Search Our Scientific Publications & Authors

J Shoulder Elbow Surg 2021 Mar 3. Epub 2021 Mar 3.

Department of Orthropaedic Surgery, Hospital of Chung-Ang University of Medicine, Seoul, Republic of Korea. Electronic address:

Background: The flexor carpi ulnaris (FCU)-split approach and the over-the-top approach have been used frequently for the fixation of anteromedial facet (AMF) fractures of the coronoid process. Clinical studies have not compared functional recovery and complication rates associated with these approaches. This study aimed to compare the clinical effectiveness of the over-the-top and FCU-split approaches for the treatment of AMF fractures of the coronoid process. Read More

Front Cell Dev Biol 2021 11;9:629274. Epub 2021 Feb 11.

Department of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China.

Although heterotopic ossification (HO) has been reported to be a common complication of the posttraumatic healing process, the underlying mechanism remains unknown. Endothelial-mesenchymal transition (EndMT) is known to play a role in HO, and our recent study observed that neuroendocrine signals can promote HO by modulating EndMT. Melatonin, a neuroendocrine hormone secreted mainly by the pineal gland, has been documented to perform its function in the skeletal system. Read More

J Pediatr Orthop 2021 Mar;41(3):e266-e271

Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital.

Background: Open arthrolysis is used for treating elbow stiffness in adults. This study evaluated the midterm outcomes after open arthrolysis in children and adolescents with posttraumatic elbow stiffness.

Methods: Data of 31 children and adolescents with posttraumatic elbow stiffness following open arthrolysis with or without hinged external fixation from 2010 to 2014 were retrospectively analyzed. Read More

Orthop Surg 2020 Oct;12(5):1471-1477

Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China.

Objectives: To evaluate the incidence and risk factors of heterotopic ossification (HO) after arthroscopic elbow release.

Methods: The present study included 101 elbows, with arthroscopic release performed on 98 patients over the 5-year period from November 2011 to December 2015. Patients were divided into three groups: group 1, with elbow arthritis, including 46 elbows in 43 patients; group 2, with posttraumatic extrinsic elbow stiffness (without intraarticular adhesion), including 23 elbows in 23 patients; and group 3, with intrinsic contractures (with intraarticular adhesion), including 32 elbows in 32 patients. Read More

Knee Surg Sports Traumatol Arthrosc 2020 Oct 31. Epub 2020 Oct 31.

Department of Orthopaedic Surgery, Medical School, Democritus University of Thrace, University General Hospital of Alexandroupolis, 68100, Alexandroupolis, Greece.

Purpose: The purpose of this study was to systematically review case reports and case series about meniscal ossicle, to summarize existing evidence. Specifically, to identify the etiology, demographic characteristics, localization, clinical features, diagnostic procedures and treatment options of this rare entity. Although, case reports/ series are of low level of evidence, a systematic review of such studies can provide and help us to gain a better understanding and awareness of meniscal ossicle. Read More

Orthop Surg 2020 Oct 4;12(5):1464-1470. Epub 2020 Oct 4.

Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China.

Objectives: To evaluate the effectiveness of arthroscopic management of posttraumatic elbow stiffness due to soft tissue problems.

Methods: A retrospective review of 30 consecutive arthroscopic elbow releases for posttraumatic stiff elbow from November 2011 to December 2019 was conducted. Stiff elbows with bony problems, such as heterotopic ossification, intraarticular nonunion or malunion, and cartilage lesions were excluded from this study. Read More

J Bone Joint Surg Am 2020 Nov;102(21):1891-1899

Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland.

Background: Heterotopic ossification (HO) is characterized by the abnormal growth of ectopic bone in soft tissues, frequently occurring within the military population because of extensive orthopaedic combat trauma. MicroRNAs (miRNAs) are small noncoding RNAs that act as post-transcriptional regulators of gene expression. We hypothesized that a clinically relevant miRNA signature could be detected in patients following injury that progressed to form HO (HO+) or did not form HO (HO-). Read More

J Pediatr Orthop 2020 Oct;40(9):e839-e843

Department of Orthopaedic Surgery, Stanford University School of Medicine, Packard Children's Hospital at Stanford, Stanford, CA.

Background: A subfibular ossicle (SO), also known as an os subfibulare, is present in ∼1% of the general population. Two theories have been proposed to explain the origin of SOs: (1) as a failure of fusion of a secondary center of ossification; (2) as a posttraumatic sequela. This report offers prospective, longitudinal radiographic evidence for the formation of SOs as a posttraumatic sequela of type VII transepiphyseal fractures of the lateral malleolus in children. Read More

J Am Acad Orthop Surg 2021 Feb;29(4):e178-e187

From the Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY.

Purpose: The ability to predict contracture development after elbow fracture would benefit patients and physicians. This study aimed to identify factors associated with the development of posttraumatic elbow joint contracture.

Methods: A retrospective review of elbow fractures (AO/Orthopaedic Trauma Association [OTA] type 13 and 21) treated at one institution between 2011 and 2015 was performed. Read More

Case Rep Orthop 2019 23;2019:3526018. Epub 2019 Oct 23.

Hip and Pelvis Unit, Orthopedic Department, University Hospital of Santa Maria, Avenida Professor Egas Moniz, 1649-035 Lisbon, Portugal.

Introduction: Pipkin fractures are rare events and usually occur as a consequence for high-energy trauma. Surgery to obtain anatomical reduction and fixation is the mainstay treatment for the majority of these injuries; nonetheless, controversy exists regarding the best surgical approach.

Description Of The Case: We present the case of a 41-year-old male, which sustained a type II Pipkin fracture following a motorcycle accident. Read More

Oper Orthop Traumatol 2020 Jun 13;32(3):248-261. Epub 2019 Nov 13.

Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.

Objective: Optimal reconstruction of acetabular anatomy and primarily stable bridging even of large bone defects in hip revision surgery by intraoperative cementless application of highly modular components of the MRS-TITAN Comfort (MRS-C) system according to the augment-and-modular-cage principle.

Indications: Acetabular defect situations in hip revision surgery, hereditary/acquired acetabular deformities, severe secondary hip osteoarthritis.

Contraindications: Extended periacetabular defects of the dorsal pillar, pelvic discontinuities, persisting posttraumatic or periprosthetic infections, lack of intraoperative bony anchorage options. Read More

Arch Orthop Trauma Surg 2020 Mar 9;140(3):331-341. Epub 2019 Sep 9.

BG Trauma Center Tübingen, Eberhard Karls University of Tübingen, Schnarrenbergstr. 95, Tübingen, Germany.

Background: Total hip arthroplasty (THA) is a challenging option for the treatment of posttraumatic arthritis due to acetabular fractures.

Methods: The study aimed to determine the short- and mid-term clinical and radiographic results of THA following acetabular fracture. The fracture pattern, the extent of injury and the initial fracture treatment were considered to evaluate the influence of these factors on the clinical-radiographic outcome. Read More

Arch Orthop Trauma Surg 2019 Dec 5;139(12):1723-1729. Epub 2019 Aug 5.

Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Munster, Germany.

Introduction: Complex radial head fractures are difficult to treat. In cases where stable fixation cannot be achieved, radial head resection or primary arthroplasty are frequently performed. Ex situ reconstruction of comminuted fractures may also be an option. Read More

Arch Orthop Trauma Surg 2019 Nov 8;139(11):1587-1597. Epub 2019 Jul 8.

Department of Orthopedic Surgery, Korea University Guro Hospital, Seoul, South Korea.

Purpose: The purposes of the study were to introduce surgical technique of fragment-specific fixation technique using multiple 2.7-mm variable-angle locking compression plates (VA LCPs) in comminuted posterior wall acetabular fractures and reported its clinical results.

Patients And Methods: Among the 68 patients, 23 with comminuted posterior wall factures with ≥ 3 fragments in the CT scan and no column involvement with a minimum follow-up duration of 12 months were enrolled in this study. Read More

Clin Orthop Relat Res 2019 Oct;477(10):2319-2328

Z. Sun, H. Cui, J. Ruan, J. Li, W. Wang, C. Fan, Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, P. R. China W. Wang, C. Fan, Department of Orthopedics, Shanghai Sixth People's Hospital East Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai, P. R. China.

Background: The elbow is more susceptible to loss of motion after trauma than any other joint. Open arthrolysis often is performed for posttraumatic elbow stiffness if the stiffness does not improve with nonsurgical treatment, but the midterm results of this procedure and factors that may limit recovery have not been widely studied.

Questions/purposes: We reviewed patients who had undergone open arthrolysis with hinged external fixator for severe posttraumatic elbow stiffness (ROM ≤ 60°) with a minimum of 5 years followup to (1) analyze ROM gains; (2) assess functional improvement with the Mayo Elbow Performance Index (MEPI) and DASH, quality of life with the SF-36, pain with VAS, and ulnar nerve function with the Amadio rating scale and Dellon classification; and (3) identify complications and risk factors that might hinder mid-term elbow motion recovery after this procedure. Read More

Technol Health Care 2019 ;27(4):431-439

Department of Orthopedics and Trauma Surgery, St. Josef-Hospital Bochum, Katholisches Klinikum Bochum, Ruhr University Bochum, Bochum, Germany.

Background: Treatment of distal intra-articular humerus fractures is still a technical challenge. Until now, little is known about the regain of strength and elbow agility after surgical treatment of these fractures. Due to small collectives there is only limited data. Read More

Orthop Res Rev 2019 4;11:41-46. Epub 2019 Feb 4.

Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran,

Background: Fractures of the acetabulum are challenging and very difficult to treat, and even after fixation, they can lead to posttraumatic arthritis. Total hip arthroplasty (THA) has been the most common surgery performed for the complications of posttraumatic arthritis in this group of patients.

Aim: In this article, it is aimed to assess the functional results and complications of the conversion to THA for posttraumatic arthritis after acetabular fracture. Read More

J Neurosurg Spine 2018 12;30(3):362-366

The authors report on the first surgical treatment for traumatic interspinous ligament calcification, with significant radiographic and symptomatic improvements at long-term follow-up. Heterotopic ossification occurs following traumatic injury but does not typically affect the interspinous ligaments. While these ligaments can calcify with age, this is rarely seen in patients younger than 50 years of age. Read More

J Bone Joint Surg Am 2018 Dec;100(23):2066-2072

Department of Orthopedic Surgery, Gumi CHA University Hospital, Gumi, South Korea.

Background: Although simple posterolateral or posterior elbow dislocations are relatively common and usually stable after closed reduction, simple posteromedial dislocations are extremely rare and poorly characterized. We investigated the clinical characteristics, soft-tissue injury patterns, treatments, and outcomes of a series of posteromedial elbow dislocations without relevant osseous lesions.

Methods: We retrospectively reviewed 20 cases of simple posteromedial elbow dislocations without relevant osseous lesions that were treated at 7 fellowship training hospitals during a 10-year period. Read More

Rev Bras Ortop 2018 Nov-Dec;53(6):805-808. Epub 2018 Sep 19.

Faculdade de Medicina, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil.

Heterotopic ossification can be defined as the formation of bone in tissues that have no ossification properties, such as in muscles and connective tissue of a periarticular region, without invasion of the joint capsule. This pathology usually has a benign course, but it can cause a reduction in the range of joint movement and hamper the rehabilitation process. Its etiology is still unknown and it usually is originated from posttraumatic complications, affecting 10-20% of patients with traumatic brain injury. Read More

World Neurosurg 2018 Dec 24;120:59-62. Epub 2018 Aug 24.

Department of Neurosurgery, University of Milan Bicocca, School of Medicine, Monza, Italy.

Background: We present a case of almost complete bifrontal dural ossification after decompressive craniectomy for severe traumatic brain injury.

Case Description: A 6-year-old boy was brought to the emergency room after a severe traumatic brain injury (Glasgow Coma Scale/Score 7). Due to rapidly increasing intracranial pressure values (>20 mm Hg) refractory to conservative therapy and in the absence of focal lesions justifying the neurological status, a bicoronal decompressive craniectomy was performed. Read More

J Orthop Trauma 2018 Aug;32 Suppl 1:S18-S19

Division of Orthopedic Trauma Surgery, Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY.

Introduction: Posttraumatic heterotopic ossification (HO) of the hip frequently follows acetabular fracture and hip surgery and can become symptomatic, with significant pain and limited range of motion (ROM). Definitive treatment may require surgical excision, which can result in serious complications if not planned and executed appropriately.

Methods: Surgical excision of posttraumatic hip HO requires appropriate indications, preoperative planning, and intraoperative guidance using fluoroscopy to maximize excision of HO and minimize complications. Read More

Ann Maxillofac Surg 2018 Jan-Jun;8(1):158-161

Oral and Maxillofacial Surgeon, Medstar Day Surgery Centre, Dubai, UAE.

Temporomandibular joint ankylosis may be true or false. Most commonly, trauma and inflammatory conditions lead to this condition. Zygomatico-coronoid ankylosis is a rare extra-articular (false) form of ankylosis of the jaw. Read More

Unfallchirurg 2018 Sep;121(9):693-703

UniversitätsCentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Carl Gustav Carus, Fetscherstr. 74, 01307, Dresden, Deutschland.

Background: Injuries to the distal tibiofibular syndesmosis are frequent and continue to generate controversy due to an extensive range of diagnostic techniques and therapeutic options.

Objective: The aim of this review is to summarize the current knowledge on syndesmotic instability and to present some recommendations for the clinical practice for acute an chronic injuries.

Material And Methods: Analysis of the current literature concerning the anatomy, etiology, diagnostics and treatment of syndesmosis injuries. Read More

Chin J Traumatol 2018 Jun 26;21(3):176-181. Epub 2018 Apr 26.

Department of Orthopaedic Surgery, University of Alabama, Birmingham, AL, USA. Electronic address:

Purpose: Posttraumatic arthritis (PTA) may develop years after acetabular fracture, hindering joint function and causing significant chronic musculoskeletal pain. Given the delayed onset of PTA, few studies have assessed outcomes of delayed total hip arthroplasty (THA) in acetabular fracture patients. This study systematically reviewed the literature for outcomes of THA in patients with PTA and prior acetabular fracture. Read More

Eur J Orthop Surg Traumatol 2018 Aug 8;28(6):1225-1229. Epub 2018 Mar 8.

Hand and Upper Extremity Surgery Unit, Hospital Universitario HM Montepríncipe, Avenida Montepríncipe, 25, 28660, Boadilla del Monte, Madrid, Spain.

Proximal radioulnar synostosis is a rare but highly disabling posttraumatic complication in periarticular elbow injuries. Surgical treatment is an option for functionally limiting proximal radioulnar synostosis; however, the approach can endanger local neurovascular structures, especially if the synostosis affects the level of the bicipital tuberosity. We report two cases of proximal radioulnar synostosis with a preoperative prono-supination range of motion of 0° and 15° treated by a reverse Sauvé-Kapandji procedure resecting a 1-cm section of the radial shaft distal to the bicipital tuberosity and leaving the synostosis in place. Read More

Acta Ortop Mex 2017 Sep-Oct;31(5):233-238

HLA Clínica Vistahermosa, Alicante, España.

Background: Open «arthrolysis» has been the standard treatment for elbow stiffness, with good results. However, the associated complications of open arthrolysis and the advancements in arthroscopic surgery have allowed including the latter as an additional approach.

Material And Methods: Between January 2014 and March 2016, 6 patients with posttraumatic elbow stiffness underwent arthroscopic surgery by the same surgical team. Read More

J Hand Surg Am 2017 Dec 6;42(12):1039.e1-1039.e6. Epub 2017 Nov 6.

Department of Orthopaedics, Wake Forest School of Medicine, Winston-Salem, NC.

Radioulnar synostosis can cause substantial loss of function, and surgical treatment can be challenging. Recurrence of the contracture related to scar or reformation of the synostosis is problematic. Several techniques have been described for prevention of recurrence. Read More

J Bone Miner Res 2018 02 3;33(2):269-282. Epub 2018 Jan 3.

Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Heterotopic ossification (HO) is a clinical condition that often reduces mobility and diminishes quality of life for affected individuals. The most severe form of progressive HO occurs in those with fibrodysplasia ossificans progressiva (FOP; OMIM #135100), a genetic disorder caused by a recurrent heterozygous gain-of-function mutation (R206H) in the bone morphogenetic protein (BMP) type I receptor ACVR1/ALK2. In individuals with FOP, episodes of HO frequently follow injury. Read More

Bone 2018 04 26;109:259-266. Epub 2017 Aug 26.

Department of Medicine, Mayo Clinic School of Medicine, Mayo Clinic, Rochester, MN, United States. Electronic address:

Background: Episodic flare-ups of fibrodysplasia ossificans progressiva (FOP) are characterized clinically by severe, often posttraumatic, connective tissue swelling and intramuscular edema, followed histologically by an intense and highly angiogenic fibroproliferative reaction. This early inflammatory and angiogenic fibroproliferative response is accompanied by the presence of abundant mast cells far in excess of other reported myopathies.

Results: Using an injury-induced, constitutively-active transgenic mouse model of FOP we show that mast cell inhibition by cromolyn, but not aprepitant, results in a dramatic reduction of heterotopic ossification. Read More