Jason A Lowe

Interests

No activities entered.

Courses

No activities entered.

Scholarly Contributions

Chapters

• Lowe, J. (2020). Biomechanics of Internal Fracture Fixation. In Synopsis of Orthopaedic Trauma Management(pp 24-32).
  More info

  1. Lowe JA, Dailey HL, Wild J. Biomechanics of Internal Fracture Fixation. In: Mullis B, Gaski G. Synopsis of Orthopaedic Trauma Management. New York, NY: Thieme Medical Publishers; 2020:24-32
• Lowe, J. (2020). Locked Plating: Essential Biomechanics for Orthopedic Trauma: A Case-Based Guide. In Essential Biomehanics for Orthopedic Trauma. Springer Nature.
  More info

  Lowe J; Locked Plating. Essential Biomechanics for Orthopedic Trauma: A Case-Based Guide. Brett D. Crist, Joseph Borrelli Jr., Edward J. Harvey (Eds.). Springer Nature (P), Switzerland AG, 2020.

Journals/Publications

• Lowe, J. (2023).

  The Major Extremity Trauma Research Consortium: Development and Impact of an Orthopaedic Trauma Research Program. 

  . J Am Acad Orthop Surg. doi:https://pubmed.ncbi.nlm.nih.gov/37671450/
• Lowe, J. (2023). “Evolution of AO Trauma North America “Basic Principles of Fracture Management” Education During the COVID-19 Pandemic. AO North America sponsored issue. The sponsored issue was distributed with the February 2023 issue of the Journal of Orthopaedic Trauma..
  More info

  Dear Dr. Lowe, This email is to confirm your article, “Evolution of AO Trauma North America “Basic Principles of Fracture Management” Education During the COVID-19 Pandemic,” was published as part of an AO North America sponsored issue. The sponsored issue was distributed with the February 2023 issue of the Journal of Orthopaedic Trauma. Thank you. Krista StormLBG Content Solutions, LLC.Reisterstown, MD 21136 | 443.904.4385 | kstorm@lbghealth.com 
• Lowe, J. (2023).  Aspirin or Low-Molecular-Weight Heparin for Thromboprophylaxis after a Fracture.. N Engl J Med.. doi:10.1056/NEJMoa2205973
• Lowe, J., & Lowe, J. (2023). Argument for Noncemented Hemiarthroplasty in Geriatric Hip Fractures. J Orthop Trauma. doi:DOI: 10.1097/BOT.0000000000002648
  More info

  Lowe J, Winkel T. Argument for Noncemented Hemiarthroplasty in Geriatric Hip Fractures. J Orthop Trauma. 2023 Sep 1;37(9):e384-e386. doi: 10.1097/BOT.0000000000002648. PMID: 37587569.
• Lowe, J., & Lowe, J. (2023). Aqueous skin antisepsis before surgical fixation of open fractures (Aqueous-PREP): a multiple-period, cluster-randomised, crossover trial. Lancet. doi:DOI: 10.1016/S0140-6736(22)01652-X
  More info

  PREP-IT Investigators. Aqueous skin antisepsis before surgical fixation of open fractures (Aqueous-PREP): a multiple-period, cluster-randomised, crossover trial. Lancet. 2022 Oct 15;400(10360):1334-1344. doi: 10.1016/S0140-6736(22)01652-X. Erratum in: Lancet. 2023 Dec 17;400(10369):2198. PMID: 36244384.
• Ouellette, E., Milne, E., Manoharan, A., Lowe, J., Latta, L., Kaimrajh, D., & Alhandi, A. (2022). Axial and Rotational Mal-Reduction (Golf Club Deformity) in Distal Femur Fractures.. Journal of orthopaedic trauma. doi:10.1097/bot.0000000000002373
  More info

  Describe mal-reduction of supra-condylar distal femur fractures stabilized with lateral femoral locking plates. Determine if mismatch in axial lateral distal femur anatomy and lateral distal femoral plate design contributes to supra-condylar distal femoral fracture mal-reduction..OTA/AO 33A were simulated in 7 cadaver femurs and fixed with a lateral distal locking femoral plate placed flush to the lateral femoral condyle (Group I). In (Group II) the anterior flange of the plate was external rotated 10 degrees in relation to the lateral condyle. A motion capture system measured translation and rotation of the articular segment as shaft screws were applied, reducing plate to femoral diaphysis. Articular segment movement was compared between Groups using Paired Student t-test, p
• Vallier, H., Tornetta, P., Teague, D., Schmidt, A., Mullis, B. H., Morshed, S., Miller, A. N., Lowe, J., Leighton, R., Kempton, L., Jones, C., Friess, D., & Agel, J. (2022). Unilateral Sacral Fractures Demonstrate Slow Recovery of Patient-Reported Outcomes Irrespective of Treatment.. Journal of orthopaedic trauma, 36(4), 179-183. doi:10.1097/bot.0000000000002260
  More info

  To report functional outcomes of unilateral sacral fractures treated both operatively and nonoperatively..Prospective, multicenter, observational study..Sixteen Level 1 trauma centers..Skeletally mature patients with unilateral zone 1 or 2 sacral fractures categorized as displaced nonoperative (DN), displaced operative (DO), nondisplaced nonoperative (NN), and nondisplaced operative (NO)..Pelvic displacement was documented on injury plain radiographs. Short Musculoskeletal Function Assessment (SMFA) scores were obtained at baseline and at 3, 6, 12, and 24 months after injury. Displacement was defined as greater than 5 mm in any plane at the time of injury..Two hundred eighty-six patients with unilateral sacral fractures were initially enrolled, with a mean age of 40 years and mean injury severity score of 16. One hundred twenty-three patients completed the 2-year follow-up as follows: 29 DN, 30 DO, 47 NN, and 17 NO with 56% loss to follow-up at 2 years. Highest dysfunction was seen at 3 months for all groups with mean SMFA dysfunction scores: 25 DN, 28 DO, 27 NN, and 31 NO. The mean SMFA scores at 2 years for all groups were 13 DN, 12 DO, 17 NN, and 17 NO..All groups (operative/nonoperative and displaced/nondisplaced) reported worst function 3 months after injury, and all but (DN) continued to recover for 2 years after injury, with peak recovery for DN seen at 1 year. No functional benefit was seen with operative intervention for either displaced or nondisplaced injuries at any time point..Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
• Johnson, J., Lowe, J. A., Trompeter, A., Mahoney, W., & Khwaja, A. (2021). Biomechanics of periprosthetic femur fractures and early weightbearing. European Journal of Orthopaedic Surgery and Traumatology. doi:10.1007/s00590-021-02969-3
• Sherman, N., Lowe, J., & Couso, M. (2021). Elbow Arthrodesis Surgical Technique.. Journal of orthopaedic trauma, 35(Suppl 2), S15. doi:10.1097/bot.0000000000002170
  More info

  Elbow arthrodesis is an uncommon salvage procedure indicated for failed total elbow arthroplasty, segmental bone loss near the elbow, and severe postinfectious or posttraumatic arthritis. This video demonstrates the surgical technique for elbow arthrodesis in a patient with segmental bony defect of the ulna and postinfectious and posttraumatic elbow arthritis after a severe left arm degloving injury with Monteggia fracture dislocation and radial head fracture.
• Lowe, J. (2020). Traumatic Hip Fracture and Primary Elective Total Hip Patients are Not the Same: A Comparison of Comorbidity Burden, Hospital Course, Postoperative Complications, and Cost of Care Analysis. JOT, 34(11), 583-588. doi:10.1097/BOT.0000000000001800
• Lowe, J. (2020). Variability in Discharge Disposition Across US Trauma Centers After Treatment for High-Energy Lower Extremity Injuries.. JOT, 34(3), e78-e85. doi:10.1097/BOT. 0000000000001657
  More info

  I was a collaborator for this journal publication
• Lowe, J. (2020). What’s Important: Patient Engagement in Research. JBJS, 102(20), 1836-1838. doi:10.2106/JBJS.19.00625
  More info

  I was a collaborator for this journal publication
• Mitchell, S. M., Lowe, J. A., Jones, C. B., Agarwal, S., Mitchell, S. M., Lowe, J. A., Jones, C. B., & Agarwal, S. (2020). The Incidence of Venous Thromboembolism Following Pelvic and Lower Extremity Trauma Despite Adherence to Modern Prophylactic Protocols.. Journal of orthopaedic trauma, 34(8), 418-421. doi:10.1097/bot.0000000000001790
  More info

  Describe the incidence of venous thromboembolism (VTE) in patients with pelvic and lower extremity long bone trauma in the setting of modern prophylaxis..Retrospective health-system database study..Multi-center health care system..Database query from 2010 to 2017 identified 11,313 adult trauma patients who received open reduction internal fixation of pelvic, acetabular, femoral neck, or intertrochanteric fractures, or received intramedullary nailing (IMN) of the femoral or tibial shaft. Patients with incomplete prophylaxis, prior history of VTE, coagulopathy, or concomitant lower extremity fracture were excluded..Mechanical and chemical VTE prophylaxis following pelvic or lower extremity fracture fixation..VTE rates..The overall VTE rate was 0.82% [0.39% deep venous thromboses (DVT); 0.43% pulmonary emboli (PE)]. By procedure, pelvic open reduction and internal fixation (ORIF) and femoral IMN had the highest VTE rates 1.70% (0.98% DVT; 0.78% PE) and 1.33% (0.75% DVT; 0.58% PE), whereas tibial IMN had the lowest incidence of VTE 0.34% (0.17% DVT; 0.17% PE). Among hip fractures, femoral neck ORIF had a VTE rate of 0.98% (0.59% DVT; 0.39% PE), whereas intertrochanteric ORIF had lower rates of 0.59% (0.20% DVT; 0.39% PE)..Despite adherence to modern VTEp protocols, nonpreventable VTE occur in 0.82% of pelvic and lower extremity orthopaedic trauma patients. Incidence ranged between 0.34% and 1.70% depending on injury/fixation method with the highest rate observed in pelvis ORIF followed by femoral IMN. In the era of pay for quality performance, it is important for health systems and auditing agencies to reconcile the difference between preventable and nonpreventable VTEs..Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
• Booth, K. A., Simmons, E. E., Viles, A. F., Gray, W. A., Kennedy, K. R., Biswal, S. H., Lowe, J. A., Xhaja, A., Kennedy, R. E., Brown, C. J., & Flood, K. L. (2019). Improving Geriatric Care Processes on Two Medical-Surgical Acute Care Units: A Pilot Study. Journal for healthcare quality : official publication of the National Association for Healthcare Quality, 41(1), 23-31.
  More info

  The Acute Care for Elders (ACE) Unit model improves cognitive and functional outcomes for hospitalized elders but reaches a small proportion of patients. To disseminate ACE Unit principles, we piloted the "Virtual ACE Intervention" that standardizes care processes for cognition and function without daily geriatrician oversight on two non-ACE units. The Virtual ACE Intervention includes staff training on geriatric assessments for cognition and function and on nurse-driven care algorithms. Completion of the geriatric assessments by nursing staff in patients aged 65 years and older and measures of patient mobility and prevalence of an abnormal delirium screening score were compared preintervention and postintervention. Postintervention, the completion of the assessments for current functional status and delirium improved (62.5% vs. 88.5%, p < .001) and (4.2% vs. 96.5%, p < .001). In a subsample analysis, in the postintervention period, more patients were up to the chair in the past day (36.4% vs. 63.5%, p = .04) and the prevalence of an abnormal delirium screening score was lower (13.6% vs. 4.8%, p = .16). The Virtual ACE Intervention is a feasible model for disseminating ACE Unit principles to non-ACE Units and may lead to increased adherence to care processes and improved clinical outcomes.
• Herman, A., Whitesell, R., Stewart, R. L., & Lowe, J. A. (2019). The impact of upright radiographs of midshaft clavicle fractures on treatment recommendations. Acta orthopaedica Belgica, 85(3), 289-296.
  More info

  Clavicle fractures' treatment recommendations are based on displacement. The goal of this paper is to determine upright clavicle radiographs at initial presentation changes timing and method of treatment. Retrospective study in a level 1 trauma center. 356 patients with clavicle fractures were reviewed. Patients with only supine radiographs (Group 1, 285 patients) were compared to patients with supine and upright radiographs (Group 2, 71 patients). Higher proportion of fractures in the upright vs supine radiographs were displaced 100% or more of the clavicle width, (52.1% vs. 33.5%, p =0.004). Treatment assignment changed from nonoperative to operative treatment more commonly in the Group 2 compared to Group 1 (43.7% vs 21.9%, p =0.019). The most common reason for surgery in Group 1 was presence of continued pain or failure to develop radiographic evidence of callus on serial radiographs (17, 53.1%) as compared to Group 2 (2, 14.2%, p =0.014). In Group 2 the most common cause for treatment change was displacement (12, 85.7%) as compared to Group 1 (15, 46.9%, p =0.014). Patients with upright x-rays are more likely to have a change in treatment because of displacement while patients that had supine x-rays have more delayed/nonunion.
• Hsu, J. R., Mir, H., Wally, M. K., Seymour, R. B., & , O. T. (2019). Clinical Practice Guidelines for Pain Management in Acute Musculoskeletal Injury. Journal of orthopaedic trauma, 33(5), e158-e182.
  More info

  We aimed to produce comprehensive guidelines and recommendations that can be utilized by orthopaedic practices as well as other specialties to improve the management of acute pain following musculoskeletal injury.
• Sanal, H. T., Boulton, C., Neyisci, C., Erdem, Y., & Lowe, J. (2019). Imaging of Pelvic and Femoral Fixation Hardware: Normal Findings and Hardware Failure. Seminars in musculoskeletal radiology, 23(2), e1-e19.
  More info

  Good outcomes following treatment of pelvic ring injuries, acetabular fractures, and femur fractures rely on restoration of native pelvic or limb alignment, anatomical reduction and rigid stability of articular fractures, and early postoperative mobilization. Multiple surgical approaches, reduction aids, and orthopaedic implants are available to stabilize these fractures. Despite best practices, complications including hardware failure, nonunions, malunions, and infections occur. This article discusses common fracture classification systems, implants, and imaging findings associated with unwanted complications in fractures of the pelvis, acetabulum, and femur.
• Taljanovic, M. S., Lowe, J. A., Chen, E., Lomasney, L. M., Schilling, J. H., & Mar, W. A. (2019). Radiologic Evaluation of Lower Leg, Ankle, and Foot Fracture Fixation Hardware. Seminars in Musculoskeletal Radiology, 23(02), e36-e55. doi:10.1055/s-0039-1681049
• Tornetta, P., Lowe, J. A., Agel, J., Mullis, B. H., Jones, C. B., Teague, D., Kempton, L., Brown, K., Friess, D., Miller, A. N., Spitler, C. A., Kubiak, E., Gary, J. L., Leighton, R., Morshed, S., & Vallier, H. A. (2019). Does Operative Intervention Provide Early Pain Relief for Patients With Unilateral Sacral Fractures and Minimal or No Displacement?. Journal of orthopaedic trauma, 33(12), 614-618.
  More info

  To compare pain after operative versus nonoperative pelvic ring injuries with unilateral sacral fractures.
• Vallier, H. A., Lowe, J. A., Agel, J., Mullis, B. H., Jones, C. B., Teague, D., Kempton, L., Miller, A. N., Spitler, C. A., Kubiak, E., Routt, M. L., Leighton, R., Morshed, S., & Tornetta, P. (2019). Surgery for Unilateral Sacral Fractures: Are the Indications Clear?. Journal of orthopaedic trauma, 33(12), 619-625.
  More info

  To evaluate unilateral sacral fractures and compare those treated operatively versus nonoperatively to determine indications for surgery.
• Chung, A. S., Hustedt, J. W., Walker, R., Jones, C., Lowe, J., & Russell, G. V. (2018). Increasing Severity of Malnutrition Is Associated With Poorer 30-Day Outcomes in Patients Undergoing Hip Fracture Surgery. Journal of orthopaedic trauma, 32(4), 155-160.
  More info

  Low serum albumin levels (hypoalbuminemia) have classically been used to identify malnutrition. The effect of increasing severity of malnutrition on postoperative outcomes in patients undergoing hip fracture surgery has not been well delineated on a large scale.
• Jones, C. B., Karr, S., Lowe, J. A., Mitchell, S. M., & Walker, J. (2018).

  Percutaneous Transiliac–Transsacral Screw Fixation of Sacral Fragility Fractures Improves Pain, Ambulation, and Rate of Disposition to Home

  . Journal of Orthopaedic Trauma. doi:10.1097/bot.0000000000001243
  More info

  To determine whether percutaneous transiliac-transsacral screw fixation improves pain, ambulation, length of stay, and the rate of disposition to home in patients with sacral fragility fractures.Retrospective cohort study.Single academic Level 1 trauma center.Elderly patients who presented with an isolated sacral fragility fracture between August 2015 and August 2017. Of the 41 patients included in the study, 16 were treated operatively and 25 were treated nonoperatively.Percutaneous transiliac-transsacral screw fixation.Pain, ambulation, length of stay, complications, and disposition.Patients treated operatively reported a greater improvement in pain as measured by the visual analog scale (3.9 vs. 0.6 points, P < 0.001). At the time of discharge, 100% of surgically treated patients were able to ambulate compared with 72% in the nonoperative group (P = 0.03). Average distance ambulating at the time of discharge was higher in the operative group (95 vs. 35 ft, P < 0.01). Length of stay was similar between the 2 groups (3.6 days in operative group vs. 4.2 days in nonoperative group, P = 0.5). Of the patients treated operatively, 75% were discharged to home compared with only 20% in the nonoperative group (P < 0.001). There were no complications related to surgery.Percutaneous transiliac-transsacral screw fixation of sacral fragility fractures lessens pain, improves ambulation, and increases the rate of disposition to home. Further investigation is needed to determine if surgical fixation provides benefit regarding medium- and long-term outcome variables.Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
• Lowe, J. A., Griffin, R., Leslie, M. P., & Pearson, J. M. (2018).

  Ten-Year Incidence of High-Energy Geriatric Trauma at a Level 1 Trauma Center.

  . Journal of orthopaedic trauma, 32(3), 129-133. doi:10.1097/bot.0000000000001052
  More info

  To examine the characteristics of high-energy geriatric trauma over time..Retrospective chart review..Level 1 trauma center..Demographic, injury, and clinical characteristics were compared between 34,017 patients with geriatric and nongeriatric high-energy trauma from 2005 to 2014 using t test, χ analysis, and negative binomial regression for annual trend in injuries..Geriatric high-energy trauma composed 11.2% of all trauma activations. Patients with geriatric high-energy trauma nearly doubled from the study period of 2005-2014 to previous 10 years (P = 0.0004). Compared with patients with nongeriatric trauma, geriatric high-energy traumas were twice as likely to be due to a fall from height (P < 0.0001), had higher Injury Severity Scores (P < 0.0001), fewer abdominal injuries (P = 0.0011), and have head trauma (P < 0.0001). Fracture patterns were similar between groups. Mortality was higher for all geriatric patients (odds ratio [OR], 4.76; 95% confidence interval [CI], 4.00-5.67), and high-energy mechanisms (OR, 4.71; 95% CI, 3.90-5.68) compared with low-energy mechanisms (OR, 3.00; 95% CI, 2.48-3.62)..The number of geriatric high-energy traumas has doubled over 10 years. Patients with geriatric trauma are sicker on presentation, based on the Injury Severity Score, and high-energy geriatrics have a 4-fold increase in mortality..Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
• Lowe, J. A., Mitchell, S. M., Agarwal, S., & Jones, C. B. (2018).

  Non-Preventable Venous Thromboembolism after Pelvic and Lower Extremity Trauma Occur Despite Adherence to Modern Prophylactic Protocols

  . Journal of The American College of Surgeons, 227(4), e43-e44. doi:10.1016/j.jamcollsurg.2018.08.113
• Lowe, J. A., Mitchell, S. M., Agarwal, S., & Jones, C. B. (2018).

  Traumatic Hip Fracture and Primary Elective Total Hip Patients Are Not the Same: A Comparison of Comorbidity Burden, Hospital Course, Postoperative Complication, and Cost of Care Analysis

  . Journal of The American College of Surgeons, 227(4), e44. doi:10.1016/j.jamcollsurg.2018.08.114
• Sprague, S., Petrisor, B., Jeray, K., McKay, P., Heels-Ansdell, D., Schemitsch, E., Liew, S., Guyatt, G., Walter, S. D., Bhandari, M., & , F. I. (2018). Wound irrigation does not affect health-related quality of life after open fractures: results of a randomized controlled trial. The bone & joint journal, 100-B(1), 88-94.
  More info

  The Fluid Lavage in Open Fracture Wounds (FLOW) trial was a multicentre, blinded, randomized controlled trial that used a 2 × 3 factorial design to evaluate the effect of irrigation solution (soap normal saline) and irrigation pressure (very low low high) on health-related quality of life (HRQL) in patients with open fractures. In this study, we used this dataset to ascertain whether these factors affect whether HRQL returns to pre-injury levels at 12-months post-injury.
• Sprague, S., Tornetta, P., Slobogean, G. P., O'Hara, N. N., McKay, P., Petrisor, B., Jeray, K. J., Schemitsch, E. H., Sanders, D., Bhandari, M., & , F. I. (2018). Are large clinical trials in orthopaedic trauma justified?. BMC musculoskeletal disorders, 19(1), 124.
  More info

  The objective of this analysis is to evaluate the necessity of large clinical trials using FLOW trial data.
• Walker, J. B., Mitchell, S. M., Karr, S. D., Lowe, J. A., & Jones, C. B. (2018). Percutaneous Transiliac-Transsacral Screw Fixation of Sacral Fragility Fractures Improves Pain, Ambulation, and Rate of Disposition to Home. Journal of orthopaedic trauma, 32(9), 452-456.
  More info

  To determine whether percutaneous transiliac-transsacral screw fixation improves pain, ambulation, length of stay, and the rate of disposition to home in patients with sacral fragility fractures.
• Herman, A., Keener, E., Dubose, C., & Lowe, J. A. (2017). Simple mathematical model of sacroiliac screws safe-zone-Easy to implement by pelvic inlet and outlet views. Journal of orthopaedic research : official publication of the Orthopaedic Research Society, 35(7), 1478-1484.
  More info

  Percutaneous sacral screw fixation is the mainstay of posterior pelvic ring fixation. This study quantifies the accuracy of fluoroscopic screw placement using post-operative CT scans and redefines the fluoroscopic safe zone using a mathematical calculation obtained from Inlet and outlet images. The authors hypothesized that a mathematical calculation of screw placement within the ala will improve accuracy of screw placement. A retrospective review of consecutive patients admitted to a level 1 trauma center with pelvic fractures fixed with iliosacral screws from January 2011 to December 2014 was performed. Accuracy of screw placement was determined by comparing fluoroscopy to post-operative CT scans. A mathematical calculation of screw position within the sacral ala was applied to determine assess screw position and compared to CT findings. Ninety-four patients with 156 screws met inclusion criteria, of which 50 (32.0%) had a cortical breech on CT. The sensitivity and specificity of the inlet-outlet safe zone using mathematical calculation were 97.1% and 84.0%, respectively. The positive and negative predictive values were 92.7% and 93.3%, respectively. Overall accuracies of the radiographic inlet-outlet and lateral safe zones were 92.9% and 70.0%, respectively (p-value = 0.004). Sacral dysmorphism was not found to be associated with sacral cortical breech. A Simple mathematical calculation (screw position relative to percentage of bone width) on the inlet-outlet provides an accurate way to predict the accuracy of sacroiliac screws. The method is easy to implement, part of the surgery work-flow, and provides higher accuracy than relying on subjective interpretation of inlet, outlet, and lateral images. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1478-1484, 2017.
• Lowe, J. A., Pearson, J., Leslie, M., & Griffin, R. (2017). Ten Year Incidence of High Energy Geriatric Trauma at a Level 1 Trauma Center. Journal of orthopaedic trauma.
  More info

  To examine the characteristics of high-energy geriatric trauma over time.
• Owen, M. T., Keener, E. M., Hyde, Z. B., Crabtree, R. M., Hudson, P. W., Griffin, R. L., & Lowe, J. A. (2017). Intraoperative Topical Antibiotics for Infection Prophylaxis in Pelvic and Acetabular Surgery. Journal of orthopaedic trauma, 31(11), 589-594.
  More info

  To determine if topical vancomycin and tobramycin powder reduces the incidence of surgical site infection after pelvic ring and acetabulum fracture surgery.
• Herman, A., Keener, E., Dubose, C., & Lowe, J. A. (2016). Zone 2 sacral fractures managed with partially-threaded screws result in low risk of neurologic injury. Injury, 47(7), 1569-73.
  More info

  Zone 2 sacral fractures account for 34% of sacral fractures with reported neurological deficit in 21-28% of patients. The purpose of this study was to examine the risk factors for neurological injury in zone 2 sacral fractures. The authors hypothesized that partially thread iliosacral screws did not increase incidence of neurologic injury.
• Momaya, A. M., Hlavacek, J., Etier, B., Johannesmeyer, D., Oladeji, L. O., Niemeier, T. E., Herrera, N., & Lowe, J. A. (2016). Risk factors for infection after operative fixation of Tibial plateau fractures. Injury, 47(7), 1501-5.
  More info

  Tibial plateau fractures are challenging to treat due to the high incidence of postoperative infections. Treating physicians should be aware of risk factors for postoperative infection in patients who undergo operative fixation.
• , F. I., Bhandari, M., Jeray, K. J., Petrisor, B. A., Devereaux, P. J., Heels-Ansdell, D., Schemitsch, E. H., Anglen, J., Della Rocca, G. J., Jones, C., Kreder, H., Liew, S., McKay, P., Papp, S., Sancheti, P., Sprague, S., Stone, T. B., Sun, X., Tanner, S. L., , Tornetta, P., et al. (2015). A Trial of Wound Irrigation in the Initial Management of Open Fracture Wounds. The New England journal of medicine, 373(27), 2629-41.
  More info

  The management of open fractures requires wound irrigation and débridement to remove contaminants, but the effectiveness of various pressures and solutions for irrigation remains controversial. We investigated the effects of castile soap versus normal saline irrigation delivered by means of high, low, or very low irrigation pressure.
• Lowe, J. A., Crist, B. D., Pfeiffer, F., & Carson, W. L. (2015). Predicting Reduction in Torsional Strength by Concentric/Eccentric RIA Reaming Normal and Osteoporotic Long Bones (Femurs). Journal of orthopaedic trauma, 29(10), e371-9.
  More info

  Reamer-irrigator-aspirator (RIA) bone graft harvesting human femurs have resulted in spiral fractures. Recommendations/studies on safe RIA diameter are noncomprehensive/inconclusive. Our purpose was to develop an analytical model to predict % reduction in torsional strength after intramedullary oversize reaming (concentric or eccentric) and to test cadaveric femurs with normal-to-osteoporotic bone mineral density to investigate its relationship to femur cross-sectional properties, bone material strength, and torsional strength reduction.
• Lowe, J. A., Rister, J., Eastman, J., & Freind, J. (2015). Injury to neurovascular structures with insertion of traction pins around the knee. Journal of orthopaedics, 12(Suppl 1), S79-82.
  More info

  Identify risk to neurovascular structures around the knee with placement of skeletal traction pins.
• Lowe, J. A., Routh, L. K., Leary, J. T., & Buzhardt, P. C. (2015). Effect of Retrograde Reaming for Tibiotalocalcaneal Arthrodesis on Subtalar Joint Destruction: A Cadaveric Study. The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons, 55(1), 72-5.
  More info

  Recent published data have suggested successful union of subtalar and tibiotalar joints without formal debridement during tibiotalocalcaneal (TTC) fusion procedures. Although previous studies have reported on the importance of the proper guidewire starting point and trajectory to obtain appropriate hindfoot alignment for successful fusion, to our knowledge, no studies have quantified the amount of articular damage to the subtalar joint with retrograde reaming. We hypothesized that reaming would destroy >50% of the posterior facet of the subtalar joint. The bilateral lower extremities of 5 cadavers were obtained and the subtalar joints exposed. Retrograde TTC nail guidewires were inserted, and a 12-mm reamer was passed through the subtalar and ankle joints. Pre- and postreaming images of the subtalar joint were obtained to compare the amount of joint destruction after reaming. We found an average of 5.89% articular destruction of the talar posterior facet and an average of 4.01% articular destruction of the posterior facet of the calcaneus. No damage to the middle facets of the subtalar joint was observed. TTC nailing is a successful procedure for ankle and subtalar joint fusion. Published studies have reported successful subtalar union using TTC nailing without formal open debridement of the subtalar joint, preserving the soft tissue envelope. TTC nail insertion using a 12-mm reamer will destroy 5.89% and 4.01% of the respective talar and calcaneal posterior facets of the subtalar joint.
• Rogers, M. E., Lowe, J. A., & Vanlandingham, S. C. (2014). Acute erector spinae compartment syndrome: case report and review of diagnostic criteria. Injury, 45(4), 813-5.
• Lowe, J. A., & Friedlaender, G. E. (2013). Osteoporosis and fragility fractures. The Orthopedic clinics of North America, 44(2), ix-x.
• Lowe, J. A., Min, W., Lee, M. A., & Wolinsky, P. R. (2012). Risk of injury to the superior gluteal nerve when using a proximal incision for insertion of a piriformis-entry reamed femoral intramedullary nail: a cadaveric study. The Journal of bone and joint surgery. American volume, 94(15), 1416-9.
  More info

  This cadaveric study evaluated the risk of injury to the superior gluteal nerve when a proximal incision site is used for insertion of an antegrade, reamed femoral intramedullary nail into the piriformis fossa. Based on prior anatomical studies, our hypothesis is that the use of a proximal incision site for intramedullary nail insertion will consistently injure the superior gluteal nerve.
• Lowe, J. A., Tejwani, N., Yoo, B. J., & Wolinsky, P. R. (2012). Surgical techniques for complex proximal tibial fractures. Instructional course lectures, 61, 39-51.
  More info

  In managing complex proximal tibia fractures, several options are available to the treating surgeon. Closed management with or without external fixation, formal open reduction and internal fixation, and intramedullary nail fixation have been described in the literature. There is a lack of consensus regarding the optimal treatment method for complex bicondylar patterns or proximal metadiaphyseal fractures with or without involvement of the articular surface. It is helpful to review the standard and alternative surgical approaches to bicondylar tibial plateau fractures and to be aware of the intramedullary nail as an alternative approach for complex proximal metadiaphyseal patterns.
• Lowe, J. A., Tejwani, N., Yoo, B., & Wolinsky, P. (2011). Surgical techniques for complex proximal tibial fractures. The Journal of bone and joint surgery. American volume, 93(16), 1548-59.
• Lowe, J. A., Vosburg, C., Murtha, Y. M., Della Rocca, G. J., & Crist, B. D. (2011). A new technique for removing intramedullary cement. Journal of orthopaedic trauma, 25(12), 762-6.
  More info

  Treatment of infected long bone fractures or nonunions requires stability for bony union, yet retained implants can lead to persistent infection. Antibiotic cement intramedullary nails, in addition to external fixation, are commonly used to deliver intramedullary antibiotics in infected long bone fractures and provide temporary stability. However, the retrieval of these nails can result in debonding of antibiotic cement, which can require significant time and effort to remove. A variety of methods, including intramedullary hooks, reverse curettes, flexible osteotomes, and stacked guide rods, are commonly used to remove cement fragments. When these methods fail to allow access to the entire length of the canal, the Reamer Irrigator Aspirator system (Synthes, Paoli, PA) serves as an effective method for removing retained intramedullary cement. The surgical technique is described, and three cases illustrate the successful use of the Reamer Irrigator Aspirator system for removal of an antibiotic cement intramedullary nail.
• Bal, B. S., Lowe, J. A., E Gietler, A., & Aleto, T. J. (2010). Heterotopic ossification after 2-incision total hip arthroplasty. The Journal of arthroplasty, 25(4), 538-40.
  More info

  We examined the incidence of heterotopic ossification (HO) in a consecutive series of total hip arthroplasties (THAs) performed with the so-called minimally invasive, 2-incision technique. Standard preoperative hip radiographs were used to grade the extent of degenerative arthritis, and comparable follow-up radiographs at 30 months after surgery were used to detect and classify HO formation. Of 121 patients, 32 (26.5%) developed HO, with the Brooker class distribution as follows: stage I, 16 patients; stage II, 9 patients; stage III, 6 patients; stage IV, 1 patient. In this study, HO formation after 2-incision THA occurred with nearly the same frequency as that reported in other studies after standard THA.
• Huang, Y. X., Jin, L. Z., Lowe, J. A., Wang, X. Y., Xu, H. Z., Teng, Y. J., Zhang, H. Z., & Chi, Y. L. (2010). Three-dimensional reconstruction of the superior mediastinum from Chinese Visible Human Female. Surgical and radiologic anatomy : SRA, 32(7), 693-8.
  More info

  This research aimed to construct three-dimensional (3D) visible models of the superior mediastinum for anatomic study and surgical approaches to the superior mediastinum.
• Lowe, J. A., Crist, B. D., Bhandari, M., & Ferguson, T. A. (2010). Optimal treatment of femoral neck fractures according to patient's physiologic age: an evidence-based review. The Orthopedic clinics of North America, 41(2), 157-66.
  More info

  For decades, the basic tenets of managing displaced femoral neck fractures have not changed, but the optimal treatment choice continues to be highly debated. The contemporary controversies associated with the treatment principles of displaced femoral neck fractures are distinct between young and old patients and are considered individually in this article about the current evidence. Although fixation constructs all seem to have similar complication rates, there is increasing evidence suggesting that total hip replacement improves patient functional outcomes for healthy, independent, elderly patients compared with hemiarthroplasty and should be considered as the treatment of choice for these patients.
• Lowe, J. A., Della Rocca, G. J., Murtha, Y., Liporace, F. A., Stover, M. D., Nork, S. E., & Crist, B. D. (2010). Complications associated with negative pressure reaming for harvesting autologous bone graft: a case series. Journal of orthopaedic trauma, 24(1), 46-52.
  More info

  A technical benefit of the reamer-irrigator-aspirator (RIA) system (Synthes, Paoli, PA) is the ability to harvest large volumes (40-90 cm3) of autogenous bone graft. Early evaluations of this technique have reported few problems, all of which were attributed to technical error. This case series reviews 6 RIA-associated complications including 4 fractures and their contributing risk factors. Cases were collected from 4 independent orthopaedic centers, and all patients underwent RIA bone graft harvesting in a lower extremity long bone injuries. In this population, 2 patients experienced acute RIA-associated events, necessitating an additional procedure or altered postoperative rehabilitation, whereas 4 patients fractured through their donor site in the early postoperative period. This series suggests that surgeons should (1) preoperatively assess cortical diameters at long bone harvest sites, (2) carefully monitor intraoperative reaming, and (3) avoid RIA bone graft harvesting in patients with a history of osteoporosis or osteopenia unless postharvest intramedullary stabilization is considered.
• Lowe, J. A., & Crist, B. D. (2009). Re: Bone graft harvest using a new intramedullary system. Clinical orthopaedics and related research, 467(10), 2749.
• Bal, B. S., & Lowe, J. A. (2008). Muscle damage in minimally invasive total hip arthroplasty: MRI evidence that it is not significant. Instructional course lectures, 57, 223-9.
  More info

  The prevalence of damage to the musculature surrounding the hip joint was assessed in a random selection of patients who had a unilateral primary total hip replacement with either the two-incision minimally invasive technique, the standard posterolateral approach, or the direct lateral approach. The musculature of the operated hip was compared with that of the normal contralateral side using MRI with a special metal subtraction protocol that allowed visualization of the muscles and tendons while minimizing metal artifacts. All patients had undergone total hip arthroplasty at least 18 months before the investigation. The data show that the standard posterolateral and direct lateral approaches are associated with an increased incidence of postoperative alterations in the hip muscles after total hip arthroplasty, when compared with two-incision minimally invasive hip replacement. The results from this study suggest that the two-incision technique for total hip replacement may have muscle-sparing advantages over other standard approaches.

Presentations

• Lowe, J. (2021). Operatively Managed Lower Limb Long bone Fractures: How Soon Should We Begin VTEp.. Arizona Chapter ACS COT, and IX Region ACS COT (2nd Place Award). Seattle , WA.