Brian Carpenter

University of North Texas Health Science Center | UNTHSC · Department of Orthopaedic Surgery

Many researchers have studied and compared various forms of intraosseous fixation. No studies have examined the effects of shear through stiffness and failure strength of a fully threaded versus a partially threaded screw. Our hypothesis was that the fully threaded lag screw technique would provide greater shear strength and resistance. Thirty-six...

The present study introduces a knotless tension band construct and compares its biomechanical behavior with that of a traditional stainless steel tension band construct. Fourth-generation composite tibial Sawbones(®) were used in the present study. Fracture models were created to mimic Orthopaedic Trauma Association type 44-B2.2 ankle fractures. A...

The purpose of this retrospective study was to determine the outcome of bimalleolar equivalent ankle fractures in patients who were treated nonoperatively. The charts of 214 patients with isolated Weber B (supination-external rotation pattern) fibula fractures were reviewed. Fifty-one patients met the inclusion criteria and were administered the Am...

Impact on Residency Training after transition from a Level 2 to Level 1 Trauma Center

Controversy remains regarding the use of arthroplasty versus arthrodesis in the surgical treatment of late-stage hallux rigidus. The purpose of our retrospective study was to report the long-term follow-up results of the metatarsal head resurfacing implant used for hemiarthroplasty. The patient assessments were conducted using the American Orthopae...

“People would rather live in homes regardless of its grayness. There is no place like home.” (L. Frank Baum, The Wonderful Wizard of Oz) This article presents an explanation and introduction to use and benefits of Color Fusion MRI of the Foot and Ankle. There are conditions/abnormalities within the complex overlapping structure of the foot and ankl...

Background Deformity of the Hallux interphalangeal joint (HIPJ) is a common complication following neuropathic 1st MPJ arthrodesis. Although largely asymptomatic, there have been no such studies evaluating the incidence of deformity and degeneration following 1st MPJ arthrodesis, in the neuropathic patient population. The aim of this paper was to h...

The number of women in podiatric medicine and surgery has increased steadily over the past 4 decades; however, there appears to be a large and continued gender gap with respect to representation in academic medicine and other positions of power. National and state level organizational data were obtained from multiple podiatry professional societies...

The number of women in podiatric medicine and surgery has increased steadily over the past 4 decades; however, there appears to be a large and continued gender gap with respect to representation in academic medicine and other positions of power. National and state level organizational data were obtained from multiple podiatry professional societies...

Fractures in the foot and ankle region represent greater than 10% of all pediatric fractures. As in the adult population, fractures occur when the skeletal system is exposed to more force than it can withstand. There are differences in the skeletal structure of a child and an adult. This chapter addresses those fractures that are different and trea...

Hallux rigidus is a common condition treated daily by surgeons worldwide. During the past decade, the standard treatment algorithm has been questioned by both patients and surgeons seeking alternatives to arthrodesis, which was previously considered the gold standard for advanced disease. Patients are living longer, and many have a more active life...

An intramedullary bone fixation device is provided with an elongate body having a longitudinal axis and an actuator to deploy at least one gripper to engage an inner surface of the intramedullary space to anchor the fixation device to the bone . Methods of repairing a fracture of a bone are also disclosed . One such method comprises inserting a fix...

Adult acquired inferior calcaneal heel pain is a common pathology seen in a foot and ankle practice. A literature review and expert panel discussion of the most common findings and treatment options are presented. Various diagnostic and treatment modalities are available to the practitioner. It is prudent to combine appropriate history and physical...

An intramedullary bone fixation device is provided with an elongate body having a longitudinal axis and an actuator to deploy at least one gripper to engage an inner surface of the intramedullary space to anchor the fixation device to the bone . Methods of repairing a fracture of a bone are also disclosed . One such method comprises inserting a fix...

Increased patient exposure has been shown to improve residency training as determined by better patient outcomes. The transition of John Peter Smith Hospital from a level II to a level I trauma center in 2009 provided a unique opportunity to investigate the direct effects of increased patient exposure on residency training in a relatively controlle...

Talar fractures present a unique problem given the anatomy of the talus, including articulations and blood supply. This chapter covers the mechanism, presentation and treatment of talar head and neck, and process fractures. Complications, such as avascular necrosis, and their treatment options are also discussed.

Heel pain is a condition precipitated by numerous etiologies and likewise a host of treatments are at the disposal of the clinician. Their application is dependent on the elucidated etiology, most of which are amenable to these conservative modalities. In those select patients in whom nonsurgical management is unsuccessful, operative intercession i...

Although ankle arthrodesis is the reference standard for end-stage ankle arthritis, loss of mobility and adjacent joint arthritis are consequences that alternatives to arthrodesis attempt to avoid. The purpose of the present study was to report the clinical results of interpositional arthroplasty using acellular dermal matrix in 4 pa- tients (age 3...

The purpose of this study was to report the preliminary results of minimally invasive technique with open reduction and internal xation of 56 displaced intra-articular calcaneus fractures in 50 patients (43 male and 7 female) using a variety of plating systems. There were 32 right-sided calcaneal fractures and 24 left-sided. We also report on wound...

18 month follow up of 4 interpositional arthroplasty cases

The traditional stainless steel wire tension band (WTB) has been popularized for small avulsion fractures at the medial malleolus. Despite the tension band principle creating a stable construct, complications continue to arise utilizing the traditional stainless steel WTB with patients experiencing hardware irritation at the tension band site and s...

LONG-TERM FOLLOW UP OF METATARSAL HEAD RESURFACING IMPLANTS FOR HALLUX RIGIDUS

The traditional stainless steel wire tension band (WTB) has been popularized for small avulsion fractures at the medial malleolus. Despite the tension band principle creating a stable construct, complications continue to arise utilizing the traditional stainless steel WTB with patients experiencing hardware irritation at the tension band site and s...

A neurofibroma is a benign nerve sheath tumor usually involved with the peripheral nervous system. Neurofibromas are commonly associated with neurofibromatosis type 1, including being an inclusion criteria, but are not always associated with the disease. Neurofibromas are uncommon in the foot and ankle and account for less than 10% of all soft tiss...

The use of locking plates has become wide-spread in the United States since the utility in the femur and tibia has been demonstrated. Specifically, the use of these plates in the foot and ankle has also become pervasive. The locking plate technology has morphed into anatomic site–specific locking plates in the foot and ankle. As one would expect, t...

McGlamry's Comprehensive Textbook of Foot and Ankle Surgery, 4th edited by Joe Southerland, 01/2012: chapter Pantalar Arthrodesis: pages 855-862; Lippincott Williams & WIlkins., ISBN: 9780781765800

The treatment of advanced hallux rigidus remains controversial, with many authors discussing arthrodesis versus arthroplasty. The purpose of this study is to report mid-term outcomes after implantation of a motion-preserving metatarsal head-resurfacing prosthetic and to present our technical considerations and modifications to the published techniq...

Synovial osteochondromatosis has been widely described in the literature. In published journals, it is referred to as synovial chondromatosis, synovial chondrometaplasia and synovial osteochondromatosis. Most cases involve multiple osteocartilagenous bodies within a joint, however there are multiple cases published of this disease affecting extraar...

We present the results of a prospective study of supination external rotation ankle injuries with an isolated fibula fracture on plain radiographs. The purpose of this study was to see if a correlation exists between the preoperative evaluation and the intraoperative arthroscopic evaluation of the deltoid ligament complex in these injuries. Gravity...

The Foot and Ankle Online Journal 3 (1): 3 Degloving injuries with open fractures of the foot and ankle are challenging. We present an injury including soft tissue and bone that required multiple procedures for limb salvage. A multidisciplinary approach was necessary to provide our patient with soft tissue coverage and the best possible outcome. Th...

Unlabelled: The use of intra-articular injections of high molecular weight elastoviscous solutions of hyaluronan or hylans (cross-linked derivatives of hyaluronan) to treat arthritis is termed viscosupplementation. The function of viscosupplementation is to restore the rheologic properties of synovial fluid. Although anecdotal data exist, no long-...

Drs. Clements, Motley, Garrett, and Carpenter reply to Drs. Öztürk, Özkan, and Yalçin: To the Editor: We appreciate the interest and perspective from our in- ternational colleagues (J Foot Ankle Surg 47(4): 372) and will do our best to address their points of interest. First, it is true that a large number of patients were excluded from our study....

Repair of segmental bone defects is an enormous challenge for foot and ankle surgeons. This report describes the case of an unusual technique for managing segmental bone voids about the ankle, namely the use of a cylindrical titanium cage packed with bone graft, and an intramedullary nail. The technique was successful at bridging a large segmental...

The Foot & Ankle Journal 1 (4): 1 A 49 year-old patient, with a history of rheumatoid arthritis, presents with suspected septic arthritis of the ankle and subtalar joints. The patient was found to have osteomyelitis of both the talus and calcaneus. The patient was treated by debridement, antibiotic impregnated PMMA beads, and ultimately, a subtalar...

The Foot & Ankle Journal 1 (2): 1 A case describing the use of the Orthosphere® Zirconia Ceramic Implant (Wright Medical Technology, Arlington, TN)is presented. The tarso-metatarsal joints in the foot are common sites for degenerative arthritis and pain secondary to trauma and biomechanical abnormalities. Often, conservative treatment is unsuccessf...

To evaluate foot and ankle function in a series of patients undergoing fibula microvascular free tissue transfer. A nonrandomized, nonblinded analysis was performed using the ankle-hindfoot scale as well as radiographic analysis to determine donor site morbidity. Overall, foot ankle function was deemed to be good in this series of patients. Average...

Aneurysmal bone cysts are unique pathologic entities that cause pain and local osseous destruction. Many surgical treatment modalities have been described. This article reports on the case of a 16-year-old high school athlete with left heel pain due to an aneurysmal bone cyst in the calcaneus. Curettage of the bone cyst was performed, and the void...

Crescentic basilar osteotomies for metatarsus primus varus and hallux valgus allow for substantial correction of the first intermetatarsal angle and the hallux valgus angle. Crescentic osteotomies have two well-documented pitfalls: sagittal plane instability and difficulty in fixation. We describe the addition of a plantar shelf to crescentic basil...

The poor vascular supply of the fifth metatarsal and its contribution to delayed union and nonunion has been doc- umented (1). This has led to a variety of proposed methods for fixation of fractures involving the fifth metatarsal. In- tramedullary screw fixation may become difficult to achieve with cystic bone or with a fifth metatarsal base that i...

Chemical burns to the lower extremity can be disabling and of serious consequence if not managed properly. The severity and rapid onset of the burns caused by hydrofluoric acid after initial contact make this a highly dangerous substance. The potential severity of injury and the following complications make it a chemical of which all physicians sho...

Puncture wounds to the foot are a common occurrence. If treated properly, the majority will be resolved without major complications. Toxic shock syndrome and streptococcal toxic shock-like syndrome are devastating complications of some staphylococcal and streptococcal infections. This paper discusses the similarities and differences between the two...

Metatarsalgia is a nondescript term which is used to describe many different painful conditions of the forefoot. Furthermore, pain in the lesser metatarsals can present in many different but dis-tinguishable locations: dorsally, plantarly, at the metatarsophalangeal joint, or in the interspace.l Metatarsalgia was first described as pain under the m...

Traumatic dislocation of the first metatarsophalangeal joint is a rare clinical finding. Ability to reduce the dislocation by nonoperative measures depends largely on the type of dislocation and involvement of the sesamoid complex. A brief description of the incidence, anatomy, and pathomechanics of dorsal dislocation of the first metatarsophalange...

A 49 year-old patient, with a history of rheumatoid arthritis, presents with suspected septic arthritis of the ankle and subtalar joints. The patient was found to have osteomyelitis of both the talus and calcaneus. The patient was treated by debridement, antibiotic impregnated PMMA beads, and ultimately, a subtalar joint fusion. This case illustrat...