Steven Koehler

Steven Koehler
Montefiore Medical Center · Department of Orthopaedics

Doctor of Medicine

About

92
Publications
6,440
Reads
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925
Citations
Citations since 2016
61 Research Items
630 Citations
2016201720182019202020212022020406080100120
2016201720182019202020212022020406080100120
2016201720182019202020212022020406080100120
2016201720182019202020212022020406080100120
Additional affiliations
July 2011 - June 2016
Mount Sinai Hospital
Position
  • Medical Doctor
August 2007 - May 2011
Icahn School of Medicine at Mount Sinai
Position
  • PhD Student
December 2006 - August 2007
Walter Reed National Military Medical Center
Position
  • Researcher

Publications

Publications (92)
Article
Full-text available
Using the hand questionnaire (HAND-Q) patient-reported outcome measure, the effects of upper extremity surgery on patients' perception of their sex life were explored. The hand is a uniquely sexual organ, and we hypothesized that self-reported measures of disease severity, quality of life, and emotional impact would correlate with sexual dissatisfa...
Article
Background The purpose of this study was to perform a biomechanical investigation on the effect of ulnar variance (UV) on the stability of the distal radioulnar joint (DRUJ) prior to and after DRUJ sectioning. Methods Ten cadaveric forearm specimens were included in the study and baseline UV was assessed radiographically. Radial motion relative to...
Article
Full-text available
Background Increased body mass may predispose children to a greater risk for radial head subluxation (RHS). Recent studies in the literature have reported a plateau in obesity prevalence among infants and toddlers. This study sought to examine recent epidemiological trends in RHS incidence from 2004 to 2018 using the National Electronic Injury Surv...
Article
Evaluating the impact of articles can be performed through bibliometric analysis or social media impact using the Altmetric Attention Score (AAS). The purpose of this study was to report on the social media impact of peripheral nerve studies; how article demographic factors, such as journal specialty (hand, orthopedics, plastic surgery), affect AAS...
Article
Background Previous studies have suggested that proximal row carpectomy (PRC) results in increased contact pressures and decreased contact areas in the radiocarpal joint. Such experiments, however, used older technologies that may be associated with considerable measurement errors. The purpose of this study was to determine whether there was a sign...
Article
Full-text available
As surgical management of carpal tunnel release (CTR) becomes ever more common, extensive research has emerged to optimize the contextualization of this procedure. In particular, CTR under the wide-awake, local-anesthesia, no-tourniquet (WALANT) technique has emerged as a cost-effective, safe, and straightforward option for the millions who undergo...
Article
Radial polydactyly is one of the most common congenital anomalies of the hand, with an incidence of 0.08 to 1.40 per 1,000 live births; it requires surgical treatment early in life. » Polydactyly occurs during weeks 5, 6, 7, and 8 of embryogenesis, principally due to misregulation of the sonic hedgehog protein within the developing limb bud. » The...
Article
PURPOSE: Elbow flexion is one of the most important functions to restore following brachial plexus damage. The authors sought to systematically review available evidence to summarize outcomes of free gracilis and non-free muscle transfers in restoring elbow flexion. METHODS: MEDLINE, EMBASE, and Cochrane were searched to identify articles reporti...
Article
Full-text available
Wide-awake local anesthesia no-tourniquet (WALANT) surgery is an attractive option for hand surgeons, particularly during resource-scarce periods, as it eliminates dependence on main operating rooms or hospital-based procedures. The limited prepping or draping used for WALANT field sterility is as effective, if not more effective, than standard ste...
Article
Background Surgical approaches to the proximal interphalangeal (PIP) joint often require disruption of soft tissue stabilizers. Additionally, PIP joint injuries frequently result in soft tissue disruption. This study evaluates the necessity of repairing soft tissue stabilizers by assessing their role in maintaining native joint congruity. Methods...
Article
Full-text available
PurposeThe purpose of this bibliometric study was to identify and analyze the most cited publications on acute distal biceps repair.Methods Using the Clarivate Analytics Web of Science database, we searched for the top 50 most cited publications on acute distal biceps repair and analyzed them based on various metrics.ResultsThe top 50 publications...
Article
Full-text available
PurposeBoth-bone forearm fractures in the adult population frequently and usually necessitate an operative reduction. The purpose of this study was to identify the 50 most cited publications regarding both-bone ORIF and evaluates their level of evidence to help guide the best treatment and management practices, as well as gauge the current level of...
Article
Full-text available
The perspective of the patient in measuring the outcome of their hand treatment is of key importance. We developed a hand-specific patient-reported outcome measure to provide a means to measure outcomes and experiences of care from the patient perspective, that is, HAND-Q. Methods: Data were collected from people with a broad range of hand condit...
Article
Full-text available
Purpose Citation analysis has been used to determine the impact of an article in a medical specialty. The purpose of this study was to identify the 50 most cited articles on olecranon fracture outcomes, indications, techniques, procedural descriptions, and complications and analyse their characteristics. Methods The Web of Science database was use...
Chapter
Trauma is a recent application of elbow arthroscopy. The complex anatomy of the elbow may necessitate extensive surgical approaches, potentially from multiple directions. Elbow arthroscopy can afford excellent exposure of the joint with minimal additional surgical trauma. When applied to elbow fractures, arthroscopy can improve the visualization of...
Article
Full-text available
Background:. Favorable rates of meaningful recovery (≥M3/S3) of processed nerve allografts (PNAs) for mixed and motor nerve injuries have been reported, but there are few reports of patients having complete PNA failure (M0/S0). The purpose of this study was to describe the outcomes, including rate of complete failures, in a case series of patients...
Article
Full-text available
Background: Collagen nerve wraps (CNWs) theoretically allow for improved nerve gliding and decreased perineural scarring, and create a secluded environment to allow for nerve myelination and axonal healing. The goal of this study was to investigate the effect of CNWs on nerve gliding as assessed by pull-out strength and nerve changes in a rabbit m...
Article
Purpose Differences in range of motion, pinch strength, biomechanical strength, or joint angulation have previously been investigated for various means of treatment of ulnar collateral ligament (UCL) tears. We sought to address a gap in the literature by comparing thumb metacarpophalangeal (MCP) joint angle measurements and biomechanical strength b...
Article
Background The purpose of this systematic review was to (1) define the cumulative humerus fracture rate after BT and (2) compare how often fracture rate was reported compared to other complications. Methods A systematic review was performed using the PRISMA guidelines. Results 39 studies reported complications and 30 reported no complications. Of...
Article
This study evaluates current guidelines for patients receiving local anesthesia, set forth by the Association of Perioperative Nurses (AORN), within the context of hand surgery. The study reviewed 217 patients and 265 operations performed under wide-awake local anesthesia no tourniquet (WALANT) technique in an outpatient procedure room with minor f...
Article
Full-text available
Vascularized bone grafting is widely used for reconstruction of osseous defects of the forearm. Fibular free flap (FFF) is one option, which relies on harvesting the peroneal artery. This procedure is subject to lower extremity anatomic variants; therefore, some recommend preoperative angiography. However, high quality evidence for this approach an...
Article
Disclaimer In an effort to expedite the publication of articles , AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with...
Article
Full-text available
PurposeThis study identifies the most impactful papers on scapholunate reconstruction and provides a quantitative assessment of the impact of these papers in order to inform future clinical practice, education, and research of this condition.Methods The Scopus database was used in May 2020 to identify the 50 most cited clinical articles pertaining...
Article
Background The scapholunate interosseous ligament (SLIL) couples the scaphoid and lunate, preventing motion and instability. Prior studies suggest that damage to the SLIL may significantly alter contact pressures of the radiocarpal joint. Questions/Purposes The purpose of this study was to investigate the contact pressure and contact area in the sc...
Article
Hand surgery is rapidly changing. The wide-awake approach, minimum dissection surgery and early protected movement have changed many things. This is an update of some of the important changes regarding early protected movement with K-wired finger fracture management, simplification of nerve decompression surgery, such as elbow median and ulnar nerv...
Article
Background: Currently, opioids are the standard of care for postoperative pain management. Avoiding unnecessary opioid exposure in patients is of current interest because of widespread abuse. Methods: This is a prospective cohort study in which wide-awake, local anesthesia, no-tourniquet (WALANT) technique was used for 94 hand/upper extremity su...
Article
Background Upper extremity (UE) microsurgical reconstruction relies upon proper wound healing for optimal outcomes. Cigarette smoking is associated with wound healing complications, yet conclusions vary regarding impact on microsurgical outcomes (replantation, revascularization, and free tissue transfer). We investigated how smoking impacted 30-day...
Article
Background The use of minor field sterility in hand/upper extremity cases has been shown to improve workflow efficiency while maintaining patient safety. As this finding has been limited to specific procedures, we investigated the safety of performing a wide array of hand/upper extremity procedures outside the main operating room using minimal fiel...
Article
Full-text available
The wide-awake local anesthesia with no tourniquet (WALANT) technique has become popularized for various hand/upper extremity procedures. Before surgery, patients receive local anesthetic, consisting of lidocaine with epinephrine, and remain awake for the entire procedure. The purpose of this review was to investigate the advantages, diverse applic...
Chapter
Edited and authored by leading international experts, Distal Radius Fractures: Evidence-Based Management provides a state-of-the-art overview of diagnosis and management based on today’s best practices. Each chapter focuses on one key issue, offering a challenging case and then questioning the reader in an engaging fashion to provide the best avail...
Article
Introduction; Kirschner wires (K-wires) have been shown to effectively stabilize fractures of the hand and wrist, but are associated with high infection rates, which may limit its use. Previous literature has attributed the risk of infection to many different aspects of a fixation technique. However, we introduce an approach to percutaneous K-wire...
Chapter
Radiographs are essential for evaluation and treatment of distal radius fractures. Complete radiographic assessment requires proper technique and all projections necessary to fully evaluate the injury. Interpretation of distal radius fracture radiographs requires more than simple identification of radial inclination, volar tilt, and radial length;...
Article
Introduction: Between 2008 and 2017, the American Pyrotechnics Association reported a 41% increase in revenue from firework sales, with 2017 showing $885 million US dollars in consumer sales. We sought to evaluate the epidemiology of firework-related upper extremity injuries during this 10-year period, hypothesizing that hand/upper extremity injur...
Article
Fasciotomy of the forearm is a well-described technique for the treatment of compartment syndrome in adults; however, it has not been discussed with sufficient details in the setting of neonatal compartment syndrome. When performing a fasciotomy, it is imperative to decompress all compartments within the forearm to limit the ischemic damage and pre...
Article
Introduction We evaluated the demographics, flap types, and 30-day complication, readmission, and reoperation rates for upper extremity free flap transfers within the National Surgical Quality Improvement Program (NSQIP) database. Materials and Methods Upper extremity free flap transfer patients in the NSQIP from 2008 to 2016 were identified. Compl...
Article
Background The gold-standard treatment for intra-articular distal humerus fractures (DHFs) is dual-plate/dual-column fixation, though optimal orientation is not yet established. With a superior method not yet identified, we propose a load-sharing construct, combining absolute stability (extramedullary plate fixation) for distal articular fragments...
Article
Introduction Despite growth in hand/upper extremity investigation, impactful studies have not been thoroughly identified. Previous studies have been limited in scope. This study sought to identify and characterize the most impactful orthopaedic papers in hand/upper extremity over the past 25 years. Materials and Methods The top 1,000 hand/upper ext...
Article
Introduction Distal radius fractures (DRFs) are increasingly managed surgically among fragility fractures due to prolonged life expectancy and surgical advancements. Yet, malnutrition can impact postoperative outcomes and complications. We sought to determine the impact of malnutrition on open reduction and internal fixation (ORIF) of DRFs during t...
Poster
Full-text available
Elbow flexion loss is a debilitating upper extremity injury requiring surgical intervention with either non-free muscle transfers or free muscle flaps. Mean strength outcomes likely indicate that free muscle flaps better restore elbow flexion than non-free muscle flaps. Non-free muscle transfers may result in improved DASH scores and ROM, although...
Poster
Full-text available
Patient-reported outcome measures (PROMs) are commonly used for the evaluation and monitoring of multiple diseases, hand and upper extremity pathologies in particular. An understanding of how patient education levels impact factors related to patient decision-making has not yet been effectively observed with established PROMs. Our institution is pa...
Article
Objectives Elbow flexion loss is a debilitating upper extremity injury. Surgical treatment options include nonfree muscle transfers (tendon transfers, nerve transfers, Steindler procedure, Oberlin transfers, and pedicled muscle transfers) or free muscle transfers. We sought to determine if free muscle transfers and nonfree muscle transfers have sim...
Article
Objectives Patients with diabetes mellitus (DM) in underserved communities are at greater risk for hand infections. We aimed to describe the features of hand infections presenting to an urban hospital via laboratories, microbiology, and antibiotic choice with respect to diabetic status. Materials and Methods Patients presenting with any hand infect...
Chapter
Total elbow arthroplasty with a semiconstrained, linked system has evolved as a reliable and predictable treatment for rheumatoid arthritis, posttraumatic arthritis, osteoarthritis, and comminuted, unreconstructable distal humerus fractures of the elbow. This chapter details the steps to successfully implant a semiconstrained, linked arthroplasty a...
Article
Background: In the setting of the rapid advancement of integumentary vascular knowledge, we hypothesized that the extrinsic blood supply to the major peripheral nerves of the upper extremity could be categorized into discrete neural "perforasomes". Methods: Total limb perfusion of the arterial system was performed with gelatin-red lead oxide in...
Article
Purpose: Current options for treating elbow instability include bony and/or ligamentous fixation with orthosis or cast immobilization, transarticular cross-pinning, temporary bridge plating, and hinged or rigid external fixation. Our purpose was to evaluate the recently developed internal joint stabilizer (IJS), which acts as an internal external...
Article
The purpose of this study was to determine if screw placement in the reduction and association of the scaphoid and the lunate (RASL) procedure affected the ability of the scapholunate joint to withstand force. After completely disrupting of the scapholunate ligament in 29 fresh-frozen cadaveric wrists, we placed the RASL screw either distal or prox...
Article
The fasciocutaneous lateral arm flap is a workhorse flap in upper extremity reconstruction. However, its adipofascial variant is not widely used. The technique can be used in various clinical scenarios. The adipofascial flap can be transposed to circumferentially wrap the radial nerve with a pliable, vascularized fat and fascial envelope, mimicking...
Article
Background: Diabetes is a risk factor for complications related to displaced ankle fractures. Limited literature exists comparing complication rates in nonoperative versus operative treatment of displaced ankle fractures in diabetics. No study has highlighted the natural history of nonoperative treatment of displaced ankle fractures in diabetics....
Article
The purpose of this study was to determine the functional, radiographic, and subjective outcome of the authors' technique of four-corner arthrodesis using the en bloc excised scaphoid as the principal donor bone graft coupled with Kirschner wire fixation. The study comprised 40 consecutive patients with progressive Stage II and III scapholunate adv...
Chapter
As a truly global sport, tennis is played by tens of millions worldwide, both for fun and competitively at all age levels. As a result, many young tennis players are playing at high levels and tennis-specific training often begins at an early age. Tennis is a stressful game to the shoulder. It requires multiple repetitions of large ranges of motion...
Article
Full-text available
Background: The purpose of this study was to evaluate 30-day postoperative complications of open reduction and internal fixation [ORIF] and total elbow arthroplasty [TEA] for the treatment of distal humerus fractures in elderly patients using a validated national database. Methods: Review of the National Surgical Quality Improvement Program (NSQ...
Article
Background: Poor positioning of patients can result in devastating permanent neurologic deficits. We describe a previously unreported cause of median nerve compression that we have termed the brachialis syndrome, associated with patient positioning that results in permanent median nerve damage. Methods: We identified this condition affecting 6 m...
Article
Background: Using a validated database, 30-day complications of primary and revision total elbow arthroplasty (TEA) were analyzed to identify risk factors of adverse events. Methods: Primary and revision TEAs from 2007 to 2013 were identified in the National Surgical Quality Improvement Program database. Bivariate and multivariate analyses of ri...
Article
The purpose of this study is to describe a modified technique for a minimally invasive approach to in situ ulnar nerve decompression and to provide long-term follow-up. Thirty-one patients were included. DASH and MHQ scores were measured. Mean postoperative DASH score was 10. Eighty percent of patients achieved a postoperative DASH score under 10....
Article
Trauma is a recent application of elbow arthroscopy. The complex anatomy of the elbow may necessitate extensive surgical approaches, potentially from multiple directions. Elbow arthroscopy can afford excellent exposure of the joint with minimal additional surgical trauma. When applied to elbow fractures, arthroscopy can improve the visualization of...
Article
Full-text available
Tourniquets are often used in total knee arthroplasty (TKA) to improve visualization of structures, shorten operative time, reduce intraoperative bleeding, and improve cementing technique. Despite these advantages, controversy remains regarding the safety of tourniquet use. Tourniquets have been associated with nerve palsies, vascular injury, and m...
Article
Full-text available
To evaluate the association between recombinant human bone morphogenetic protein-2 (rhBMP-2) and malignancy. The use of rhBMP-2 in spine surgery has been the topic of much debate as studies assessing the association between rhBMP-2 and malignancy have come to conflicting conclusions. A systematic review of the literature was performed using the Pub...
Article
Hypothesis: We hypothesize that a technique for all-arthroscopic fixation of capitellum osteochondritis dissecans (OCD) lesions using suture fixation and autogenous iliac crest bone grafting offers a successful alternative to open internal fixation techniques as shown by 2-year validated patient-reported outcomes. Methods: Our technique uses art...
Article
Full-text available
Malunions are a well-recognized complication of pediatric supracondylar humeral fractures. Results of corrective osteotomies vary, and complication rates have been reported to be as high as 40%. Considering the high rate of complications for malunion correction, we investigated the feasibility of arthroscopy. We present a technique for arthroscopic...
Article
Recent studies have noted an increased risk of low energy subtrochanteric and femoral shaft fractures termed "atypical femur fractures" (AFFs) associated with long-term bisphosphonate use. As such, many clinicians have begun recommending a "drug holiday" to reduce the risks associated with long-term bisphosphonate use. We present two cases of AFFs...
Article
This study evaluates the arthroscopic reduction association scapholunate technique and outcomes. A total of 18 patients with chronic scapholunate instability with mean follow-up of 36 months were reviewed. Postoperatively, the mean visual analogue score was 2.5 and the mean DASH score was 8. The grip strength was 27 kg on the operative side compare...
Article
Full-text available
Although typically reported in thumb and small fingers, collateral ligament ruptures of the metacarpophalangeal (MCP) joints have been described in all digits. Traditional open repair requires a dissection that violates the sagittal band and may result in increased scarring and decreased hand function. Arthroscopic repair of MCP collateral ligament...
Article
The coronoid process serves as an important constraint that provides ulnohumeral joint stability. We describe a novel approach to coronoid fractures that minimizes surgical dissection, without compromising fracture visualization. We present the case of a 65-year-old woman who sustained an anteromedial facet fracture of the coronoid process. The elb...