Publications by authors named "Kristin McPhillips"

4 Publications

  • Page 1 of 1

Effectiveness of Pneumococcal Vaccines.

Am Fam Physician 2018 05;97(9):Online

Memorial Health Family Medicine Residency, Savannah, GA, USA.

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May 2018

Locking Compression Pilon Plate for Fixation of Comminuted Posterior Wall Acetabular Fractures: A Novel Technique.

J Orthop Trauma 2017 Jan;31(1):e32-e36

*Orthopaedic Institute, Geisinger Medical Center, Danville, PA; and †Memorial University Medical Center, Savannah, GA.

Posterior wall acetabular fractures involving a large portion the wall's width and with extensive comminution are difficult fractures to manage operatively. Cortical substitution with a pelvic reconstruction plate and supplemental spring plates has been the traditional means of fixation for these fractures. This option, however, requires the use of multiple, unlinked plates and provides no reliable option for peripheral fixation in comminuted fragments. We describe a novel technique for operative fixation of large, comminuted posterior wall fractures using a single distal tibia pilon plate with the option for peripheral locking screw fixation and report on a series of 20 consecutive patients treated with this method.
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http://dx.doi.org/10.1097/BOT.0000000000000675DOI Listing
January 2017

Role of Sonication for Detection of Infection in Explanted Orthopaedic Trauma Implants.

J Orthop Trauma 2016 May;30(5):e175-80

Departments of *Orthopaedic Surgery, and †Infectious Disease, Geisinger Medical Center, Danville, PA; and ‡Center for Health Research, Geisinger Medical Center, Danville, PA.

Objectives: Sonication is a new technology that uses high-frequency sound waves to mechanically dislodge bacteria adherent in biofilms. Unlike arthroplasty, its role in orthopaedic trauma has not been described. The goal of this study was to explore the utility of sonication in orthopaedic trauma.

Design: Retrospective review.

Setting: Level I trauma center.

Patients: One hundred forty-six sonicated metallic orthopaedic devices from September 2010 to May 2013 were included. Patients were divided into 3 groups: clinically infected, elective implant removals, and nonunion.

Intervention: Sonication culture results were retrospectively reviewed for all patients undergoing implant removal.

Outcomes: Sonication results were the primary study outcome and were considered positive for culture growth if equal to or greater than 20 colony-forming units per plate.

Results: In 32 patients with clinical infection, tissue cultures were positive in 30 (94%) and negative in 2 (6%). In contrast, sonication cultures were positive in 19 patients (59%) and did not identify additional organisms. Of the 72 patients who underwent elective implant removal, 52 had pain. Sonication cultures were positive in 5 of these 52 patients (10%) and in 0 of 20 patients with no pain. Sonication culture results were negative in all 42 patients who underwent nonunion surgery.

Conclusions: Sonication of orthopaedic trauma implants in patients with clinically apparent infection or "aseptic" nonunion offered negligible additional information. Sonication demonstrated a positive microbiologic yield in a subset of patients with painful implants; further research is required to better establish the frequency of subclinical infection and to determine the diagnostic role of traditional cultures and sonication.

Level Of Evidence: Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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http://dx.doi.org/10.1097/BOT.0000000000000512DOI Listing
May 2016

Clinical indications of computed tomography (CT) of the head in patients with low-energy geriatric hip fractures.

Injury 2015 Nov 3;46(11):2185-9. Epub 2015 Jul 3.

Department of Orthopaedic Surgery, Geisinger Medical Center, 100 N. Academy Ave, Danville, PA 17822-2130, USA(1). Electronic address:

Objective: To define the role of head computed tomography (CT) scans in the geriatric population with isolated low-energy femur fractures and describe the pertinent clinical variables which are associated with positive CT findings with the objective to decrease the number of unnecessary CT scans performed.

Design: Retrospective review.

Setting: Level I trauma centre.

Patients: Eleven hundred ninety-two (1192) patients sustaining a femur fracture following a low-energy fall.

Main Outcome Measurement: Pertinent clinical variables that were associated with CTs that yielded positive findings.

Results: Two hundred fifty patients (21%) underwent a head CT scan as part of their evaluation. Of these patients, 83% suffered proximal femur fractures, 11% shaft fractures and 6% distal fractures. The majority of the patients were evaluated by the emergency department (ED) with only 18% (44/250) being evaluated by the trauma team. Average patient age was 83 years (range 65-99 years). One hundred seventy-three patients (69%) were on some form of antiplatelet medication or anticoagulation. Of the 250 patients who underwent head CT scan, 16 (6%) patients had acute findings (haemorrhage - 15, infarct - 1), and none of the patients required neurosurgical intervention.

Conclusion: None of the patients with a traumatic injury required a neurosurgical invention after sustaining a low energy fall (0/1192). Head CT scans should have a limited role in the work-up of this patient population and should be reserved for patients with a history and physical findings that support head trauma.

Level Of Evidence: Prognostic level III. See instructions for authors for a complete description of levels of evidence.
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http://dx.doi.org/10.1016/j.injury.2015.06.036DOI Listing
November 2015