Sonographic Findings in Subcoracoid Impingement Syndrome: A Case Report and Literature Review.

Unlabelled: Subcoracoid impingement syndrome is a rare and underrecognized cause of anterior shoulder pain. Currently, subcoracoid impingement syndrome is understood to involve impingement of anatomic structures such as the subcoracoid bursa and subscapularis tendon within the coracohumeral space, and there are no reports of sonographic findings in subcoracoid impingement syndrome other than the impingement of thickened subscapularis bursa. Here we report a case of subcoracoid impingement syndrome, including a novel sonographic finding, arthroscopic findings, and a proposed pathophysiology.

Osteogenic gene expression correlates with development of heterotopic ossification in war wounds.

Background: Heterotopic ossification (HO) is a frequent complication of modern wartime extremity injuries. The biological mechanisms responsible for the development of HO in traumatic wounds remain elusive.

Question/purposes: The aims of our study were to (1) characterize the expression profile of osteogenesis-related gene transcripts in traumatic war wounds in which HO developed; and (2) determine whether expression at the mRNA level correlated with functional protein expression and HO formation.

Outcomes of manipulation under anesthesia versus surgical management of combat-related arthrofibrosis of the knee.

The purpose of this study was to compare the outcomes of manipulation under anesthesia (MUA) to arthrolysis for combat-related arthrofibrosis. Sixty-one knees in 56 patients who underwent treatment for arthrofibrosis secondary to lower extremity trauma were reviewed. Knee range of motion preoperatively, postoperatively, and at follow-up was analyzed.

Injury severity score underpredicts injury severity and resource utilization in combat-related amputations.

Objective: Assess effectiveness of Injury Severity Score (ISS) in predicting injury severity in combat-related amputations.

Design: Retrospective evaluation of prospectively collected data.

Setting: Military medical center.

Occult femoral neck fracture associated with vitamin D deficiency diagnosed by MRI: case report.

Hip fractures in the young are exceedingly rare and are usually seen in instances of high energy trauma or metabolically altered bone states. In this case report, we present an occult femoral neck fracture, diagnosed by magnetic resonance imaging, in an otherwise healthy, young, active duty male patient with an isolated vitamin D deficiency treated using cannulated percutaneous screws.

Inflammatory cytokine and chemokine expression is associated with heterotopic ossification in high-energy penetrating war injuries.

Objective: Heterotopic ossification (HO) develops frequently after modern high-energy penetrating war injuries. The purpose of this prospective study was to identify and characterize the unique cytokine and chemokine profile associated with the development of HO as it pertained to the systemic inflammatory response after penetrating combat-related trauma.

Methods: Patients with high-energy penetrating extremity wounds were prospectively enrolled.

Predisposing risk factors for non-contact ACL injuries in military subjects.

Purpose: The goal of this study was to document the incidence of anterior cruciate ligament (ACL) tears and possible risk factors for these injuries in a large population of young, athletic subjects.

Methods: The authors retrospectively reviewed the US Naval Academy's database of midshipmen admitted in 1999 and 2000 (n = 2,345) and prospectively followed until graduation 4 years later or disenrollment. Excluded were 658 who had a history of preadmission ACL injury or surgery, those without initial radiographs or documented baseline height and weight, or those who had documented contact ACL injuries.

Incidence of pulmonary embolus in combat casualties with extremity amputations and fractures.

Background: The objective of this retrospective study was to determine the incidence of pulmonary embolism (PE) in casualties of wartime extremity wounds and specifically in casualties with a trauma-associated amputation.

Methods: Records of all combat-wounded evacuated and admitted between March 1, 2003, and December 31, 2007, were retrospectively reviewed. Continuous and categorical variables were studied with the Student's t test, Fisher's exact test or χ² test; multivariate analysis was performed using a stepwise regression logistic model.

Monitoring the healing of combat wounds using Raman spectroscopic mapping.

Soldiers wounded in modern warfare present with extensive and complicated acute wounds, confounded by an overwhelming inflammatory response. The pathophysiology of acute wounds is unknown and timing of wound closure remains subjective. Collagen gene expression profiles are presented for 24 patients.

Case report: Fresh-stored osteochondral allograft for treatment of osteochondritis dissecans the femoral head.

Osteochondral defects of the femoral head are exceedingly rare, with limited treatment options. Restoration procedures for similar defects involving the knee and ankle have been well described. In this report, we present a young patient who had a symptomatic osteochondral defect of the femoral head develop secondary to trauma and underwent subsequent treatment using a fresh-stored osteochondral allograft via a trochanteric osteotomy.

Bioartificial dermal substitute: a preliminary report on its use for the management of complex combat-related soft tissue wounds.

Objective: To report our institutional experience with the use of a bioartificial dermal substitute (Integra) combined with subatmospheric pressure [vacuum-assisted closure (VAC)] dressings followed by delayed split-thickness skin grafting for management of complex combat-related soft tissue wounds secondary to blast injuries.

Design: Retrospective review of patients treated December 2004 through November 2005.

Setting: Military treatment facility.

Adjacent level load transfer following vertebral augmentation in the cadaveric spine.

Study Design: In vitro biomechanics.

Objective: To determine if osteoporotic vertebral compression fracture (VCF) augmentation increases adjacent level load transfer.

Summary Of Background Data: Osteoporotic VCF subsequent to augmentation may result from disease progression or increased adjacent level load transfer, or both.

The mechanics of polymethylmethacrylate augmentation.

Osteoporosis frequently leads to vertebral compression fractures. Percutaneous cement augmentation, one recent technique, may alter the biomechanics of the vertebral body and spinal segment. These alterations reportedly predispose the spinal segment to additional vertebral compression fractures.