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Jeffrey F Sodl

Publications and source records attributed to Jeffrey F Sodl.

3 recordsLinked to original sources

Mastication causing segmental spinal motion in common cervical orthoses.

STUDY DESIGN: In vivo fluoroscopic quantification of segmental cervical spinal motion in asymptomatic volunteers during mastication. OBJECTIVE: To quantify the degree of segmental cervical spine motion in patients during mastication and while wearing several commonly used cervical orthoses. SUMMARY OF BACKGROUND DATA: Cervical orthoses are routinely used to stabilize the cervical spine after trauma or cervical fusion and are, in some cases, prescribed to be worn at all times, including during eating. METHODS: Seven volunteers with an average age of 31 years (range, 26-42 years) had 5 seconds of continuous lateral cervical fluoroscopic imaging while they chewed gum without any cervical orthosis (control) and while wearing a soft collar turned forward then backward, a Philadelphia collar, a Miami J collar, or a two-poster brace. Still images were created from the fluoroscopy video, which allowed for quantification of the amount of segmental motion. RESULTS: All cervical collars produced statistically greater motion at occiput-C1 and C1-C2 when compared with no collar. The motion was greatest at the occiput-C1 junction and decreased to the C4 level. No motion was detected in any subject in any brace below C4. The two-poster brace produced the most segmental motion at occiput-C1 (6.3 degrees +/- 2.0 degrees) compared with the soft collar turned backwards (1.9 degrees +/- 1.9 degrees). No subject had any segmental motion below C2 in the soft collar. No segmental spinal motion was observed without a cervical brace. CONCLUSIONS: To limit upper cervical spine segmental motion during mastication, for patients with unstable cervical spines, we propose a two-poster brace with removal of the mandibular component to allow for free mandibular action. For stable spines, we propose a soft collar turned backwards. Patients should be educated with this information.

Adult↗

Infrapatellar fat pad disruption: a radiographic sign of patellar tendon rupture.

UNLABELLED: After knee trauma, radiographs showing patella alta supercede other signs that suggest patellar tendon rupture. However, without patella alta the diagnosis may be missed. A standard lateral radiograph with the knee flexed showed the infrapatellar fat pad as a dark band with a smooth contour. Our pilot study identified a disruption of the fat pad contour as a radiographic sign of tendon rupture. Two blinded reviewers independently analyzed randomly selected lateral radiographs of the knees of 14 patients with knee injuries. Seven patients had confirmed ruptures diagnosed at surgery, and the other patients had different diagnoses. There were 12 men and two women with an average age of 49 years (range, 20-81 years). One observer detected five of the seven disrupted tendons and six of the seven intact tendons. The other observer detected six of the seven disrupted tendons and all seven intact tendons. Disruption in the contour of the infrapatellar fat pad on routine lateral view radiographs was a reasonably reliable sign of patellar tendon rupture. Diagnostic accuracy should increase when used with the patient's history, physical examination, and other radiographic signs. Absence of this sign should not supersede other suggestive signs of patella tendon rupture. LEVEL OF EVIDENCE: Diagnostic study, Level II (development of diagnostic criteria on consecutive patients--with universally applied reference "gold" standard). See the Guidelines for Authors for a complete description of levels of evidence.

Adipose Tissue↗

Development and use of a wrist fusion plate for children and adolescents.

Arthrodesis is a widely accepted treatment for several destructive disorders of the wrist joint. Previous literature has shown that compression plating is a reliable technique for achieving rigid fixation and fusion in adults. The goal of this study was to apply similar principles of adult wrist fusion to children, using a custom-designed fusion plate sized for children. Five children underwent wrist fusion using rigid fixation and dorsal plate application. Mean age at time of surgery was 16.4 years. The indication for surgery was paralysis (spinal cord injury) in three and spasticity (cerebral palsy and traumatic brain injury) in two. Surgery was performed through a dorsal approach and combined with carpectomy in the two patients with spasticity. Follow-up averaged 2.2 years and radiographs showed solid fusion and proper alignment of plate and screws. Improved stability and limb function were noted by patients and family. There were no instances of hardware failure, and plate removal has not been required.

Adolescent↗