Richard Uhl - Academia.edu (original) (raw)

Papers by Richard Uhl

PubMed, Jul 1, 1989

Low fractures of the femoral neck are often treated by reduction and internal fixation with a sli... more Low fractures of the femoral neck are often treated by reduction and internal fixation with a sliding screw and plate. In base of the neck fractures, a supplemental cannulated screw should be used to prevent rotation of the femoral head and neck during sliding screw insertion. It is critical that the large sliding screw and the smaller supplemental screw are inserted in parallel alignment, without impinging upon each other. This article describes an easily manufactured guide that facilitates parallel placement of the screws and assures adequate clearance between the two screws.

The Journal of Hand Surgery, Jul 1, 1995

Fractures of the carpus are often difficult to diagnose and treat because of complex bony archite... more Fractures of the carpus are often difficult to diagnose and treat because of complex bony architecture.' Significant carpal disruption may present with only minimally abnormal findings on hand x-ray films. The posteroanterior x-ray film of a normal carpus will show three arcs? Although the initial x-ray films of our patient were abnormal, and the disruption of the arcs clear, the true nature of the injury was not readily apparent. Although some authors have found conventional lateral tomography with 1-2 mm increments to be reliable, most recommend the use of multi-plane computed tomography reconstruction? -5 The injury in this case became apparent when using this technique.

Orthopedics, May 1, 2008

Bicondylar tibial plateau fractures usually include damage to the soft tissue, and efforts to fix... more Bicondylar tibial plateau fractures usually include damage to the soft tissue, and efforts to fix both the lateral and medial columns with plates can result in tissue loss and infection.

Journal of Pediatric Orthopaedics B, 2008

Injury Extra, Nov 1, 2008

Orthopaedic review, 1989

The ideal treatment of Achilles tendon ruptures has always been controversial. Nonoperative treat... more The ideal treatment of Achilles tendon ruptures has always been controversial. Nonoperative treatment has been criticized for its high rerupture rate and surgical treatment has been criticized for its high complication rate. This paper describes a surgical method of repair that can be used for acute or late ruptures, and has been associated with a low complication and rerupture rate.

Current Orthopaedic Practice, Jul 1, 2015

Background:Inadequate health literacy has been correlated with poorer health and worse outcomes i... more Background:Inadequate health literacy has been correlated with poorer health and worse outcomes in musculoskeletal health. It is therefore helpful to identify those with deficiencies to obtain better results. Through the use of a previously developed Literacy in Musculoskeletal Problems (LiMP) questionnaire, the prevalence of musculoskeletal literacy was compared between patients in an emergency department (ED) and an outpatient orthopaedic practice. Methods:In this cross-sectional study, 130 participants completed a demographic survey and the LiMP questionnaire. A t-test was used to compare the prevalence of inadequate literacy in the ED and outpatient settings. A x2 test determined the influence of demographic parameters. Results:The overall prevalence of inadequate musculoskeletal literacy was 45%. Outpatients were significantly more likely to possess adequate literacy as compared with ED subjects (P<0.05). In both groups, patients who had previously seen a physician for a musculoskeletal complaint were significantly more likely to have adequate musculoskeletal literacy (P<0.05). In the ED, Caucasians also were significantly more likely to have adequate musculoskeletal literacy (P<0.05) compared with other ethnicities. Conclusions:The prevalence of inadequate musculoskeletal literacy is concerning as is the discrepancy in literacy observed between ED and outpatient participants. Future interventions and educational campaigns must focus on the demographics most at-risk, such as those identified in this study.

Orthopedics, 2014

ENCHONDROMA

Direct real-time measurement of in vivo forces in the lumbar spine

Bulletin of the Hospital for Joint Diseases Orthopaedic Institute, 1990

A 25-year-old female with primary malignant fibrous histiocytoma of the distal fibula is presente... more A 25-year-old female with primary malignant fibrous histiocytoma of the distal fibula is presented. Malignant fibrous histiocytoma of bone is a rare primary bone tumor in this anatomic location. Careful preoperative staging studies and neoadjunct chemotherapy permitted an unusual resection to be performed resulting in successful limb salvage for the patient.

Orthopaedic review, 1992

A traumatic lateral dislocation with internal rotation of the patella can be unreducible using co... more A traumatic lateral dislocation with internal rotation of the patella can be unreducible using conventional maneuvers. These unusual dislocations may involve locking of the patella on the lateral femoral condyle. In these cases, reduction can be achieved by applying a downward force to the lateral aspect of the patella, which reduces the rotational deformity and unlocks the medial patellar facet.

JBJS Open Access, 2021

Abstract As a result of the COVID-19 pandemic, the use of telemedicine has rapidly accelerated. O... more Abstract As a result of the COVID-19 pandemic, the use of telemedicine has rapidly accelerated. Our orthopaedic department created a telemedicine educational program for residents using standardized patient scenarios. Training residents to use telemedicine will help them navigate through unforeseen issues that otherwise may have never been a consideration. This is not only useful for today's climate but also potentially for the duration of their careers.

Journal of the American Academy of Orthopaedic Surgeons, 2014

Diabetes mellitus is a disease of uncontrolled hyperglycemia. Despite a more sophisticated unders... more Diabetes mellitus is a disease of uncontrolled hyperglycemia. Despite a more sophisticated understanding of the pathophysiology of diabetes mellitus and despite pharmacologic advancements that enable better glycemic control, the prevalence of this disease and its devastating sequelae continue to rise. The adverse effects of diabetes on the nervous, vascular, and immune systems render the musculoskeletal system vulnerable to considerable damage. Foot involvement has traditionally been thought of as the most severe and frequently encountered orthopaedic consequence. However, the upper extremity, spine, and muscles are also commonly affected. Orthopaedic surgeons are more involved than ever in the care of patients with diabetes mellitus, and they play a vital role in the multidisciplinary approach used to treat these patients. As a result, surgeons must have a comprehensive understanding of the musculoskeletal manifestations and perioperative considerations of diabetes in order to most effectively care for patients with diabetes mellitus.

Operative Techniques in Orthopaedics, 1993

Current Therapy in Pain, 2009

Journal of the American Academy of Orthopaedic Surgeons, 2018

Wound management is a notable healthcare and financial burden, accounting for >$10 billion in ... more Wound management is a notable healthcare and financial burden, accounting for >$10 billion in annual healthcare spending in the United States. A multidisciplinary approach involving orthopaedic and plastic surgeons, wound care nursing, and medical and support staff is often necessary to improve outcomes. Orthopaedic surgeons must be familiar with the fundamental principles and evidenced-based concepts for the management of acute and chronic wounds. Knowledge of surgical dressings, negative pressure wound therapy, tissue expanders, dermal apposition, biologics, and extracellular matrices can aide practitioners in optimizing wound care.

Current Therapy in Pain, 2009

PubMed, Jul 1, 1989

Low fractures of the femoral neck are often treated by reduction and internal fixation with a sli... more Low fractures of the femoral neck are often treated by reduction and internal fixation with a sliding screw and plate. In base of the neck fractures, a supplemental cannulated screw should be used to prevent rotation of the femoral head and neck during sliding screw insertion. It is critical that the large sliding screw and the smaller supplemental screw are inserted in parallel alignment, without impinging upon each other. This article describes an easily manufactured guide that facilitates parallel placement of the screws and assures adequate clearance between the two screws.

The Journal of Hand Surgery, Jul 1, 1995

Fractures of the carpus are often difficult to diagnose and treat because of complex bony archite... more Fractures of the carpus are often difficult to diagnose and treat because of complex bony architecture.' Significant carpal disruption may present with only minimally abnormal findings on hand x-ray films. The posteroanterior x-ray film of a normal carpus will show three arcs? Although the initial x-ray films of our patient were abnormal, and the disruption of the arcs clear, the true nature of the injury was not readily apparent. Although some authors have found conventional lateral tomography with 1-2 mm increments to be reliable, most recommend the use of multi-plane computed tomography reconstruction? -5 The injury in this case became apparent when using this technique.

Orthopedics, May 1, 2008

Bicondylar tibial plateau fractures usually include damage to the soft tissue, and efforts to fix... more Bicondylar tibial plateau fractures usually include damage to the soft tissue, and efforts to fix both the lateral and medial columns with plates can result in tissue loss and infection.

Journal of Pediatric Orthopaedics B, 2008

Injury Extra, Nov 1, 2008

Orthopaedic review, 1989

The ideal treatment of Achilles tendon ruptures has always been controversial. Nonoperative treat... more The ideal treatment of Achilles tendon ruptures has always been controversial. Nonoperative treatment has been criticized for its high rerupture rate and surgical treatment has been criticized for its high complication rate. This paper describes a surgical method of repair that can be used for acute or late ruptures, and has been associated with a low complication and rerupture rate.

Current Orthopaedic Practice, Jul 1, 2015

Background:Inadequate health literacy has been correlated with poorer health and worse outcomes i... more Background:Inadequate health literacy has been correlated with poorer health and worse outcomes in musculoskeletal health. It is therefore helpful to identify those with deficiencies to obtain better results. Through the use of a previously developed Literacy in Musculoskeletal Problems (LiMP) questionnaire, the prevalence of musculoskeletal literacy was compared between patients in an emergency department (ED) and an outpatient orthopaedic practice. Methods:In this cross-sectional study, 130 participants completed a demographic survey and the LiMP questionnaire. A t-test was used to compare the prevalence of inadequate literacy in the ED and outpatient settings. A x2 test determined the influence of demographic parameters. Results:The overall prevalence of inadequate musculoskeletal literacy was 45%. Outpatients were significantly more likely to possess adequate literacy as compared with ED subjects (P<0.05). In both groups, patients who had previously seen a physician for a musculoskeletal complaint were significantly more likely to have adequate musculoskeletal literacy (P<0.05). In the ED, Caucasians also were significantly more likely to have adequate musculoskeletal literacy (P<0.05) compared with other ethnicities. Conclusions:The prevalence of inadequate musculoskeletal literacy is concerning as is the discrepancy in literacy observed between ED and outpatient participants. Future interventions and educational campaigns must focus on the demographics most at-risk, such as those identified in this study.

Orthopedics, 2014

ENCHONDROMA

Direct real-time measurement of in vivo forces in the lumbar spine

Bulletin of the Hospital for Joint Diseases Orthopaedic Institute, 1990

A 25-year-old female with primary malignant fibrous histiocytoma of the distal fibula is presente... more A 25-year-old female with primary malignant fibrous histiocytoma of the distal fibula is presented. Malignant fibrous histiocytoma of bone is a rare primary bone tumor in this anatomic location. Careful preoperative staging studies and neoadjunct chemotherapy permitted an unusual resection to be performed resulting in successful limb salvage for the patient.

Orthopaedic review, 1992

A traumatic lateral dislocation with internal rotation of the patella can be unreducible using co... more A traumatic lateral dislocation with internal rotation of the patella can be unreducible using conventional maneuvers. These unusual dislocations may involve locking of the patella on the lateral femoral condyle. In these cases, reduction can be achieved by applying a downward force to the lateral aspect of the patella, which reduces the rotational deformity and unlocks the medial patellar facet.

JBJS Open Access, 2021

Abstract As a result of the COVID-19 pandemic, the use of telemedicine has rapidly accelerated. O... more Abstract As a result of the COVID-19 pandemic, the use of telemedicine has rapidly accelerated. Our orthopaedic department created a telemedicine educational program for residents using standardized patient scenarios. Training residents to use telemedicine will help them navigate through unforeseen issues that otherwise may have never been a consideration. This is not only useful for today's climate but also potentially for the duration of their careers.

Journal of the American Academy of Orthopaedic Surgeons, 2014

Diabetes mellitus is a disease of uncontrolled hyperglycemia. Despite a more sophisticated unders... more Diabetes mellitus is a disease of uncontrolled hyperglycemia. Despite a more sophisticated understanding of the pathophysiology of diabetes mellitus and despite pharmacologic advancements that enable better glycemic control, the prevalence of this disease and its devastating sequelae continue to rise. The adverse effects of diabetes on the nervous, vascular, and immune systems render the musculoskeletal system vulnerable to considerable damage. Foot involvement has traditionally been thought of as the most severe and frequently encountered orthopaedic consequence. However, the upper extremity, spine, and muscles are also commonly affected. Orthopaedic surgeons are more involved than ever in the care of patients with diabetes mellitus, and they play a vital role in the multidisciplinary approach used to treat these patients. As a result, surgeons must have a comprehensive understanding of the musculoskeletal manifestations and perioperative considerations of diabetes in order to most effectively care for patients with diabetes mellitus.

Operative Techniques in Orthopaedics, 1993

Current Therapy in Pain, 2009

Journal of the American Academy of Orthopaedic Surgeons, 2018

Wound management is a notable healthcare and financial burden, accounting for >$10 billion in ... more Wound management is a notable healthcare and financial burden, accounting for >$10 billion in annual healthcare spending in the United States. A multidisciplinary approach involving orthopaedic and plastic surgeons, wound care nursing, and medical and support staff is often necessary to improve outcomes. Orthopaedic surgeons must be familiar with the fundamental principles and evidenced-based concepts for the management of acute and chronic wounds. Knowledge of surgical dressings, negative pressure wound therapy, tissue expanders, dermal apposition, biologics, and extracellular matrices can aide practitioners in optimizing wound care.

Current Therapy in Pain, 2009