as well as faster return to work. The success of these surgical constructs compared with those of historical attempts at open fixation is largely the result of modern plating technology and improvement in surgical approaches. Clinical evidence continues to grow regarding proper indications and techniques for surgical stabilization of flail chest. © 2014 the American Academy of Orthopaedic Surgeons.


Columbus, OH, November 28, 2016 --( Dr. Scott Stephens is a board-certified orthopedic surgeon specializing in shoulder and elbow surgery, and sports medicine. He performs all aspects of shoulder surgery from minimally invasive arthroscopy to complex shoulder replacements. Areas of special interest include shoulder arthritis, rotator cuff, distal humerus fractures, and biceps tendon ruptures/ tendinitis. Dr. Stephens received his medical degree from University of Toledo School of Medicine and completed his orthopedic surgery residency at Mount Carmel Medical Center in Columbus, Ohio. Following residency, he completed dual fellowship sub-specialty training. His first fellowship was in Sports Medicine and Arthroscopy in Miami, Florida at Doctor’s Hospital where he assisted in the care and treatment of the 2013 NBA Champion Miami Heat. He then completed a Shoulder and Elbow Fellowship at the University of Texas at San Antonio under the guidance of world-renowned shoulder and elbow surgeons Drs. Rockwood, Morrey, and Wirth. While there, he learned the latest techniques in shoulder and elbow arthroscopy and reconstruction. "I believe that the best patient care comes from taking the time to get to know patients in order to individualize treatment and allow patients to return to activities that they enjoy,” said Dr. Stephens. “I utilize the most current operative and non-operative treatment techniques in order to customize the best plan of care." Dr. Stephens is now accepting new patients. He will treat patients at the OrthoNeuro Dublin, Downtown Columbus, Pickerington, and Westerville locations starting in November. He will have privileges at Mt. Carmel and OhioHealth hospitals. To schedule an appointment, please contact OrthoNeuro at 614-890-6555 or visit the OrthoNeuro website at OrthoNeuro OrthoNeuro is a multidisciplinary group of board-certified physicians specializing in orthopedic surgery, neurology, spine surgery, and physical medicine and rehabilitation. With offices in Downtown Columbus, Dublin, New Albany, Pickerington, and Westerville, OrthoNeuro is committed to providing patients throughout Greater Central Ohio with convenient access to an exceptional patient care experience. Columbus, OH, November 28, 2016 --( PR.com )-- OrthoNeuro announced today that Dr. Scott Stephens joined their multi-specialty physician practice on November 28th, 2016.Dr. Scott Stephens is a board-certified orthopedic surgeon specializing in shoulder and elbow surgery, and sports medicine. He performs all aspects of shoulder surgery from minimally invasive arthroscopy to complex shoulder replacements. Areas of special interest include shoulder arthritis, rotator cuff, distal humerus fractures, and biceps tendon ruptures/ tendinitis.Dr. Stephens received his medical degree from University of Toledo School of Medicine and completed his orthopedic surgery residency at Mount Carmel Medical Center in Columbus, Ohio. Following residency, he completed dual fellowship sub-specialty training. His first fellowship was in Sports Medicine and Arthroscopy in Miami, Florida at Doctor’s Hospital where he assisted in the care and treatment of the 2013 NBA Champion Miami Heat. He then completed a Shoulder and Elbow Fellowship at the University of Texas at San Antonio under the guidance of world-renowned shoulder and elbow surgeons Drs. Rockwood, Morrey, and Wirth. While there, he learned the latest techniques in shoulder and elbow arthroscopy and reconstruction."I believe that the best patient care comes from taking the time to get to know patients in order to individualize treatment and allow patients to return to activities that they enjoy,” said Dr. Stephens. “I utilize the most current operative and non-operative treatment techniques in order to customize the best plan of care."Dr. Stephens is now accepting new patients. He will treat patients at the OrthoNeuro Dublin, Downtown Columbus, Pickerington, and Westerville locations starting in November. He will have privileges at Mt. Carmel and OhioHealth hospitals. To schedule an appointment, please contact OrthoNeuro at 614-890-6555 or visit the OrthoNeuro website at www.orthoneuro.com OrthoNeuroOrthoNeuro is a multidisciplinary group of board-certified physicians specializing in orthopedic surgery, neurology, spine surgery, and physical medicine and rehabilitation. With offices in Downtown Columbus, Dublin, New Albany, Pickerington, and Westerville, OrthoNeuro is committed to providing patients throughout Greater Central Ohio with convenient access to an exceptional patient care experience. Click here to view the list of recent Press Releases from OrthoNeuro


Fowler T.T.,Mount Carmel Medical Center
American journal of orthopedics (Belle Mead, N.J.) | Year: 2013

Dislocation of the scapula is a rare disorder. The nomenclature in the literature can be confusing as a result of nonspecific terms such as locked scapula and dislocated scapula when referring to both intra- and extra-thoracic dislocations. After a thorough review of the literature we further define and classify scapular dislocations to better understand prognosis and patient education. We report a case of a low-energy intrathoracic dislocation of the scapula due to anomalous anatomy. Similar to another reported case in the literature, we have been able to document recurrence of intrathoracic scapular dislocation only in association with persistent chest wall defects following rib resection.


Dimitris K.,Mount Carmel Medical Center | Taylor B.C.,Mount Carmel Medical Center | Steensen R.N.,Mount Carmel Medical Center
Journal of Arthroplasty | Year: 2010

Intraoperative disruption of the medial collateral ligament during total knee arthroplasty is an uncommon complication that can be avoided by retractor placement as well as by careful cutting of the femur and tibia. This study evaluated the excursion of a small and large oscillating saw blade and compared the data against the widths of both the medial and lateral femoral condyle cuts. We discovered that the large saw blade had a statistically significantly larger excursion than the medial and lateral condyle width in women, as well as the lateral condyle width in men. The small saw blade excursion did not exceed any condyle width. We conclude that the smaller saw blade should be considered when making these cuts because the excursion of the large saw blade may exceed the width of cut needed and endanger important structures such as collateral ligaments. © 2010.


Backes J.R.,Mount Carmel Medical Center
The journal of knee surgery | Year: 2013

The medial collateral ligament (MCL) is the primary restraint to valgus stress of the knee. Although the MCL has demonstrated an ability to reliably heal with conservative management, chronic medial instability has been well described following an isolated MCL injury or in combination with an anterior cruciate ligament (ACL) tear. When the MCL heals with persistent medial laxity surgical treatment may be necessary to prevent chronic medial instability and valgus overload of a reconstructed cruciate ligament. We present a simple technique for MCL recession that can be used for isolated MCL laxity as well as in chronic ACL/MCL knee injuries. This technique allows for secure fixation with bone-to-bone healing, avoids donor-site morbidity, maintains relative MCL isometry, and can be performed through a modest incision. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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