Biomedical subjects

Norman S Turner

Publications and source records attributed to Norman S Turner.

6 recordsLinked to original sources

PubMed2007

Anatomic compartments of the foot: a 3-Tesla magnetic resonance imaging study.

There is neither consensus on the number nor agreement on the location of the anatomic compartments of the foot. This project utilized high-resolution magnetic resonance imaging (MRI) to identify foot compartments. The purpose of this study was to devise a new system using 3-Tesla (3T) MRI that assessed the number and location of these compartments. Six feet from healthy volunteers were imaged. From these, 10 compartments were described: (1) medial, (2) calcaneal, (3) lateral, (4) central superficial, (5) central deep (adductor), (6-9) interossei, and (10) skin. The 3T MRI and foot/ankle coil allowed us to assess the number and location of foot compartments.

Compartment Syndromes↗

PubMed2006

A quantitative composite scoring tool for orthopaedic residency screening and selection.

The ability to accurately screen and select orthopaedic resident applicants with eventual successful outcomes has been historically difficult. Many preresidency selection variables are subjective in nature and a more standardized objective scoring method seems desirable. A quantitative composite scoring tool (QCST) to be used in a standardized manner to help predict orthopaedic residency performance from application materials was developed. In 64 orthopaedic residents, four predictors (United States Medical Licensing Examination [USMLE] Part I scores, Alpha Omega Alpha status, junior year clinical clerkship honors grades, and the QCST score) were analyzed with respect to four residency outcomes assessments. The outcomes included three standardized assessments, the orthopaedic in-training examination scores (OITE), the American Board of Orthopaedic Surgery (ABOS) written and oral examinations, and an internal outcomes assessment, attainment of satisfactory chief resident associate (CRA) status. Collectively, the QCST score had the strongest association as a predictor for all three standardized outcomes assessments (p < 0.001). Honors grades during junior years clinical clerkships was most strongly associated with satisfactory CRA status (p < 0.001). A composite scoring tool that is an effective predictor of orthopaedic resident outcomes can be developed. Additional work is still required to refine this scoring tool for orthopaedic residency screening and selection.

Clinical Competence↗

PubMed2005

Enhanced survival using the distally based sural artery interpolation flap.

The reverse sural artery flap is frequently used for reconstruction of the distal third of the leg, ankle, and heel. The major disadvantage of the flap is compression of the pedicle within the subcutaneous tunnel and venous congestion. Others have cited a decrease in this problem by harvesting a midline cuff of gastrocnemius muscle, including more subcutaneous tissue and using a wider-than-usual pedicle. We describe an interpolation flap technique of simply avoiding a subcutaneous tunnel and exteriorizing the pedicle with no other alterations to flap design or elevation techniques. Seven distally based reverse sural artery flaps were performed on ambulatory patients between 2001 and 2002. Venous congestion did not occur in any of the flaps. All patients were ambulatory after surgery and did not require the use of a custom shoe. We conclude that transferring the flap in 2 stages without the use of a tunnel improves the reliability of the flap and eliminates venous congestion.

Adolescent↗

PubMed2004

Wound complications after open Achilles tendon repair: an analysis of risk factors.

Operative treatment of Achilles tendon ruptures has the risk of wound complications. The purpose of this study is to determine the risk ratio for specific risk factors associated with wound related complications in patients with operatively treated Achilles tendon ruptures. Between 1978 and 2001, 167 open Achilles tendon repairs were done at our institution. Clinical data were retrospectively reviewed. Tobacco use, diabetes, age, gender, timing of surgery, body mass index and steroid use were evaluated as potential risk factors for wound healing complications. One patient was lost to follow-up and two patients had nonsimultaneous ruptures and only the first repair was included; the remaining patients were followed up until complete wound healing. There were 17 wound complications in 164 patients (10.4%). Significant risk factors for development of wound complications included tobacco use (p < 0.0001), steroid use (p = 0.0005), and female sex (p = 0.0400). For those patients who had one or more of the following risk factors: diabetes, tobacco use, or steroid use; eight of 19 (42.1%) had a complication, compared with nine of 145 (6.2%) for those without risk factors present (p < 0.0001). Surgeons doing open Achilles tendon repairs should be cognizant of the specific risk factors identifled in this study, because they might impact decision making with regard to operative versus nonoperative treatment.

Achilles Tendon↗

PubMed2003

Open ankle fractures in patients with diabetes mellitus.

Complications after surgical treatment of closed ankle fractures in patients with diabetes previously have been well documented. The purpose of this study was to evaluate the union rate, infection rate, and soft tissue complication rate in open ankle fractures in patients with diabetes. Between January 1, 1981 and December 31, 2000, 14 open ankle fractures in 13 patients with diabetes were treated. The mean followup was 19 months (range, 6-84 months). All patients were followed up until union, amputation, or for at least 6 months. Nine of 14 extremities (64%) had wound healing complications. Ultimately, five patients (six extremities; 42%) had below the knee amputation. Only three of 14 fractures in three patients healed without complications. Open ankle fractures in patients with diabetes are limb-threatening injuries with high amputation and infection rates despite contemporary techniques of open reduction and internal fixation, intravenous antibiotics, and emergent irrigation and debridement.

Adult↗

PubMed2003

Locked fracture dislocation of the calcaneus treated with minimal open reduction and percutaneous fixation: a report of two cases and review of the literature.

Fractures of the calcaneus with associated locked dislocation of the posterior facet have been previously described. Two patients with a calcaneal fracture with a locked dislocation of a portion of the posterior facet were treated with minimally invasive open reduction and percutaneous screw fixation of the fragment with cannulated screws. Both patients had satisfactory reductions and healed the fractures without any soft-tissue complications. This technique can be a useful addition to the armamentarium of the surgeon treating these injuries, especially in the patient at high risk for wound complications.

Adult↗