David Romano

University of Texas at El Paso, El Paso, Texas, United States

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Publications (4)4.57 Total impact

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    ABSTRACT: First described in 1734, the extensor digitorum brevis manus (EDBM) is an anomalous extensor muscle found in the dorsum of the wrist and hand. Extensor muscle variants of the hand are not uncommon, and EDBM has an estimated reported incidence of approximately 2%. Although few extensor muscle variants become clinically significant, there is a paucity of literature discussing these anatomic variants, with most reports arising from cadaveric studies or isolated case series. Similarly, there are few established indications for surgical treatment of EDBM. In this case report, we describe the successful treatment of a young patient with persistently symptomatic anomalous extensor tendon with surgical excision and propose an algorithm for management after failure of conservative measures. © Association of Military Surgeons of the U.S. All rights reserved.
    Military medicine 10/2015; 180(10):e1115-e1117. DOI:10.7205/MILMED-D-14-00697 · 0.77 Impact Factor
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    ABSTRACT: Literature evaluating surgical outcomes after ankle fixation in an active patient population is limited. This study determined occupational outcomes and return to running following ankle fracture fixation in a military cohort. All service members undergoing ankle fracture fixation at a single military hospital from August 2007 to August 2012 were reviewed. Univariate analysis determined the association between patient demographic information, type of fracture fixation, and the development of posttraumatic ankle arthritis and functional outcomes, including medical separation, return to running, and reoperation. Seventy-two primary ankle fracture fixation procedures were performed on patients with mean age of 29.1 years. The majority of patients were male (88%), were 25 years of age or older (61%), were of junior rank (57%), underwent unimalleolar fracture fixation (78%), and did not require syndesmotic fixation (54%). The average follow-up was 35.9 months. The mean time to radiographic union was 8.6 weeks. Twelve service members (17%) were medically separated from the military due to refractory pain following ankle fracture fixation with a minimum of 2-year occupational follow-up. Among military service members undergoing ankle fracture fixation, 64% returned to running. Service members with higher occupational demands had a statistical trend to return to running (odds ratio [OR] 2.49; 95% CI, 0.93-6.68). Junior enlisted rank was a risk factor for medical separation (OR 11.00; 95% CI, 1.34-90.57). Radiographic evidence of posttraumatic ankle osteoarthritis occurred in 8 (11%) service members. At mean 3-year follow-up, 83% of service members undergoing ankle fracture fixation remained on active duty or successfully completed their military service, while nearly two-thirds returned to occupationally required daily running. Level IV, retrospective case series. © The Author(s) 2015.
    03/2015; 36(7). DOI:10.1177/1071100715575497
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    ABSTRACT: Retrospective review of prospectively collected data. To describe the impact of patient demographics, injury-specific factors, and medical co-morbidities on outcomes after hip fracture using the National Sample Program (NSP) of the National Trauma Data Bank (NTDB). The 2008 NSP-NTDB was queried to identify patients sustaining hip fractures. Patient demographics, co-morbidities, injury-specific factors, and outcomes (including mortality and complications) were recorded and a national estimate model was developed. Unadjusted differences for risk factors were evaluated using t test/Wald Chi square analyses. Weighted logistic regression and sensitivity analyses were performed to control for all factors in the model. The weighted sample contained 44,419 incidents of hip fracture. The average age was 72.7. Sixty-two percent of the population was female and 80 % was white. The mortality rate was 4.5 % and 12.5 % sustained at least one complication. Seventeen percent of patients who sustained at least one complication died. Dialysis, presenting in shock, cardiac disease, male sex, and ISS were significant predictors of mortality, while dialysis, obesity, cardiac disease, diabetes, and a procedure delay of ≥2 days influenced complications. The major potential modifiable risk factor appears to be time to procedure, which had a significant impact on complications. This is the first study to postulate predictors of morbidity and mortality following hip fracture in a US national model. While many co-morbidities appear to be influential in predicting outcome, some of the more significant factors include the presence of shock, dialysis, obesity, and time to surgery. Prognostic study, Level II.
    Archives of Orthopaedic and Trauma Surgery 02/2014; 134(5). DOI:10.1007/s00402-014-1959-y · 1.60 Impact Factor
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    ABSTRACT: STUDY DESIGN:: Retrospective database review. OBJECTIVE:: To describe the incidence of, and risk factors for, lumbar spine fractures within the population of the US military. SUMMARYOF BACKGROUND DATA:: Fractures of the lumbar region are an important health concern; however, the epidemiology of this injury has not been extensively studied in the United States. METHODS:: International Classification of Diseases, Clinical Modification, Ninth Revision codes for lumbar spine fractures were used in a search of the Defense Medical Epidemiology Database, identifying all individuals who sustained such injuries between 2001 and 2010. The database was also used to obtain the complete number of individuals serving in the Armed Forces over the same time period. Information regarding race, rank, branch of service, sex, and age was obtained for all individuals identified as having lumbar spine fractures as well as for the whole military population. The incidence of lumbar spine fractures was determined for the cohort. Unadjusted incidence rates were derived for risk factors and multivariate Poisson regression analysis, controlling for all other risks, was used to obtain adjusted incidence rate ratios and identify statistically significant risks for lumbar fractures. RESULTS:: Between 2001 and 2010, the overall incidence of lumbar fractures was 0.38 per 1000 person-years. Male sex, white race, enlisted ranks, service in the Army and Marines, and age were found to be significant predictors of lumbar spine fracture. Service in the Army demonstrated the highest rate of lumbar fractures (0.48 per 1000 person-years). CONCLUSIONS:: This investigation is the first to document the incidence and postulate risk factors for lumbar spine fracture in an American population. In this study, males, whites, enlisted personnel, those serving in the Army and Marines, and individuals aged 20-24 or greater than 40 were found to be at an increased risk of lumbar fracture.
    Journal of spinal disorders & techniques 11/2011; 26(4). DOI:10.1097/BSD.0b013e31823f3237 · 2.20 Impact Factor

Publication Stats

12 Citations
4.57 Total Impact Points


  • 2015
    • University of Texas at El Paso
      El Paso, Texas, United States
    • William Beaumont Army Medical Center
      El Paso, Texas, United States