Jeffrey Marchessault - Academia.edu (original) (raw)
Papers by Jeffrey Marchessault
Journal of orthopaedic case reports, 2024
Journal of Orthopaedic Case Reports
Introduction: Mallet finger is a common hand injury in sports in which the terminal extensor tend... more Introduction: Mallet finger is a common hand injury in sports in which the terminal extensor tendon is disrupted. This case report describes the rare occurrence of joint autofusion following surgical fixation of an unstable mallet finger injury. Case Report: We present a case of a 13-year-old right-hand dominant boy who sustained a right long finger bony mallet injury while playing football. Treatment consisted of closed reduction, percutaneous pinning of the right long finger distal interphalangeal (DIP) joint. He went on to heal with residual DIP joint stiffness and only 20° of residual motion that were noted on the early follow-up. Seven years later, he presented with no motion at the right long finger DIP joint. X-rays of his right long finger showed a complete fusion of bone across the DIP joint. Conclusion: Autofusion as a complication of mallet finger surgery is an unprecedently rare finding, especially in the absence of any predisposing factors. This complication must be con...
Current Orthopaedic Practice, 2018
The Journal of Hand Surgery, 2011
Upper extremity amputations are common. Fortunately, most of these involve loss of only a finger ... more Upper extremity amputations are common. Fortunately, most of these involve loss of only a finger or portion thereof. Hand and upper limb surgeons are best suited to lead the team and help these patients following these injuries. Proximal amputations can be devastating for the patient, but recent prosthetic advances have helped many patients lead a better life and, often, return to activities they were involved in before their amputation. The purpose of this article is to review the current prostheses available for upper extremity amputees.
Hand (New York, N.Y.), 2017
Successful surgical management of thumb carpometacarpal (CMC) arthritis requires treatment of coe... more Successful surgical management of thumb carpometacarpal (CMC) arthritis requires treatment of coexisting metacarpophalangeal (MCP) hyperextension deformity when present. The surgeon's decision to offer thumb CMC arthritis patients the option of no additional treatment, MCP capsulodesis, or MCP arthrodesis relies on the severity of the MCP deformity measured in clinic. The authors present a novel patient-performed radiographic stress view to measure MCP hyperextension. Fifty-seven thumbs in 30 consecutive patients offered thumb CMC arthroplasty were enrolled. Clinic goniometer measurements, patient-performed stress view radiographs, and intraoperative manual stress views of each MCP joint were documented for study. Paired samples t test was used to compare the differences between the preoperative measurements and intraoperative measurements of the right and left thumb groups. The clinic goniometer measurements were significantly different ( P = .0001) than the MCP stress view obt...
The Journal of the American Board of Family Practice
Although rotator cuff tears are well documented in the literature, there have been relatively few... more Although rotator cuff tears are well documented in the literature, there have been relatively few reported cases of isolated subscapularis tears. To our knowledge, no case has been reported that describes an isolated subscapularis tear in a woman without anterior shoulder dislocation or bony avulsion. This report outlines the case of a healthy 46-year-old woman with no history of shoulder problems who sustained injury to her right shoulder while hanging a light fixture. We highlight several key points to early diagnosis and underscore operative management for a successful outcome. Isolated subscapularis tendon ruptures are uncommon in women. Increased vigilance during the history and physical examination is necessary to detect these injuries. Subscapularis tendon ruptures are commonly mistaken for degenerative rotator cuff tears or subacromial impingement syndrome. The lift-off test can isolate a subscapularis injury. Pertinent radiographic and magnetic resonance imaging findings ar...
Supplemental material, Revision_Supplemental_Table_S1 for Dorsal Capsule Interpositional Arthropl... more Supplemental material, Revision_Supplemental_Table_S1 for Dorsal Capsule Interpositional Arthroplasty of the Metacarpophalangeal Joint by Kent L. Walker, Alexandra N. Johnson and Jeffrey A. Marchessault in HAND
BACKGROUND Although rotator cuff tears are well documented in the literature, there have been rel... more BACKGROUND Although rotator cuff tears are well documented in the literature, there have been relatively few reported cases of isolated subscapularis tears. To our knowledge, no case has been reported that describes an isolated subscapularis tear in a woman without anterior shoulder dislocation or bony avulsion. METHODS This report outlines the case of a healthy 46-year-old woman with no history of shoulder problems who sustained injury to her right shoulder while hanging a light fixture. We highlight several key points to early diagnosis and underscore operative management for a successful outcome. RESULTS AND CONCLUSIONS Isolated subscapularis tendon ruptures are uncommon in women. Increased vigilance during the history and physical examination is necessary to detect these injuries. Subscapularis tendon ruptures are commonly mistaken for degenerative rotator cuff tears or subacromial impingement syndrome. The lift-off test can isolate a subscapularis injury. Pertinent radiographic...
HAND
Background: Current recommendations for osteoarthritis of the metacarpophalangeal joint (MCPJ) ar... more Background: Current recommendations for osteoarthritis of the metacarpophalangeal joint (MCPJ) are confined to implant arthroplasty to preserve joint motion and provide pain relief. This study documents the median 2-year results of a novel soft tissue arthroplasty technique that interposes the dorsal capsule. Methods: A retrospective review of 10 MCPJ dorsal capsule interposition arthroplasties in 8 patients was conducted. Physical evaluation assessed MCPJ range of motion (ROM), grip strength, and pain. Outcome tests used were the Michigan Hand Outcome Score, Visual Analog Scale (VAS), and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH). Kellgren and Lawrence Classification assessed severity of MCPJ osteoarthritis on preoperative radiographs. Results: The mean follow-up was 29 months from surgery. Average VAS was 2/10 postoperatively and average postoperative ROM improved 7 degrees. Average postoperative grip strength of the surgical hand was 30 kg. The QuickDASH avera...
Aviation Space and Environmental Medicine
A U.S. Air Force F-15 pilot presented with a painless testicular mass. Nonseminomatous germ cell ... more A U.S. Air Force F-15 pilot presented with a painless testicular mass. Nonseminomatous germ cell tumor (NSGCT) of the testis was diagnosed at orchiectomy. Retroperitoneal lymph node dissection (RPLND) yielded pathology stage IIa disease when 2 of 21 abdominal lymph nodes were positive. The patient immediately underwent adjuvant chemotherapy consisting of etoposide and cisplatin. Follow-up tumor markers, abdominal and chest CT scans were negative. Randomized, prospective studies have shown excellent response rates to low volume metastatic disease. This pilot's risk of sudden incapacitation due to this tumor following orchiectomy, RPLND, and immediate adjuvant chemotherapy is below the 1% threshold set forth by the U.S. Air Force for unrestricted flying waiver. Chemotherapy for testicular cancer carries significant morbidity risks that may complicate a pilot's return to status and these are reviewed. The overall recovery from chemotherapy is poorly quantified and needs to be f...
Data Revues 07490712 V25i3 S0749071209000389, Aug 20, 2011
A wide range of hand and wrist injuries occur in today's ... more A wide range of hand and wrist injuries occur in today's recreational and elite athletes and account for 3% to 9% of all sports injuries. The onus is on the physician to discriminate between injuries that can be managed with an early return to sport, and those injuries that place the athlete at risk of further injury if they are not managed aggressively from the outset. The physician and the athlete must understand the balance between safe, early return to sport, and prompt surgical treatment that prevents late disability.
Orthopedics, 2006
This article illustrates the posteromedial elbow approach to address both coronoid and olecranon ... more This article illustrates the posteromedial elbow approach to address both coronoid and olecranon ulnar fractures. Olecranon and coronoid fractures were simulated in 6 cadaveric elbows. The osteotomies were made with a percutaneously placed osteotome through the olecranon fossa and the elbow joint. To expose these osteotomies, each elbow underwent a posterior midline skin incision, medial skin flap elevation, anterior transposition of the ulnar nerve, and subperiosteal elevation of the ulnar arm of the flexor carpi ulnaris. Fracture fixation was performed with posteriorly placed plates and screws. Each procedure was documented using radiographs and digital photography. The 6 procedures illustrated a surgical approach that is expedient in exposing the olecranon, medial elbow joint, and medial coronoid wall. All osteotomies were anatomically reduced and internally fixed in this setting. This technique allowed supine positioning of the cadaver and the use of an arm table for radiographi...
The Journal of the American Board of Family Practice / American Board of Family Practice
Although rotator cuff tears are well documented in the literature, there have been relatively few... more Although rotator cuff tears are well documented in the literature, there have been relatively few reported cases of isolated subscapularis tears. To our knowledge, no case has been reported that describes an isolated subscapularis tear in a woman without anterior shoulder dislocation or bony avulsion. This report outlines the case of a healthy 46-year-old woman with no history of shoulder problems who sustained injury to her right shoulder while hanging a light fixture. We highlight several key points to early diagnosis and underscore operative management for a successful outcome. Isolated subscapularis tendon ruptures are uncommon in women. Increased vigilance during the history and physical examination is necessary to detect these injuries. Subscapularis tendon ruptures are commonly mistaken for degenerative rotator cuff tears or subacromial impingement syndrome. The lift-off test can isolate a subscapularis injury. Pertinent radiographic and magnetic resonance imaging findings ar...
The Journal of Hand Surgery, 2011
Acquired upper extremity amputations beyond the finger can have substantial physical, psychologic... more Acquired upper extremity amputations beyond the finger can have substantial physical, psychological, social, and economic consequences for the patient. The hand surgeon is one of a team of specialists in the care of these patients, but the surgeon plays a critical role in the surgical management of these wounds. The execution of a successful amputation at each level of the limb allows maximum use of the residual extremity, with or without a prosthesis, and minimizes the known complications of these injuries. This article reviews current surgical options in performing and managing upper extremity amputations proximal to the
Hand Clinics, 2009
A wide range of hand and wrist injuries occur in today's ... more A wide range of hand and wrist injuries occur in today's recreational and elite athletes and account for 3% to 9% of all sports injuries. The onus is on the physician to discriminate between injuries that can be managed with an early return to sport, and those injuries that place the athlete at risk of further injury if they are not managed aggressively from the outset. The physician and the athlete must understand the balance between safe, early return to sport, and prompt surgical treatment that prevents late disability.
The Journal of Hand Surgery, 2011
Upper extremity amputations are common. Fortunately, most of these involve loss of only a finger ... more Upper extremity amputations are common. Fortunately, most of these involve loss of only a finger or portion thereof. Hand and upper limb surgeons are best suited to lead the team and help these patients following these injuries. Proximal amputations can be devastating for the patient, but recent prosthetic advances have helped many patients lead a better life and, often, return to activities they were involved in before their amputation. The purpose of this article is to review the current prostheses available for upper extremity amputees. (J Hand Surg
Journal of orthopaedic case reports, 2024
Journal of Orthopaedic Case Reports
Introduction: Mallet finger is a common hand injury in sports in which the terminal extensor tend... more Introduction: Mallet finger is a common hand injury in sports in which the terminal extensor tendon is disrupted. This case report describes the rare occurrence of joint autofusion following surgical fixation of an unstable mallet finger injury. Case Report: We present a case of a 13-year-old right-hand dominant boy who sustained a right long finger bony mallet injury while playing football. Treatment consisted of closed reduction, percutaneous pinning of the right long finger distal interphalangeal (DIP) joint. He went on to heal with residual DIP joint stiffness and only 20° of residual motion that were noted on the early follow-up. Seven years later, he presented with no motion at the right long finger DIP joint. X-rays of his right long finger showed a complete fusion of bone across the DIP joint. Conclusion: Autofusion as a complication of mallet finger surgery is an unprecedently rare finding, especially in the absence of any predisposing factors. This complication must be con...
Current Orthopaedic Practice, 2018
The Journal of Hand Surgery, 2011
Upper extremity amputations are common. Fortunately, most of these involve loss of only a finger ... more Upper extremity amputations are common. Fortunately, most of these involve loss of only a finger or portion thereof. Hand and upper limb surgeons are best suited to lead the team and help these patients following these injuries. Proximal amputations can be devastating for the patient, but recent prosthetic advances have helped many patients lead a better life and, often, return to activities they were involved in before their amputation. The purpose of this article is to review the current prostheses available for upper extremity amputees.
Hand (New York, N.Y.), 2017
Successful surgical management of thumb carpometacarpal (CMC) arthritis requires treatment of coe... more Successful surgical management of thumb carpometacarpal (CMC) arthritis requires treatment of coexisting metacarpophalangeal (MCP) hyperextension deformity when present. The surgeon's decision to offer thumb CMC arthritis patients the option of no additional treatment, MCP capsulodesis, or MCP arthrodesis relies on the severity of the MCP deformity measured in clinic. The authors present a novel patient-performed radiographic stress view to measure MCP hyperextension. Fifty-seven thumbs in 30 consecutive patients offered thumb CMC arthroplasty were enrolled. Clinic goniometer measurements, patient-performed stress view radiographs, and intraoperative manual stress views of each MCP joint were documented for study. Paired samples t test was used to compare the differences between the preoperative measurements and intraoperative measurements of the right and left thumb groups. The clinic goniometer measurements were significantly different ( P = .0001) than the MCP stress view obt...
The Journal of the American Board of Family Practice
Although rotator cuff tears are well documented in the literature, there have been relatively few... more Although rotator cuff tears are well documented in the literature, there have been relatively few reported cases of isolated subscapularis tears. To our knowledge, no case has been reported that describes an isolated subscapularis tear in a woman without anterior shoulder dislocation or bony avulsion. This report outlines the case of a healthy 46-year-old woman with no history of shoulder problems who sustained injury to her right shoulder while hanging a light fixture. We highlight several key points to early diagnosis and underscore operative management for a successful outcome. Isolated subscapularis tendon ruptures are uncommon in women. Increased vigilance during the history and physical examination is necessary to detect these injuries. Subscapularis tendon ruptures are commonly mistaken for degenerative rotator cuff tears or subacromial impingement syndrome. The lift-off test can isolate a subscapularis injury. Pertinent radiographic and magnetic resonance imaging findings ar...
Supplemental material, Revision_Supplemental_Table_S1 for Dorsal Capsule Interpositional Arthropl... more Supplemental material, Revision_Supplemental_Table_S1 for Dorsal Capsule Interpositional Arthroplasty of the Metacarpophalangeal Joint by Kent L. Walker, Alexandra N. Johnson and Jeffrey A. Marchessault in HAND
BACKGROUND Although rotator cuff tears are well documented in the literature, there have been rel... more BACKGROUND Although rotator cuff tears are well documented in the literature, there have been relatively few reported cases of isolated subscapularis tears. To our knowledge, no case has been reported that describes an isolated subscapularis tear in a woman without anterior shoulder dislocation or bony avulsion. METHODS This report outlines the case of a healthy 46-year-old woman with no history of shoulder problems who sustained injury to her right shoulder while hanging a light fixture. We highlight several key points to early diagnosis and underscore operative management for a successful outcome. RESULTS AND CONCLUSIONS Isolated subscapularis tendon ruptures are uncommon in women. Increased vigilance during the history and physical examination is necessary to detect these injuries. Subscapularis tendon ruptures are commonly mistaken for degenerative rotator cuff tears or subacromial impingement syndrome. The lift-off test can isolate a subscapularis injury. Pertinent radiographic...
HAND
Background: Current recommendations for osteoarthritis of the metacarpophalangeal joint (MCPJ) ar... more Background: Current recommendations for osteoarthritis of the metacarpophalangeal joint (MCPJ) are confined to implant arthroplasty to preserve joint motion and provide pain relief. This study documents the median 2-year results of a novel soft tissue arthroplasty technique that interposes the dorsal capsule. Methods: A retrospective review of 10 MCPJ dorsal capsule interposition arthroplasties in 8 patients was conducted. Physical evaluation assessed MCPJ range of motion (ROM), grip strength, and pain. Outcome tests used were the Michigan Hand Outcome Score, Visual Analog Scale (VAS), and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH). Kellgren and Lawrence Classification assessed severity of MCPJ osteoarthritis on preoperative radiographs. Results: The mean follow-up was 29 months from surgery. Average VAS was 2/10 postoperatively and average postoperative ROM improved 7 degrees. Average postoperative grip strength of the surgical hand was 30 kg. The QuickDASH avera...
Aviation Space and Environmental Medicine
A U.S. Air Force F-15 pilot presented with a painless testicular mass. Nonseminomatous germ cell ... more A U.S. Air Force F-15 pilot presented with a painless testicular mass. Nonseminomatous germ cell tumor (NSGCT) of the testis was diagnosed at orchiectomy. Retroperitoneal lymph node dissection (RPLND) yielded pathology stage IIa disease when 2 of 21 abdominal lymph nodes were positive. The patient immediately underwent adjuvant chemotherapy consisting of etoposide and cisplatin. Follow-up tumor markers, abdominal and chest CT scans were negative. Randomized, prospective studies have shown excellent response rates to low volume metastatic disease. This pilot's risk of sudden incapacitation due to this tumor following orchiectomy, RPLND, and immediate adjuvant chemotherapy is below the 1% threshold set forth by the U.S. Air Force for unrestricted flying waiver. Chemotherapy for testicular cancer carries significant morbidity risks that may complicate a pilot's return to status and these are reviewed. The overall recovery from chemotherapy is poorly quantified and needs to be f...
Data Revues 07490712 V25i3 S0749071209000389, Aug 20, 2011
A wide range of hand and wrist injuries occur in today's ... more A wide range of hand and wrist injuries occur in today's recreational and elite athletes and account for 3% to 9% of all sports injuries. The onus is on the physician to discriminate between injuries that can be managed with an early return to sport, and those injuries that place the athlete at risk of further injury if they are not managed aggressively from the outset. The physician and the athlete must understand the balance between safe, early return to sport, and prompt surgical treatment that prevents late disability.
Orthopedics, 2006
This article illustrates the posteromedial elbow approach to address both coronoid and olecranon ... more This article illustrates the posteromedial elbow approach to address both coronoid and olecranon ulnar fractures. Olecranon and coronoid fractures were simulated in 6 cadaveric elbows. The osteotomies were made with a percutaneously placed osteotome through the olecranon fossa and the elbow joint. To expose these osteotomies, each elbow underwent a posterior midline skin incision, medial skin flap elevation, anterior transposition of the ulnar nerve, and subperiosteal elevation of the ulnar arm of the flexor carpi ulnaris. Fracture fixation was performed with posteriorly placed plates and screws. Each procedure was documented using radiographs and digital photography. The 6 procedures illustrated a surgical approach that is expedient in exposing the olecranon, medial elbow joint, and medial coronoid wall. All osteotomies were anatomically reduced and internally fixed in this setting. This technique allowed supine positioning of the cadaver and the use of an arm table for radiographi...
The Journal of the American Board of Family Practice / American Board of Family Practice
Although rotator cuff tears are well documented in the literature, there have been relatively few... more Although rotator cuff tears are well documented in the literature, there have been relatively few reported cases of isolated subscapularis tears. To our knowledge, no case has been reported that describes an isolated subscapularis tear in a woman without anterior shoulder dislocation or bony avulsion. This report outlines the case of a healthy 46-year-old woman with no history of shoulder problems who sustained injury to her right shoulder while hanging a light fixture. We highlight several key points to early diagnosis and underscore operative management for a successful outcome. Isolated subscapularis tendon ruptures are uncommon in women. Increased vigilance during the history and physical examination is necessary to detect these injuries. Subscapularis tendon ruptures are commonly mistaken for degenerative rotator cuff tears or subacromial impingement syndrome. The lift-off test can isolate a subscapularis injury. Pertinent radiographic and magnetic resonance imaging findings ar...
The Journal of Hand Surgery, 2011
Acquired upper extremity amputations beyond the finger can have substantial physical, psychologic... more Acquired upper extremity amputations beyond the finger can have substantial physical, psychological, social, and economic consequences for the patient. The hand surgeon is one of a team of specialists in the care of these patients, but the surgeon plays a critical role in the surgical management of these wounds. The execution of a successful amputation at each level of the limb allows maximum use of the residual extremity, with or without a prosthesis, and minimizes the known complications of these injuries. This article reviews current surgical options in performing and managing upper extremity amputations proximal to the
Hand Clinics, 2009
A wide range of hand and wrist injuries occur in today's ... more A wide range of hand and wrist injuries occur in today's recreational and elite athletes and account for 3% to 9% of all sports injuries. The onus is on the physician to discriminate between injuries that can be managed with an early return to sport, and those injuries that place the athlete at risk of further injury if they are not managed aggressively from the outset. The physician and the athlete must understand the balance between safe, early return to sport, and prompt surgical treatment that prevents late disability.
The Journal of Hand Surgery, 2011
Upper extremity amputations are common. Fortunately, most of these involve loss of only a finger ... more Upper extremity amputations are common. Fortunately, most of these involve loss of only a finger or portion thereof. Hand and upper limb surgeons are best suited to lead the team and help these patients following these injuries. Proximal amputations can be devastating for the patient, but recent prosthetic advances have helped many patients lead a better life and, often, return to activities they were involved in before their amputation. The purpose of this article is to review the current prostheses available for upper extremity amputees. (J Hand Surg