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Lincoln A.E.,MedStar Research Institute | Caswell S.V.,George Mason University | Almquist J.L.,Fairfax County Public Schools | Dunn R.E.,MedStar Research Institute | And 2 more authors.
American Journal of Sports Medicine | Year: 2011

Background: Understanding the risk and trends of sports-related concussion among 12 scholastic sports may contribute to concussion detection, treatment, and prevention. Purpose: To examine the incidence and relative risk of concussion in 12 high school boys' and girls' sports between academic years 1997-1998 and 2007-2008. Study Design: Descriptive epidemiology study. Methods: Data were prospectively gathered for 25 schools in a large public high school system. All schools used an electronic medical record-keeping program. A certified athletic trainer was on-site for games and practices and electronically recorded all injuries daily. Results: In sum, 2651 concussions were observed in 10 926 892 athlete-exposures, with an incidence rate of 0.24 per 1000. Boys' sports accounted for 53% of athlete-exposures and 75% of all concussions. Football accounted for more than half of all concussions, and it had the highest incidence rate (0.60). Girls' soccer had the most concussions among the girls' sports and the second-highest incidence rate of all 12 sports (0.35). Concussion rate increased 4.2-fold (95% confidence interval, 3.4-5.2) over the 11 years (15.5% annual increase). In similar boys' and girls' sports (baseball/softball, basketball, and soccer), girls had roughly twice the concussion risk of boys. Concussion rate increased over time in all 12 sports. Conclusion: Although the collision sports of football and boys' lacrosse had the highest number of concussions and football the highest concussion rate, concussion occurred in all other sports and was observed in girls' sports at rates similar to or higher than those of boys' sports. The increase over time in all sports may reflect actual increased occurrence or greater coding sensitivity with widely disseminated guidance on concussion detection and treatment. The high-participation collision sports of football and boys' lacrosse warrant continued vigilance, but the findings suggest that focus on concussion detection, treatment, and prevention should not be limited to those sports traditionally associated with concussion risk. © 2011 The Author(s).


ALBANY, N.Y., Nov. 09, 2016 (GLOBE NEWSWIRE) -- AngioDynamics (NASDAQ:ANGO), a leading provider of innovative, minimally invasive medical devices for vascular access, surgery, peripheral vascular disease and oncology, today announced the appointment of Eileen Auen and Jan Stern Reed to the Company’s Board of Directors. Both Ms. Auen and Ms. Reed bring significant leadership, management and healthcare experience that will prove beneficial as the Company continues to execute on its strategic growth initiatives. “We are excited about the opportunity to work with Ms. Auen and Ms. Reed to build upon the positive momentum we have generated across our business. Both candidates bring exceptional experience and will contribute immediately to the strategic direction of AngioDynamics,” stated Jim Clemmer, Chief Executive Officer. “These additions to our Board underscore AngioDynamics’ commitment to bringing in top talent and building an outstanding team to lead our company towards the next stage of growth.” Ms. Auen most recently served as Executive Chairman of Helios, a $1 billion healthcare services firm formed by the merger of PMSI and Progressive Medical in 2013. Prior roles include Chairman and Chief Executive Officer of PMSI, Head of Healthcare Management at Aetna, and Chief Executive Officer of APS Healthcare. She currently provides consulting services to the healthcare industry through Deep Run Consulting, a firm she founded. Ms. Auen earned a bachelor's degree in Economics and Finance from Towson University, and an M.B.A. from the University of Virginia Darden School of Business. Ms. Auen currently serves as the Lead Director for ICF International (NASDAQ:ICFI). She also serves as a member of the Board of Directors for Medstar Union Memorial Hospital and Tufts Health Plan. Ms. Reed was most recently Senior Vice President, General Counsel and Corporate Secretary at Walgreens Boots Alliance, Inc., a global pharmacy-led, health and wellbeing enterprise with annual revenues in excess of $115 billion. Prior to this role, Ms. Reed also served as Executive Vice President of Human Resources, General Counsel and Corporate Secretary of Solo Cup Company, and Associate General Counsel, Corporate Secretary and Chief Governance Officer at Baxter International Inc. Ms. Reed earned a Bachelor of Arts degree, with honors, in Psychology from the University of Michigan, and a Juris Doctor from Northwestern University School of Law. Ms. Reed currently serves as a member of the Board of Directors for Stepan Company (NYSE:SCL). With the additions of Ms. Auen and Ms. Reed as independent directors, AngioDynamics’ Board of Directors will consist of 10 members, led by Chairman Howard Donnelly. AngioDynamics Inc. is a leading provider of innovative, minimally invasive medical devices used by professional healthcare providers for vascular access, surgery, peripheral vascular disease and oncology. AngioDynamics' diverse product lines include market-leading ablation systems, fluid management systems, vascular access products, angiographic products and accessories, drainage products, thrombolytic products and venous products. More information is available at AngioDynamics.com. AngioDynamics, the AngioDynamics logo are trademarks and/or registered trademarks of AngioDynamics Inc., an affiliate or a subsidiary.


Murthi A.M.,Union Memorial Hospital | Ramirez M.A.,Union Memorial Hospital
Journal of the American Academy of Orthopaedic Surgeons | Year: 2012

Approximately 20% of all shoulder dislocations occur in patients aged >60 years. Older patients who sustain a primary shoulder dislocation are much less likely than younger patients to suffer from recurrence. However, older patients are more likely than younger patients to sustain injuries to the rotator cuff, axillary nerve, or brachial plexus. Rotator cuff tears are significantly more common than nerve palsies, and rotator cuff tears can be mistaken for nerve palsies. Older patients with persistent shoulder pain and dysfunction after dislocation should be carefully evaluated for rotator cuff pathology. Although dislocation is a common injury in the older population, these concomitant injuries-especially of the rotator cuff-are often missed. Copyright © 2012 by the American Academy of Orthopaedic Surgeons.


Ohlson B.L.,Union Memorial Hospital
American journal of orthopedics (Belle Mead, N.J.) | Year: 2011

Augmented retrograde intramedullary (IM) nail fixation was compared with augmented periarticular locking- plate fixation for tibiotalocalcaneal arthrodesis. Specimens in 10 matched pairs were randomly assigned to a fixation construct and loaded cyclically in dorsiflexion. The groups did not differ in initial or final stiffness, load to failure, or construct deformation. No correlation was found between bone mineral density and construct deformation for either group. A humeral locking plate may be a viable alternative to an IM nail for tibiotalocalcaneal fixation in cases not amenable to IM nailing.


Anand P.,Union Memorial Hospital | Nunley J.A.,Duke University | DeOrio J.K.,Duke University
Foot and Ankle International | Year: 2013

Background: Triple arthrodesis through a 2-incision approach has been the primary salvage procedure for rigid hindfoot malalignment resulting from posterior tibialis dysfunction. However, complications like calcaneocuboid joint nonunion, lateral wound dehiscence, and adjacent joint arthritis have been reported after triple arthrodesis. Hence we adopted single-incision medial approach arthrodesis of subtalar and talonavicular joints, sparing the uninvolved calcaneocuboid joint and lateral skin. Method: We report the results of a series of 18 feet with posterior tibialis dysfunction that had correction of malalignment by this approach. Mean age at surgery was 65 years. The mean follow-up was 24 months. Results: There was statistically significant improvement in all the radiological parameters measured. There were no wound-related complications. The union rate was 89%. There were 2 malunions, and 2 feet developed valgus ankle deformity. The overall satisfaction rate among patients was 78%. Conclusion: We present a case series of treatment of posterior tibialis tendon dysfunction by arthrodesis of the subtalar and talonavicular joints through an isolated medial approach. The results were not encouraging enough to recommend adopting this approach as an alternative to triple arthrodesis. Level of Evidence: Level IV, retrospective case series. © The Author(s) 2013.


Iorio M.L.,Union Memorial Hospital | Masden D.L.,Union Memorial Hospital | Higgins J.P.,Union Memorial Hospital
Journal of Hand Surgery | Year: 2011

Purpose: The medial femoral condyle (MFC) vascularized corticoperiosteal flap has been well described for the treatment of nonunion with minimal bone loss. Recent applications of this donor site as a corticocancellous flap for large intercalary defects bring into question the vascular territory of bone supplied by the descending genicular artery (DGA). This study's purpose is to delineate the proximal extent of periosteal blood supply of the medial column of the femur provided by the DGA system. Methods: In 18 cadaveric specimens, the DGA was isolated, measured, and cannulated. Using subtraction techniques of fluoroscopic angiography, the vascular network and proximal-most extent of periosteal perfusion were recorded using radiopaque contrast dye. Results: The DGA branched from the superficial femoral artery 14.2 ± 2.4 cm proximal to the joint line of the knee. The length of the vascular pedicle to its attachment onto the periosteum was 7.7 ± 2.2 cm. All specimens demonstrated a filigree of periosteal vessels dominated by a transverse and a longitudinal branch at the level of the condyle. Proximal perfusion was consistently noted by a large, longitudinal medial metaphyseal periosteal artery. The medial metaphyseal periosteal artery demonstrated that the proximal-most perfusion of the DGA was 13.7 ± 1.3 cm proximal to the joint line. Average femur length was 47.1 ± 3.1 cm. The DGA provided perfusion of 29% ± 2% of the total length of the medial femur. Conclusions: The DGA provides a large and reliable region of periosteal perfusion, suggesting that corticocancellous MFC harvest might provide the benefits of vascularized bone for large, intercalary nonunion defects conventionally treated with fibula flaps. Clinical relevance: Harvest of MFC osseous flaps extending up to 13.7 cm proximal to the joint line can be perfused from the DGA pedicle. The MFC donor site might, therefore, be a reliable option for vascularized reconstruction of larger bone defects. © 2011 American Society for Surgery of the Hand. All rights reserved.


Parikh P.M.,Union Memorial Hospital
Plastic and Reconstructive Surgery | Year: 2010

Background: Little research to date has investigated musculoskeletal injury in the surgical workforce. This study estimates the prevalence and functional impact of work-related injury in plastic surgeons and other surgical specialists. Methods: A validated self-assessment of work-related injury was administered to surgeons at various professional conferences, over the telephone, and via email. Prevalence rates for each injury were tabulated, and a regression analysis was conducted to identify potential associations between demographic risk factors and self-reported injury. Results: Of 500 surveys administered, 339 (67.8 percent) were returned. Musculoskeletal symptoms were observed in 81.5 percent of surveyed surgeons. Of 17 injuries of interest, the most prevalent conditions were muscle strain, vision changes, cervical pain, lumbar pain, and shoulder arthritis/bursitis. Carpal tunnel syndrome and epicondylitis were reported by 15.1 and 13.5 percent of respondents, respectively, more than three times general population prevalence rates. Years in practice were associated with carpal tunnel syndrome. Microscope usage of 3 hours or more per week was associated with cervical and thoracic pain. Hand surgeons appeared to be more prone to thumb arthritis than other specialties. Conclusions: Self-reported injury is more prevalent in surgery than in previously described, labor-intensive populations. Sampled surgeons appear younger than the general surgery workforce, and as a result, this study may underestimate the prevalence of occupational injury, particularly carpal tunnel syndrome. This study underscores the need for a formal, multicenter assessment of occupational injury in surgeons. Copyright © 2010 by the American Society of Plastic Surgeons.


Higgins J.P.,Union Memorial Hospital
Journal of Hand Surgery | Year: 2011

Our understanding of the hemodynamic consequences of radial artery harvest to the upper extremity has changed our considerations when approaching soft tissue defects of the hand. A critical assessment of the donor site morbidity of radial forearm (and radial artery) harvest is necessary to discern the role this flap should have in our current and future reconstructive armamentarium. A review of the available data and discussion of its implications is provided. © 2011 American Society for Surgery of the Hand.


Thomas P.R.,Union Memorial Hospital
Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association | Year: 2010

We compared the Bristow procedure with a conjoined tendon transfer to investigate the role of the sling alone in restoring anterior translation in a simple soft-tissue instability model without bony defects. Ten matched cadaveric shoulder pairs were randomly assigned to receive a Bristow procedure or a conjoined tendon transfer alone. Specimens were tested in a simple soft-tissue model with low load simulating anterior translation of the glenohumeral joint. The conditions (intact, cut, and repaired) and treatments (Bristow and conjoined tendon transfer alone) were compared for anteroposterior translation. Anterior translation increased from 3.4 +/- 0.6 mm (mean +/- SEM) to 12.0 +/- 1.3 mm after the cut and decreased to 5.2 +/- 0.7 mm with the Bristow procedure. Anterior translation increased from 2.8 +/- 0.4 mm to 12.2 +/- 1.9 mm after the cut and decreased to 4.9 +/- 0.5 mm after conjoined tendon transfer alone. Although the repair increased the stability of the glenohumeral joint as reflected in significantly decreased anterior translation, anterior translation in the repaired joint was significantly greater than that in the intact condition for both procedures (P < .05). There were no significant differences in anterior translation between the 2 treatments at any test stage. There was no difference between the Bristow procedure and conjoined tendon transfer alone in restoring anteroposterior translation in a simple soft-tissue shoulder instability model with low load and no bony defect. Further investigation of the described conjoined tendon procedure should be done to evaluate the procedure with significant bony defects. 2010 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.


Higgins J.P.,Union Memorial Hospital
Journal of Hand Surgery | Year: 2011

Since its first clinical description by Marco Godina in 1986, the technique of temporary ectopic banking of amputated parts has been employed in a growing body of reported cases. This installment provides a review of the reported cases in the international literature to date, focusing on our evolving understanding of clinical indications, operative timing, and surgical technical consideration. Two illustrative cases are provided to highlight these concepts. © 2011 American Society for Surgery of the Hand.

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