Lisa M Truchan

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Scholarly Contributions

Journals/Publications

• Hughes, T. M., Rowan, F. A., & Truchan, L. M. (2017). Lower Leg Fracture Irreducibility Resulting From Entrapment of the Fibula Within the Tibial Shaft. American journal of orthopedics (Belle Mead, N.J.), 46(3), E160-E162.
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  The tibia is the most commonly fractured long bone. Tibia fractures are simple, and most are amenable to immediate closed reduction. Reported cases of irreducibility resulting from entrapment of soft-tissue structures are rare. We report the case of a 23-year-old man who, in a high-speed motor vehicle crash, sustained a closed lower leg fracture that was later found to have a unique pattern in which the fibula was entrapped in the medullary cavity of the tibia. Limited open reduction was performed, and the entrapped distal fibula was removed with use of a bone hook. The tibia was reduced, and a nail placed in standard fashion. The postoperative course leading to full recovery was unremarkable. This irreducible fracture pattern, not previously reported, should be considered during difficult closed reductions in order to prevent unnecessary neurovascular or bony injury.
• Matthews, J. R., Margolis, D. S., Wu, E., & Truchan, L. M. (2015). Brachial Plexopathy Following Use of Recombinant Human BMP-2 for Treatment of Atrophic Delayed Union of the Clavicle. The Journal of Bone and Joint Surgery, 1-5.
• Schannen, A. P., Truchan, L., Goshima, K., Bentley, R., & DeSilva, G. L. (2015). Sural Versus Perforator Flaps for Distal Medial Leg Wounds. Orthopedics, 38(12), e1059-64.
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  Soft tissue coverage of distal medial ankle wounds is a challenging problem in orthopedic surgery because of the limited local tissues and prominent instrumentation. Traditionally, these wounds required free tissue transfer to achieve suitable coverage and subsequent bony union. To better respect the reconstructive ladder and to avoid the inherent difficulty of free flap coverage, rotational flaps have been used to cover these wounds. Both sural fasciocutaneous flaps and rotational fasciocutaneous perforator (propeller) flaps have been described for distal medial soft tissue coverage. The authors performed a retrospective chart review of patients who underwent distal medial leg coverage with the use of either sural flaps or rotational fasciocutaneous perforator flaps. The authors identified 14 patients by Current Procedural Terminology code who met the study criteria. The average age and degree of medical comorbidities were comparable in the 2 groups. The authors reviewed their medical records to evaluate fracture healing, flap size, complications, and return to normal shoe wear. All 7 sural flaps healed without incident, with underlying fracture healing. Of the 7 perforator flaps, 6 healed without incident, with underlying fracture healing. One perforator-based flap was complicated by superficial tip necrosis and went on to heal with local wound care. All patients returned to normal shoe wear. Both sural artery rotational flaps and posterior tibial artery-based rotational flaps are viable options for coverage of the distal medial leg. Coverage can be achieved reliably without microsurgery, anticoagulation, or monitoring in the intensive care unit. [Orthopedics. 2015; 38(12):e1059-e1064.].
• Dezfuli, B., Larkins, C., Ruth, J. T., & Truchan, L. M. (2014). Pediatric Supracondylar Humerus Fractures: Are Medial Pins Indicated?. Open Journal of Orthopaedics, 123-129.
• Margolis, D. S., Wu, E. W., & Truchan, L. M. (2013). Axonal loss in murine peripheral nerves following exposure to recombinant human bone morphogenetic protein-2 in an absorbable collagen sponge. The Journal of bone and joint surgery. American volume, 95(7), 611-9.
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  With the proven efficacy of recombinant human bone morphogenetic protein-2 (rhBMP-2) to treat open tibial fractures and promote spine fusion, there has been an increase in its off-label use. Recent studies have shown that BMPs play a role in nerve development and regeneration. Little is known about changes that result when rhBMP-2 is used in the vicinity of peripheral nerves. The purpose of this study is to characterize changes in peripheral nerves following exposure to rhBMP-2-soaked collagen sponges.
• Wild, J. R., Askam, B. M., Margolis, D. S., Geffre, C. P., Krupinski, E. A., & Truchan, L. M. (2012). Biomechanical evaluation of suture-augmented locking plate fixation for proximal third fractures of the olecranon. Journal of orthopaedic trauma, 26(9), 533-8.
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  To describe a method of suture augmentation of locking plate fixation (PF) of proximal olecranon fractures and to evaluate the biomechanical effectiveness of the suture augmentation using a human cadaveric model.
• Baltzer, A. W., Whalen, J. D., Wooley, P., Latterman, C., Truchan, L. M., Robbins, P. D., & Evans, C. H. (2001). Gene therapy for osteoporosis: evaluation in a murine ovariectomy model. Gene therapy, 8(23), 1770-6.
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  Various cytokines and cytokine antagonists hold promise as new therapeutic agents for osteoporosis, but their application is hindered by delivery problems. Gene transfer offers an attractive technology with which to obviate these restrictions. Its utility was evaluated in an animal model of osteoporosis. Disease was induced by surgical ovariectomy and monitored by measuring bone weight after 12 days, and by histomorphometry after 5 weeks. Genes were transferred to the mice by intramedullary injection of adenoviral vectors. LacZ and luciferase marker genes were used to identify the bone marrow cells transduced by this procedure, and to track the possible spread of transgenes to other organs. The effect on bone loss of transferring a cDNA encoding the human interleukin-1 receptor antagonist (IL-1Ra) was then evaluated. The intramedullary injection of adenoviral vectors transduced lining osteoblasts, osteocytes and cells within the bone marrow. Luciferase activity persisted within the injected femora and adjacent musculature for at least 3 weeks, and in the draining lymph nodes for 2 weeks. Transient, low level expression was present in the liver, but no luciferase was detected at any time in the lung or spleen. Intramedullary introduction of the IL-1Ra gene resulted in circulation of the corresponding protein at concentrations that peaked on day 3, and returned to baseline by day 12. Transfer of the IL-1Ra gene strongly reduced the early loss of bone mass occurring in response to ovariectomy. Furthermore, it completely inhibited the loss of matrix detected by histomorphometry at 5 weeks. The protective effect of this gene was not restricted to bones receiving intramedullary injection of the vector, but occurred in all bones that were evaluated. This proof of concept encourages further development of gene therapy approaches to the treatment of osteoporosis.

Presentations

• Taljanovic, M., Taljanovic, M., Wild, J. R., Esparza, M., Esparza, M., Mohty, K., Krupinski, E., Gimber, L. H., Gimber, L. H., Truchan, L. M., Chadaz, T., Chadaz, T., Chadaz, T., Truchan, L. M., Truchan, L. M., Krupinski, E., Krupinski, E., Gimber, L. H., Mohty, K., , Mohty, K., et al. (2017, Nov/Fall). Ultrasound Evaluation of Radial Nerve Palsy Associated with Humeral Shaft Fracture to Guide Operative Versus Conservative Treatment. RSNA (Radiological Society of North America) 2017.
• Wild, J. R., Taljanovic, M., Taljanovic, M., Esparza, M., Esparza, M., Mohty, K., Krupinski, E., Gimber, L. H., Gimber, L. H., Truchan, L. M., Chadaz, T., Chadaz, T., Chadaz, T., Truchan, L. M., Truchan, L. M., Krupinski, E., Krupinski, E., Gimber, L. H., Mohty, K., , Mohty, K., et al. (2017, Nov/Fall). Ultrasound Evaluation of Radial Nerve Palsy Associated with Humeral Shaft Fracture to Guide Operative Versus Conservative Treatment. RSNA (Radiological Society of North America) 2017.