Publications by authors named "Zachary Fulton"

Introduction: Scapula fractures are infrequently operated on due to the high union rate and well-preserved motion despite a large degree of angular deformity. Scapula fractures with intrathoracic interposition are rare and typically require open reduction due to an increased risk of pleural injury from the interposed segment. While there are several reports of intrathoracic interposition of scapular fractures requiring open reduction, only one case involved subsequent fragment fixation in an adult.

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Bilateral intertrochanteric (IT) femur fractures are rare, and appropriate evaluation and treatment can vary depending on concurrent patient comorbidities. Even less has been described for patients with bilateral IT fractures with pre-existing paraplegia. This case report describes the unique case of a 72-year-old paraplegic female who presented with bilateral IT femur fractures due to a wheelchair accident.

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Here, we present a novel emergency department reduction for a rare case of dissociative scaphoid and lunate dislocation with an ipsilateral elbow dislocation. Dissociative scaphoid and lunate dislocations have rarely been described in the literature. Most often, the reduction is performed on an urgent basis in the operating room because of the difficulty of closed reduction and associated complications, such as acute carpal tunnel syndrome.

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While amputation techniques have improved over time, questions remain around how to best treat neuromas and severed nerves in the amputee population, specifically for trauma-related amputees. This systematic review investigates and summarizes outcomes following targeted muscle reinnervation (TMR) for the trauma-related amputee population. Studies were classified based on primary or secondary TMR and relevant outcomes, including the ability to use a prosthesis, post-TMR opioid use, Patient-Reported Outcomes Measurement Information System (PROMIS) scores for phantom limb pain and residual limb pain, and overall pain resolution/reduction.

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Athletes commonly sustain high-energy direct impact injuries to the shoulder, with acromioclavicular joint (ACJ) injuries accounting for over half. Ipsilateral ACJ injury and diaphyseal clavicle fracture occur nearly 7% of the time. There is limited literature offering treatment suggestions for this unique injury pattern and limited evidence providing guidance to suggest which injury patterns should be treated operatively or nonoperatively.

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Background: For adults undergoing complex, multilevel spinal surgery, tranexamic acid (TXA) is an antifibrinolytic agent used to reduce blood loss. The optimal dosing of intravenous TXA remains unclear. This systematic review and meta-analysis compare various dosing regimens of intravenous TXA used in patients undergoing multilevel spine surgery (≥2 levels).

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Bilateral tibiofemoral knee dislocations are a relatively rare injury, and there is a scarcity of literature on its appropriate evaluation and treatment. Even less knee dislocations with concomitant popliteal artery injury have been described. Postoperative graft occlusion accounts for approximately half of the overall complication rate, occurring in up to 18% of the patients undergoing femoropopliteal bypass grafting.

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Case: We report a case of bilateral capitate osteonecrosis in a patient who has a history of acute lymphocytic leukemia treated with systemic steroids and other chemotherapeutic agents. After exhausting conservative treatment, the patient underwent surgical management with a right-sided 4-corner arthrodesis and left-sided vascular pedicle graft, providing pain relief and improved function.

Conclusion: In patients with a history of hematologic malignancy, clinicians should consider osteonecrosis of the capitate as a cause of wrist pain.

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Src family tyrosine kinases (SFKs) are critical players in normal and aberrant biological processes. While phosphorylation importantly regulates SFKs at two known tyrosines, large-scale phosphoproteomics have revealed four additional tyrosines commonly phosphorylated in SFKs. We found these novel tyrosines to be autophosphorylation sites.

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Background: Talipes equinovarus is the most common congenital lower limb abnormality. Decreased calf size has been found to have negative impacts on patients' subjective appraisals of long-term outcomes. This study compares calf circumference ratios in 2 groups of patients with unilateral clubfoot, those treated according to the Ponseti method and those treated with extensive surgery, to determine whether the current standard of care achieves better anatomic outcomes.

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