Summer 2013 New program focuses on hip preservationWhile childhood hip disorders such as dysplasia, Perthes and slipped epiphysis aren’t new, Campbell Clinic and Le Bonheur physicians

New program focuses on hip preservation Early, less-invasive treatment gives teens, young adults new options

Le Bonheur Children’s and Campbell Clinic recently formed a Hip

Preservation Program, treating adolescents and young adults

with hip problems. The comprehensive program aims to

diagnose and treat early symptom-

atic hip conditions in order to delay

or prevent total hip replacement or

arthritis.

While childhood hip

disorders such as dysplasia, Perthes

and slipped epiphysis aren’t new,

Campbell Clinic and Le Bonheur

physicians are now offering some

new and innovative treatment

alternatives with positive out-

comes to address these and other

hip deformities.

“There is a new field in ortho-

paedics that allows us to diagnose

and treat children and young

adolescents with hip disorders that

benefit from ‘hip preservation,’ “

said Le Bonheur/Campbell Clinic

Pediatric Orthopaedic Surgeon

James Beaty, MD. “This means we

treat hip problems that would

normally lead to early arthritis of

the hip. We try to preserve com-

plete use of their hip and delay

the risk and onset of early arthritis

of the hip.”

The spectrum of treatment

for hip preservation includes diag-

nosis, conservative non-surgical

treatment and arthroscopic surgery of the hip. The program focuses

on using less-invasive techniques like arthroscopy to treat hip condi-

tions when possible. Other larger open operations like periacetabular

osteotomy, acetabuloplasty and proximal femoral osteotomy are also

provided when needed.

The hip preservation team includes adult and pediatric ortho-

paedic surgeons whose expertise ranges from congenital defects to

sports-related hip injuries. It also includes radiologists, physical

therapists and nurse practitioners experienced in diagnosing and

treating hip conditions in a pediatric population.

“We have the knowledge and training to both diagnose and

treat the full spectrum of adolescent and young adult hip

disease,” said Beaty.

Le Bonheur hip patient, 14-year-old Claire Whitaker of Olive

Branch, Miss., experienced severe

hip pain after eight years of play-

ing competitive soccer. When Claire

finally sought medical attention for

her pain, she and her family were

surprised to learn that what they

thought was a pulled muscle was

actually a torn labrum caused by hip

dysplasia. Claire was offered surgery

to fix the problem. (See full story

on Page 3.)

“Although Claire had been

experiencing symptoms for a year,

it was fortunate that she was

referred to us early in the disease

process before she sustained severe

hip cartilage damage,” said Derek

Kelly, MD, who performed Claire’s

surgery. “It was our hope that labral

repair and reorientation of Claire’s

acetabulum will prevent her from

developing arthritis at a young age.”

She was back to practicing with her

team eight weeks after surgery.

Hip preservation research also

continues to grow. Kelly is part of

the International Perthes Study

Group – a multicenter research

study evaluating Perthes in chil-

dren. Legg–Calvé–Perthes disease

(Perthes) occurs when loss of blood supply to the femoral head leads

to collapse or deformity of the hip joint. The study group has prospec-

tive study protocols currently in place for children ages 6-8 and ages

8-11. The group hopes to discover the utility of new diagnostic tools

such as perfusion MRI and new treatments such as injectables or

prolonged weight-bearing restriction.

“By formalizing a hip preservation center and studying the latest

techniques and approaches to adolescent and young adult hip prob-

lems, we hope to continue to advance the field of orthopaedics and

improve the outcomes of our patients for years to come,” said Pediatric

Orthopaedic Surgeon David Spence, MD.

Summer 2013

lebonheur.org/ortho

campbellclinic.com

Memphis, Tennessee

Pediatric OrthOPaedics

• Hip fracture

• Legg-Calvé-Perthes disease (Perthes)

• Slipped capital femoral epiphysis (SCFE)

• Infantile and adolescent hip dysplasia

• Femoroacetabular impingement (FAI)

• Labral tears

Hip coNditioNs treated at Le BoNHeur/campBeLL cLiNic iNcLude:

Dr. David Spence examines orthopaedic patient Lakeisha Beasley.

EPOS Traveling FellowsLe Bonheur Children’s was one of four sites chosen to host

the European Paediatric Orthopaedic Society’s 2013 Traveling Fellows. The EPOS Traveling Fellowship sends three emerging leaders in the field of pediatric orthopaedic surgeons to differ-ent U.S. centers every other year to expand their knowledge and build collaboration in the field. On alternate years a team of U.S. surgeons is hosted by surgeons at leading European centers.

Le Bonheur Pediatric Orthopaedic Surgeon Jeffrey R. Sawyer, MD, is a former traveling fellow whose site visits included Helsinki, Finland, Dusseldorf, Germany, Vienna, Austria, and Warsaw, Poland. This year’s fellows spent three days in April at Le Bonheur meeting with the Campbell Clinic/Le Bonheur pediatric orthopaedic team.

Le Bonheur orthopaedic team with 2013 with EPOS fellows.

Researchers evaluate use of MRI in diagnosing spondylolysis

MRI is an effective tool for diagnosing pars stress reactions and fractures, according to a recent Le Bonheur and Campbell Clinic study.

Pediatric orthopaedic surgeons looked at different imaging modalities for diagnosing spondylolysis, a defect or stress fracture of the vertebrae. The research-ers aimed to determine the effectiveness of MRI when it comes to detecting this condition.

The study included 26 patients with a presumptive diagnosis of spondylolysis who each had both a CT scan and a MRI scan within 30 days of each other. Researchers reviewed the patients’ clinic and radiographic data, com-paring MRI and CT images for presence of the fracture.

Of 39 pars lesions (stress reaction or fracture), MRI was effective in iden-tifying 36, or 92 percent. Additionally, MRI identified 11 lesions in nine patients with a negative CT.

MRI has been very useful in the early detection of spondylolysis or a stress fracture of the vertebrae. A unique finding from the study was the finding of 11 lesions or stress reactions that did not show a fracture on CT. Researchers believe these stress reactions occur prior to definitive fracture and have allowed for early treatment.

Study compares operative vs. non-operative treatment of medial epicondyle fractures of the humerus

Medial epicondyle fractures of the humerus treated non-operatively can result in radiographic deformity and instability, according to researchers at Le Bonheur Children’s. The research compared clinical and radiologic outcomes of medial epicondyle fractures that were treat-ed operatively versus fractures treated non-operatively.

Treatment of such fractures of the distal humerus in the pediatric population remains controversial. Most physicians agree that non-displaced fractures are best managed non-operatively, while fractures with entrapped fragments and open fractures are best treated operatively.

“This leaves a subset of fractures – displaced, but not incarcerated – in which the preferred treatment remains unknown,” said Derek Kelly, MD, a pediatric orthopae-dic surgeon with Le Bonheur and Campbell Clinic

and a lead investigator on the study.Medial epicondyle fracture patients (31 total) were

subdivided into three groups for the study: non-dis-placed fractures; incarcerated fragments; and displaced but not incarcerated fractures (which were further divided into operative and non-operative subgroups). Non-displaced fractures were treated non-operatively; incarcerated fragments were treated with surgery. Of the 21 fractures in the third subgroup, 14 were repaired operatively, and seven were treated non-operatively. Average follow up for the study patients was just more than four years.

Clinical outcomes were assessed with a follow-up exam and the Japanese Orthopaedic Association elbow assessment score. Final follow-up radiographs of the injured and contralateral elbow were reviewed to identify bony union, width of the humerus and the vertical position of the medial epicondyle. Valgus stress radiographs were also obtained and compared to the contralateral elbow to assess elbow instability.

Results showed both operative and non-operative treatment of this subset produced good outcome scores and high union rates, but there were more radiographic deformities and instability in the displaced, non-opera-tive group.

Surgeons compare inter-, intra-observer variability for femoral shaft fractures

Researchers at Le Bonheur and Campbell Clinic have found considerable inter- and intra-observer variability in the classification of femoral shaft fractures in children younger than 3 years. Classification of such fractures is an important part of evaluating young children for possible non-accidental trauma.

“Orthopaedic surgeons are part of a multidisci-plinary team responsible for the diagnosis and treatment of children with non-accidental traumatic injuries,” said

Jeffrey R. Sawyer, MD, a Le Bonheur/Campbell Clinic pediatric orthopaedic surgeon and one of the study’s lead investigators. “Effective communication between all team members is essential given the tremendous impact making the correct diagnosis of non-accidental trauma has on patients and their families.”

The Le Bonheur study looked at classification of femoral shaft fractures according to three groups with varied training and background: orthopaedic surgeons, emergency room physicians and musculoskeletal radiologists. Years of experience and training were also taken into consideration for the study.

The researchers identified children ages 3 years or younger with a closed femural fracture between 2005 and 2011. A formulized ratio was used to standardize the images and eliminate variability due to error. Fifty radiographs fit the inclusion criteria for the study.

Fourteen different reviewers — seven orthopaedic surgeons, five emergency room physicians and two musculoskeletal radiologists – reviewed each patient’s AP and lateral radiographs. Observers classified each fracture as transverse, oblique or spiral. A second review, with images presented in a different order, was per-formed at least 10 days later.

Results showed that the ability of different special-ists to reproducibly classify pediatric femur fractures is highly variable. Intra-observer reliability was stronger than inter-observer reliability, perhaps suggesting the characterizing features of each fracture are not shared among the different specialties.

Pediatric Orthopaedic Research Update

Nurse practitioners conduct research, presentWork from Le Bonheur’s orthopaedic nurse practitioners is contributing to advancements in the field. Most recent published research and presentations include:

Rhodes, L. National Association of Pediatric Nurse Practitioners, 34th Annual Conference, April 2013. Podium Presentation: “Overuse Injuries: A Pain in My Knee.”

Rhodes, L. Society of Pediatric Nurses, March 2013 meeting, Podium Presentation: “Pediatric Sexual and Physical Assault.”

Nawaf, C. B., Kelly, D. M., Warner, Jr., W.C., Beaty, J. H., Rhodes, L. N. & Sawyer, J. R. (2012). Fat embolism syndrome in an adolescent before surgical treatment of an isolated closed tibial shaft fracture. The American Journal of Orthopedics, 41(12): 565-568.

Hines-Dowell, S., Lee, S., Baskins, S., Janecek, A., Rhodes, L. & Gresham, F. (2012). Osteogenesis imperfecta type VIII: A case report. Journal of Neonatal Nursing, 18(6): 217-220.

Le Bonheur Children’s Hospital, Nursing Grand Rounds, November 2012. Podium presentation: “Does a pre-operative tour alleviate anxiety in patients having posterior spinal fusion surgery?”

Southwest Community College, Guest Lecturer, September & November 2012. Presentation: “Pediatric Sexual Assault.”

Scott D. Rhodes L., Warner W., Kelly D., Sawyer J. Post-Operative Constipation in Pediatric Orthopaedic Patients: A Pilot Study Comparing Miralax to Mineral Oil. Presented at the Pediatric Orthopaedic Practitioners Society, Denver, Colo., May 2012.

Rhodes L., Scott D., Nash C., Barkoh K., Warner W., Kelly D., Sawyer J. Does Pre-Operative Orientation Decrease the Anxiety Associated with Spinal Fusion of Scoliosis. Presented at the Pediatric Orthopaedic Practitioners Society, Denver, Colo., May 2012.     

Rhodes, L. Roundtable discussion: Pediatric Sports Medicine. Pediatric Orthopaedic Practitioners Society, Denver, Colo., May 2012.

Rhodes L. Podium presentation: Does a pre-operative tour alleviate anxiety in patients having posterior spinal fusion surgery? Le Bonheur Children’s Hospital, Nursing Grand Rounds, November 2012.

Rhodes L. Pediatric Sexual Assault. Southwest Community College, Guest Lecturer, September & November 2012.

Rhodes L. Poster presentation: Anxiety in posterior spinal fusion for adolescent idiopathic scoliosis: Does pre-operative hospital orientation alleviate fears? Sigma Theta Tau Nursing Conference, Memphis, Tenn., April 2012. 

Scott, D. Podium presentation: Pediatric Septic Arthritis. Le Bonheur Children’s Hospital Nursing Grand Rounds, April 2012.

Scott, D. Podium presentation: Pediatric Dermatology; Pediatric Infectious Diseases. Le Bonheur Children’s Hospital Pediatric Certification Review Course, June 2012.

Scott, D. Poster presentation: Evidence Based Practice: Comparing Miralax and Mineral Oil for Prevention of Constipation in Pediatrics.  Sigma Theta Tau Nursing Conference, Memphis, Tenn., April 2012. 

Scott, D. Roundtable discussion: What Are We Doing About Childhood Obesity in Pediatric Orthopedics? Tennessee Nurses Association Annual Convention, Nashville, Tenn., October 2012.

MRI demostrating edema in L5 pars and pedicle

Single screw fixation of displaced medial epicondyle fracture

Average Intra-Observer ReliabilityOverall 0.65Orthopaedic Surgeons 0.71Radiologists 0.75ER Physicians 0.54

Average Inter-Observer ReliabilityOverall 0.48Orthopaedic Surgeons 0.54Radiologists 0.76ER Physicians 0.38

Scale:< 0.2 = Poor Agreement0.21-0.4 = Fair Agreement0.41-0.6 = Moderate Agreement0.61-0.8 = Strong Agreement> 0.8 = Near Complete Agreement

CT demonstrating bilateral pars defects

Claire Whitaker: Peri-Acetabular Osteotomy

Claire Whitaker, 14, of Olive Branch, Miss., thought the pain she was feeling in her left hip was normal wear-and-tear from playing eight years of competitive soccer. She had been feeling the sharp pain for about three months.

“We thought it was a minor muscle injury,” said her father, Whit Whitaker.

Eventually the pain grew worse and began to slow her down in soccer games and practices. She went to see doctors at Campbell Clinic in Memphis, Tenn., in January 2013 and was diagnosed with bilateral hip dysplasia and a left hip labral tear, which was detected using MRI arthrogram.

“We discussed many treatment options and decided on a Bernese (Ganz) Peri-Acetabular Osteotomy with simultaneous open labral repair using suture anchors,” said Le Bonheur/Campbell Clinic Pediatric Orthopaedic Surgeon Derek Kelly, MD. “This approach was chosen because it allows us to correct both of her problems in the same setting.”

Doctors performed a labral repair through a T-shared capsulotomy using two suture anchors before performing the osteotomy.

They used an abductor muscle-sparing technique and stabilized the osteotomy with a number of 3.5-mm screws.

The operation was a success. Claire’s center-edge angle improved from 19 to 30 degrees, and she was able to walk without crutches six weeks after the operation.

Her recovery came just in time for soccer tryouts. Claire made her high school’s varsity team this spring and will be able to participate in some drills at camp this summer.

“We are glad that Claire has done so well in the short term. She is a fast healer and was able to get back to her activities very quickly. But we are also hopeful that this surgery will protect Claire’s hip for the long term and hopefully delay or prevent the development of severe osteoarthritis,” said Kelly.

14-year-old Claire Whitaker

Andrew Greenland: Trauma

Four-year-old Andrew Greenland is a star on his local baseball team. He does not even use a tee. It’s hard to tell that only one year ago Andrew was in a lawn mower accident that severely injured his left arm.

“I rushed home from work after I got the call Andrew was hurt,” said Heather. “When I got to him, I could see how badly his arm was mangled.”

Andrew had fallen off of his grandparents’ riding lawn mower, and the blades ran over his left arm.

Heather and her husband, Wesley, both nurses, helped paramedics wrap and put pressure on the wound before a helicopter arrived to trans-port Andrew from Munford, Tenn., to Le Bonheur Children’s Hospital in Memphis.

Andrew was admitted to the Pediatric Intensive Care Unit; doctors were not sure if they could save his arm.

According to Le Bonheur Pediatric Orthopaedic Surgeon James Beaty, MD, Andrew had a significant injury with loss of his elbow joint surface and muscle, as well as the skin and nerves around the elbow and forearm.

“I was so impressed that almost as soon as we got to Le Bonheur, orthopaedic surgeons were in our room, telling us he would be OK. They laid out a detailed plan

of how they were going to save his arm,” said Heather.

Andrew remained at Le Bonheur for 23 days and under-went a total of eight surgeries to repair his arm. Operations included external fixation and several other orthopaedic and plastic reconstruc-tive surgeries. Andrew remained in external fixation for six weeks.

He also underwent intense physical therapy for three months, continuing his rehabilitation after discharge.

Today, Andrew is doing well. He has limited elbow motion but almost complete use of his wrist. Now 4, Andrew is able to play base-ball, his favorite sport, five days a week. Andrew and his family still travel to Le Bonheur for checkups with the orthopaedic and plastic surgery teams.

“We are pleased and proud to see Andrew’s progress and outcome now from a year ago,” said Beaty. “The joy for their family after a tough injury is the reason we do what we do.”

Advanced techniques help orthopaedic patients

4-year-old Andrew Greenland

AP and lateral X-rays of the arm

Orthopaedic surgeons at Le Bonheur and Campbell Clinic are using the most advanced technology to treat pediatric orthopaedic conditions. Patients from around the region continue to travel to Le Bonheur for high-level care and advanced techniques.

Bilateral adolescent hip dysplasia Healed Bernese Periacetabular Osteotomy with restoration of center-edge angle

Claire Whitaker

Non-Profit Org.

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Memphis, TNPermit No. 3093

848 Adams AvenueMemphis Tennessee 38103

Research, Publications and PresentationsLe Bonheur Children’s Hospital and Campbell Clinic’s five surgeons are actively involved in research and presentations in the pediatric orthopaedic field. Highlights from their work are listed below:

Publications Grear B. J., Neumann J., Warner W.C., Sawyer J. R., Kelly D. M. Patient follow-up in pediatric ortho-paedic retrospective call-back studies. Current Orthopedic Practice. 23(6):590–594, November/December 2012.Warner W.C., Astur N., Klimo P. Jr, Muhlbauer M.S., Gabrick K. Occipitocervical fusion using a con-toured rod and wire construct in children: a reappraisal of a vintage technique. J Neurosurg Pediatr. 2012 Nov 16. [Epub ahead of print] Miller D.J., Kelly D.M., Spence D.D., Beaty J.H., Warner W.C. Jr, Sawyer J.R. Locked intramedullary nailing in the treatment of femoral shaft fractures in children younger than 12 years of age: indica-tions and preliminary report of outcomes. Journal of Pediatric Orthopaedics. 2012 Dec;32(8):777-80. doi: 10.1097/BPO.0b013e31826bb0ba. Grear B., Sawyer J.R., Warner W.C. Jr, Beaty J.H., Kelly D.M. Factors Affecting Research Subject Rate of Return in Pediatric Orthopedic Retrospective Review Studies. Current Orthopedic Practice. 23(6):590-594, Nov/Dec 2012. DOI: 10.1097/BCO.0B013e31826efee5. Spence D., Shore B., Graham H.K. The Role of Hip Surveillance in Children with Cerebral Palsy. Curr Rev Musculoskelet Med: 5:126-134, 2012. Sawyer, J.R., Beebe, M., Creek, A.T., Yantis, M., Kelly, D.M., Warner, W.C.  Age-related Patterns of Spine Injury in Children Involved in All-Terrain Vehicle Accidents. Journal of Pediatric Orthopaedics. 2012 Jul;32(5):435-9. PMID: 22706455. Backstrom, I.C.; Maclennan, P.A.; Sawyer, J.R.; Creek, A.T.; Rue, L.W. 3rd; Gilbert, S.T.  Pediatric obesity and traumatic lower-extremity long-bone fracture outcomes. J Trauma Acute Care Surg. 2012 Aug 17 (Epub ahead of print)           Norton, B, Mulligan, R, Rush, J.K., Kelly, D.M., Warner, W.C., Sawyer, J.R.  Proximal femoral fractures in children and adolescents:an update.  COP Volume 23   Number 5  September/October 2012 429-434       Brey J.M., Conoley J., Canale S.T., Beaty J.H., Warner W.C. Jr, Kelly D.M., Sawyer J.R. Tibial tuberosity fractures in adolescents: is a posterior metaphyseal fracture component a predictor of complications? Journal Pediatric Orthopaedics. 2012 Sep; 32(6):561-6. PubMed PMID: 22892616. Jaquith, B., Chase, A., Flinn, P., Warner, W., Sawyer, J., Freeman, B, Kelly, D. Screws versus hooks: implant cost and deformity correction in adolescent idiopathic scoliosis. (2012) Journal of Children’s Orthopaedics, Online First(TM), 23April2012Arkader, Tolo,Warner, Sponseller, Skaggs. Pediatric chance fractures: a multicenterperspective: Journal of Pediatric Orthopaedics. 2011 Oct-Nov;31(7):741-4. PMID: 21926870Larson AN, Sucato DJ, Herring JA, Adolfsen SE, Kelly DM, Martus JE, Lovejoy JF, Browne R,Delarocha A. A Prospective Multicenter Study of Legg-Calvé-Perthes Disease: Functional andRadiographic Outcomes of Nonoperative Treatment at a Mean Follow-up of Twenty Years. JBone Joint Surg Am. 2012 Apr 4;94(7):584-92.Sawyer JR, Beebe M, Creek AT, Yantis M, Kelly DM, Warner WC Jr. Age-related Patterns ofSpine Injury in Children Involved in All-Terrain Vehicle Accidents. J Pediatr Orthop. 2012Jul;32(5):435-9.Sawyer JR, Bernard MS, Schroeder RJ, Kelly DM, Warner WC Jr. (2011) Trends in all-terrainvehicle-related spinal injuries in children and adolescents. Journal of Pediatric Orthopaedics,31(6):623-7.Rachel JN, Williams JB, Sawyer JR, Warner WC, Kelly DM. (2011) Is radiographic evaluationnecessary in children with a clinical diagnosis of calcaneal apophysitis (Sever disease)?Journal of Pediatric Orthopaedics, 31(5):548-50.Sawyer JR, Kelly DM, Kellum E, Warner WC Jr. (2011) Orthopaedic aspects of all-terrain vehi-clerelated injury. Journal of the American Academy of Orthopaedic Surgeons, 19(4):219-25.Nawaf CB, Kelly CM, Warner WC, Beaty JH, Sawyer JR. (2011) Fat Embolism Syndrome in anAdolescent Before Surgical Treatment of an Isolated Closed Tibial Shaft Fracture. Acceptedfor publication – American Journal of Orthopaedics.Jaquith BP, Chase A, Flinn P, Sawyer JR, Warner WC Jr, Freeman BL, Kelly DM. (2011) CostComparison of Correction Obtained with Pedicle Screw and Hook Constructs in AdolescentIdiopathic Scoliosis. Submitted for publication – Journal of Children’s Orthopaedics.Brey JM, Conoley J, Canale ST, Beaty JH, Warner WC Jr, Kelly DM, Sawyer JR. (2011) TibialTuberosity Fracture in Adolescents: Is a Salter-Harris Type IV Posterior Fracture Component aPredictor of Complications? Submitted for publication – Journal of Pediatric Orthopaedics.Miller J, Kelly DM, Spence DD, Beaty JH, Warner WC Jr, Sawyer JR. (2011) LockedIntramedullary Nailing in the Treatment of Femoral Shaft Fracture in Children Youngerthan Twelve Years of Age: Indications and Preliminary Report of Outcomes. Submitted forpublication – Journal of Pediatric Orthopaedics.Warner Jr. WC, Sawyer JR: Kyphosis In Lovell and Winter’s Pediatric Orthopaedics 7thEdition. Submitted for Publication.Rachel JN, Williams JB, Sawyer JR, Warner Jr WC, Kelly DM (2011) Is RadiographicEvaluation Necessary in Children with a Clinical Diagnosis of Calcaneal Apophysitis(Sever Disease)? Journal of Pediatric Orthopaedics, 31:548-550.Sawyer JR, Kelly DM, Beaty JH, Warner Jr. WC, Canale ST (2011) Kickstand Modificationfor External Fixation of Lower Extremity Fractures in Children. Journal of Children’sOrthopaedics, 5:63-67.Cross JD, Rush JK, Kelly DM, Warner Jr, WC, Sawyer JR (2010) The Treatment of PediatricLower Extremity Deformity Using the Taylor Spatial Frame. Current Orthopaedic Practice,22 (2): 135-141.Beaty, J.H. (2010). Fractures of the lateral humeral condyle are the second mostfrequent elbow fracture in children. Journal of Orthopaedic Trauma, 24(7):438.No abstract available. PMID: 2057707Anand, K.J., Eubanks, J.W. 3rd, Kelly, D.M., Meier, J.W., Saltzman, J.A., Crisler, S.C., Kraus,G.J., Spentzas, T. & Chesney, R.W. (2010). Pediatric Patients Seen in Port-au-Prince, Haiti.Clinical Pediatrics (Phila). 2010 Aug 19. [Epub ahead of print]Sawyer, J.R., Kellum, E.L., Creek, A.T. and Wood, G.W. 3rd. (2010) Acute compartmentsyndrome of the hand after a wasp sting: a case report. Journal of PediatricOrthopaedics, 19(1):82-5.Sawyer, J.R., Ivie, C.B., Huff, A.L., Wheeler, C., Kelly, D.M., Beaty, J.H. & Canale, S.T.(2010). Emergency room visits by pediatric fracture patients treated with castimmobilization. Journal of Pediatric Orthopaedics, 30(3):248-52.PMID: 20357591Katz, D.E., Herring, J.A., Browne, R.H., Kelly, D.M. & Birch, J.G. (2010)Brace wearcontrol of curve progression in adolescent idiopathic scoliosis. Journal of Bone and JointSurgery, American edition, 92(6):1343-52.Kelly, D.M., McCarthy, R.E., McCullough, F.L. & Kelly, H.R. (2010). Long-term outcomes ofanterior spinal fusion with instrumentation for thoracolumbar and lumbar curves in adolescentidiopathic scoliosis. Spine (Philadelphia, Pa. 1976), 35(2):194-8.Sawyer JR, Kellum EL, Kelly DM, Warner Jr WC (2009) Orthopaedic Aspects of All-TerrainVehicle Accidents. Accepted for publication - Journal of the American Academy ofOrthopaedic SurgeonsLee, M.C., Kelly, D.M., Sucato, D.J. & Herring, J.A. (2009). Familial bilateralosteochondritis dissecans of the femoral head. A case series. Journal of Bone andJoint Surgery, American edition. 91(11):2700-7. No abstract available.Sawyer JR, Ivie C, Huff A, Kelly DM, Warner Jr WC, Beaty JH, Canale ST: (2009)Unplanned Emergency Room Visits by Children Treated with Cast Immobilization.Journal of Pediatric Orthopaedics 30(3): 248-52.Sawyer, J.R., Kapoor M., Gonzales M.H., Warner W.C. Jr., Canale S.T. & Beaty J.H. (2009).Heterotopic ossification of the hip after non-accidental injury in a child:case report. Journal of Pediatric Orthopaedics, 29(8):865-7.PMID: 19934700Beaty, J.H. (2009). The future of orthopedics. Journal of Orthopaedic Science,14(3):245-7.Epub 2009 Jun 5. No abstract available. PMID: 19499288Rhodes LN, Huff AL, Kelly DM,Warner WC, Sawyer JR. (2009) Pediatric Fracture Clinics: Current Status and FutureDirections. Pediatric Health 3:439-444.Sawyer, J.R. & Kapoor, M. (2009). The limping child: a systematic approach todiagnosis. American Family Physician, 79(3):215-24. Review.Sawyer JR, Hicks J, Beaty JH, Canale ST, Warner Jr. WC, Beaty JH (2009) The Hammerlock Position for Treatment of Medial Epicondyle Fractures”. Current Orthopaedic Practice 20(5):572-4 .Beebe MJ, Kelly DM, Warner Jr. WC, Sawyer JR (2009) Current Controversies in theTreatment of Pediatric Femur Fractures. Current Orthopaedic Practice 20(6):634-9.Pershad, J., Williams, S., Wan J. & Sawyer, J.R. (2009). Pediatric distal radial fractures treated by emergency physicians. The Journal of Emergency Medicine, 37(3):341-4. Epub 2009 Feb 6.Kahn S, Sawyer JR, Pershad J. (2009) Prospective Randomized Comparison of PediatricForearm Fractures Reduced by Pediatric Emergency Room Physicians. Accepted for publication– Academic Emergency Medicine.

PresentationsJim Beaty, MDBeaty, J.H., Warner, W.C., Sawyer, J.R., Kelly, D.M., Larsen, Moisan, Witte, Elzey. Medial Ulnar Collateral Ligament Origin on the Medial Epicondylar Apophysis in the Skeletally Immature Elbow: An MRI Anatomical Study. Presented at the American Academy of Orthopaedic Surgeons, Chicago, Ill., March 2013. Beaty, J.H., Warner, W.C., Sawyer, J.R., Kelly, D.M., Larsen, Moisan, Witte, Elzey. Medial Ulnar Collateral Ligament Origin on the Medial Epicondylar Apophysis in the Skeletally Immature Elbow: An MRI Anatomical Study. Poster presented at POSNA annual meeting, Toronto, Ontario, May 2013.Beaty, J.H., Warner, W.C., Sawyer, J.R., Spence, D., Kelly, D.M., Pretell, Murphy, Moisan. Surgical Treatment of Symptomatic Accessory Navicular in Children and Adolescent: Is Simple Excision Enough? ePoster presented at POSNA annual meeting, Toronto, Ontario, May 2013.Beaty, J., Kelly, D., Sawyer, J.R., Warner, W.C., Grear, B. Factors Affecting Research Subject Return Rate in Pediatric Orthopaedic Retrospective Review Studies. Presented at American Academy of Pediatrics, New Orleans, La., October 2012.

Beaty, J., Spence, D., Stranch, E., Miller, J., Kelly, D.M., Sawyer, J.R., Warner, W.C. Retrospective chart and x-ray review of Intramedulary Nailing of Pediatric Femur Fractures in Children Less Than Twelve Years of Age. Presented at Pediatric Orthopaedic Society of North America, Denver, Colo., May 2012.Beaty, J., Brey, J., Conoley, J., Canale, S.T., Warner, W.C., Kelly, D.M., Sawyer, J.R. Tibial tuberosity fractures in adolescents: is a posterior metaphyseal fracture component a predictor of complications? Presented at Pediatric Orthopaedic Society of North America, Denver, Colo., May 2012.Beaty, J., Brey, J., Conoley, J., Canale, S.T., Warner, W.C., Kelly, D.M., Sawyer, J.R. Tibial tuberosity fractures in adolescents: is a posterior metaphyseal fracture component a predictor of complications? Presented at American Academy of Orthopaedic Surgeons, San Francisco, Calif., February 2012.Beaty, Jim. Developing Teaching Skills to Enhance Learning. Presented at the AmericanAcademy of Orthopaedic Surgeons, San Diego, Calif., February 2011.Beaty, Jim. Elbow Fractures in Children: 2011 Update. Visiting Professor , Presented at theUniversity of Pittsburgh, May 2011.Beaty, Jim. Elbow Fractures in Children. Visiting Professor, Presented at St. Luke’s Roosevelt,New York, N.Y., June 2011.Beaty, Jim. Elbow Fractures: Treatments and Complications – 2011 Update. Visiting Professor,Presented at the University of California, San Francisco, Calif., June 2011.Beaty, Jim. Elbow and Femur Fractures. Visiting Professor, Presented at the University ofCalifornia (Journal Club – SCFE), San Francisco, Calif., June 2011.Beaty, Jim. The Orthopaedic Life and Career. Visiting Professor , Presented at the University ofCalifornia, San Francisco, Calif., June 2011.Beaty, Jim. ICL; Fractures of the Lower Extremities in Children. Presented at the AmericanAcademy of Orthopaedic Surgeons, Annual Meeting, San Diego, Calif., February 2011.Beaty, Jim. ICL; The Art of The Orthopaedic Lecture. Presented at the American Academy ofOrthopaedic Surgeons, Annual Meeting, San Diego, Calif., February 2011.Beaty, Jim. Elbow Fractures in Children: 2011 Update. Visiting Professor, Presented at theUniversity of Pittsburgh, May 2011.Beaty, Jim. Elbow Fractures in Children: 2011 Update. Visiting Professor , Presented at St.Luke’s Roosevelt, New York, N.Y., June 2011.Beaty, Jim. Elbow Fractures: Treatments and Complications. Visiting Professor, Presented atthe University of California, San Francisco, Calif., June 2011.Beaty, Jim. Journal Club – SCFE, Elbow and Femur Fractures. Visiting Professor, Presented atthe University of California, San Francisco, Calif., June 2011.Beaty, Jim. The Orthopaedic Life and Career. Visiting Professor, Presented at the University ofCalifornia, San Francisco, Calif., June 2011.Beaty, Jim. Sports Injuries of the Foot and Ankle in Children. Presented at the Pediatric OrthopaedicSymposium, Le Bonheur Children’s Hospital, Memphis, Tenn., Nov. 5, 2011.Beaty, Jim. Legg Calve Perthes Disease: Treatment and Controversies. Presented at the Pediatric Orthopaedic Symposium, Le Bonheur Children’s Hospital, Memphis, Tenn., Nov. 5, 2011.Beaty, Jim. The Orthopaedic Alphabet and Leadership 25 Annual Grice Day. Presented atBoston Children’s Hospital, Boston, Nov. 9, 2011.Beaty, Jim. Developing Teaching Skills to Enhance Learning. Presented at the AmericanAcademy of Orthopaedic Surgeons, San Diego, Calif., February 2011.Beaty, Jim. The Orthopaedic Lecture. Presented at the American Academy of OrthopaedicSurgeons, Annual Meeting, New Orleans, La., March 9-12, 2010.Beaty, Jim. Fractures of the Lower Extremity in Children - Staying out of Trouble. Presented atthe American Academy of Orthopaedic Surgeons, Annual Meeting,New Orleans, La., March 9-12, 2010.Beaty, Jim. Fractures of the Shoulder in the Adolescent Athlete. Presented at the American Academy of Orthopaedic Surgeons, Annual Meeting, New Orleans, La., March 9-12, 2010.Beaty, Jim. Elbow Fractures in Children – What is Really New. Visiting Professor, Presented geof Georgia, Augusta, Ga., Nov. 19-22, 2009.Beaty, Jim. Musculoskeletal Infections in Children and Adolescents: Current Concepts.Visiting Professor, Presented at the Medical College of Georgia, Augusta, Ga.,Nov. 19-22, 2009.Beaty, Jim. Tarsal Coalition: Diagnosis and Treatment Visiting Professor. Presentedat the Medical College of Georgia, Augusta, Ga., Nov. 19-22, 2009.Beaty, Jim. Pediatric Fractures – What is Really New? Visiting Professor, Presented at thePhiladelphia Orthopaedic Society – Howard Steele, Philadelphia, Pa., Oct., 5, 2009.Beaty, Jim. Fractures of the Hip in Children and Adolescents. Visiting Professor, Presented atthe Drexel Department of Orthopaedics, Oct. 5, 2009.Beaty, Jim. Fractures About the Elbow in Children – Treatment and Complications 2009.Visiting Professor, Presented at the Carolina’s Medical Center, Charlotte, N.C., June 19, 2009.Beaty, Jim. Changes in the Academic and Private Practice Arena. Presented at the American Academy of Orthopaedic Surgeons, Board of Directors, Rosemont, Ill.,May 13-16, 2009.Beaty, Jim. The Asheville Forum Physician Perspective. Presented at the AmericanAcademy of Orthopaedic Surgeons, Board of Directors, New York, NY, May 2009Beaty, Jim. Leadership Qualities and Initiatives. Presented at the American Academy ofOrthopaedic Surgeons, Rosemont, Ill, Oct. 15-17, 2009.Beaty, Jim. Pediatric Orthopaedic Trauma Now and the Futur.e Presented at the PediatricOrthopaedic Society of North America Annual Meeting, Boston, Mass., April 29, 2009.Beaty, Jim. Emergency Call issues. Presented at the AOA Symposium: Current PediatricOrthopaedic Issues – A Small Window into Global Orthopaedic Issues, June 11 2009.

William C. Warner Jr., MDWarner, W.C., Sawyer, J.R., Kelly, D.M., Rush, Scott, S. Magnetic Resonance and Computed Tomography Roles in Spondylolysis Diagnosis. Presented at the American Academy of Orthopaedic Surgeons, Chicago, Ill., March 2013. Warner, W.C., Sawyer, J.R., Kelly, D.M., Beaty, J.H., Larsen, Moisan, Witte, Elzey. Medial Ulnar Collateral Ligament Origin on the Medial Epicondylar Apophysis in the Skeletally Immature Elbow: An MRI Anatomical Study. Presented at the American Academy of Orthopaedic Surgeons, Chicago, Ill., March 2013. Warner, W.C., Sawyer, J.R., Kelly, D.M., Beaty, J.H., Larsen, Moisan, Witte, Elzey. Medial Ulnar Collateral Ligament Origin on the Medial Epicondylar Apophysis in the Skeletally Immature Elbow: An MRI Anatomical Study. Poster presented at POSNA annual meeting, Toronto, Ontario, May 2013.Warner, W.C., Sawyer, J.R., Kelly, D.M., Rush, Scott, S. Magnetic Resonance and Computed Tomography Roles in Spondylolysis Diagnosis. ePoster presented at POSNA annual meeting, Toronto, Ontario, May 2013.Warner, W.C., Sawyer, J.R., Spence, D., Kelly, D.M., Beaty, J.H., Pretell, Murphy, Moisan. Surgical Treatment of Symptomatic Accessory Navicular in Children and Adolescent: Is Simple Excision Enough? ePoster presented at POSNA annual meeting, Toronto, Ontario, May 2013.Warner, W.C., Astur, Klimo, Sawyer, Kelly, Muhlbauer. Traumatic Atlanto-Occipital Dislocation in Children: Evaluation, Treatment and Outcomes. ePoster presented at POSNA annual meeting, Toronto, Ontario, May 2013.Warner, W.C., Astur, N., Flynn, J.M., Glotzbecker, M., van Bosse, H.J., Hoashi, J.S., d’Amato, C.R., Moisan, A., Kelly, D.M., Sawyer, J.R. The Efficacy of Rib-Based Distraction with VEPTR in Treatment of Early Onset Scoliosis in Patients with Arthrogryposis. Presented at XIV Brazilian Spine Society, Florianópolis, SC, Brazil, April 27 – 30, 2013. Warner, W.C., Klimo, P., Astur, N., Gabrick, K., Muhlbauer, M.S., Occipitocervical fusion using a contoured rod and wire construct in children: a reappraisal of a vintage technique. Presented at XIV Brazilian Spine Society, Florianópolis, SC, Brazil, April 27 – 30, 2013.Warner, W.C., Cannon, Astur, Kelly, Sawyer. Characterization of Radiation Exposure in Early Onset Scoliosis Patients Treated with the Vertical Expandable Prosthetic Titanium Rib. ePoster presented at XIV Brazilian Spine Society, Florianópolis, SC, Brazil, April 27 – 30, 2013.Warner, W.C., Occipitocervical fusion in children using wires and Luque rod construct: a 20-year review. Presented at the American Society of Pediatric Neurosurgeons, February 2012.Warner, W.C., Astur, N., Flynn, J.M., Glotzbecker, M., Van Bosse, H.J., Hoashi, J.S., d’Amato, C.R., Moisan, A., Kelly, D., Sawyer, J.R., The Efficacy of VEPTR in Treating Patients with EOS and TIS and Arthrogryposis. Presented at International Meeting on Advanced Spine Techniques, Istanbul, Turkey, Summer 2012.Warner, W. C., Sawyer, J.R., Kelly, D. M., Murphy, R. Case report of 2 subjects with broken SCFE screws. Presented at the American Academy of Pediatrics, New Orleans, La., October 2012.Warner, W.C., Beaty, J., Kelly, D., Sawyer, J.R., Grear, B. Factors Affecting Research Subject Return Rate in Pediatric Orthopaedic Retrospective Review Studies. Presented at American Academy of Pediatrics, New Orleans, La., October 2012.Warner, W.C., Beaty, J., Spence, D., Stranch, E., Miller, J., Kelly, D.M., Sawyer, J.R., Retrospective chart and x-ray review of Intramedulary Nailing of Pediatric Femur Fractures in Children Less Than Twelve Years of Age. Presented at Pediatric Orthopaedic Society of North America, Denver, Colo., May 2012.Warner, W.C., Beaty, J., Brey, J., Conoley, J., Canale, S.T., Kelly, D.M., Sawyer, J.R. Tibial tuberosity fractures in adolescents: is a posterior metaphyseal fracture component a predictor of complications? Presented at Pediatric Orthopaedic Society of North America, Denver, Colo., May 2012.Warner, W.C., Beaty, J., Brey, J., Conoley, J., Canale, S.T., Kelly, D.M., Sawyer, J.R. Tibial tuberosity fractures in adolescents: is a posterior metaphyseal fracture component a predictor of complications? Presented at American Academy of Orthopaedic Surgeons, San Francisco, Calif., February 2012.WCWarner, PKlimo, NAstur Neto, MMuhlbauer (2012) “Occipitocervical Fusion Using aContoured Rod and Wire Construct in Children: A Reappraisal of a Vintage Technique”American Society of Pediatric Neurosurgeons, JNS: PediatricsWarner, William. Medial epicondyle fracture. Presented at POSNA annual meeting.Waikola Hawaii, 2010.Warner, William. MRSA update. Presented at POSNA annual meeting. Albuquerque, N.M., 2008.

Jeffrey R. Sawyer, MDSawyer, J.R., Warner, W.C., Kelly, D.M., Rush, Scott, S. Magnetic Resonance and Computed Tomography Roles in Spondylolysis Diagnosis. Presented at the American Academy of Orthopaedic Surgeons, Chicago, Ill., March 2013. Sawyer, J.R., Warner, W.C., Kelly, D.M., Beaty, J.H., Larsen, Moisan, Witte, Elzey. Medial Ulnar Collateral Ligament Origin on the Medial Epicondylar Apophysis in the Skeletally Immature Elbow: An MRI Anatomical Study. Presented at the American Academy of Orthopaedic Surgeons, Chicago, Ill., March 2013.

Sawyer, J.R., Warner, W.C., Kelly, D.M., Beaty, J.H., Larsen, Moisan, Witte, Elzey. Medial Ulnar Collateral Ligament Origin on the Medial Epicondylar Apophysis in the Skeletally Immature Elbow: An MRI Anatomical Study. Poster presented at POSNA annual meeting, Toronto, Ontario, May 2013.Sawyer, J.R., Warner, W.C., Kelly, D.M., Rush, Scott, S. Magnetic Resonance and Computed Tomography Roles in Spondylolysis Diagnosis. ePoster presented at POSNA annual meeting, Toronto, Ontario, May 2013.Sawyer, J.R., Warner, W.C., Spence, D., Kelly, D.M., Beaty, J.H., Pretell, Murphy, Moisan. Surgical Treatment of Symptomatic Accessory Navicular in Children and Adolescent: Is Simple Excision Enough? ePoster presented at POSNA annual meeting, Toronto, Ontario, May 2013.Sawyer, Warner, W.C., Astur, Klimo, Kelly, Muhlbauer. Traumatic Atlanto-Occipital Dislocation in Children: Evaluation, Treatment and Outcomes. ePoster presented at POSNA annual meeting, Toronto, Ontario, May 2013.Sawyer, J.R., Warner, W.C., Astur, N., Flynn, J.M., Glotzbecker, M., van Bosse, H.J., Hoashi, J.S., d’Amato, C.R., Moisan, A., Kelly, D.M., The Efficacy of Rib-Based Distraction with VEPTR in Treatment of Early Onset Scoliosis in Patients with Arthrogryposis. Presented at XIV Brazilian Spine Society, Florianópolis, SC, Brazil, April 27 – 30, 2013. Sawyer, Warner, W.C., Cannon, Astur, Kelly. Characterization of Radiation Exposure in Early Onset Scoliosis Patients Treated with the Vertical Expandable Prosthetic Titanium Rib. ePoster presented at XIV Brazilian Spine Society, Florianópolis, SC, Brazil, April 27 – 30, 2013.Sawyer, J.R., Warner, W.C., Astur, N., Flynn, J.M., Glotzbecker, M., Van Bosse, H.J., Hoashi, J.S., d’Amato, C.R., Moisan, A., Kelly, D., The Efficacy of VEPTR in Treating Patients with EOS and TIS and Arthrogryposis. Presented at International Meeting on Advanced Spine Techniques, Istanbul, Turkey, Summer 2012.Sawyer, J.R., Warner, W. C., Kelly, D. M., Murphy, R. Case report of 2 subjects with broken SCFE screws. Presented at the American Academy of Pediatrics, New Orleans, La., October 2012.Sawyer, J.R., Beaty, J., Kelly, D., Warner, W.C., Grear, B. Factors Affecting Research Subject Return Rate in Pediatric Orthopaedic Retrospective Review Studies. Presented at American Academy of Pediatrics, New Orleans, La., October 2012.Sawyer, J.R., Beaty, J., Spence, D., Stranch, E., Miller, J., Kelly, D.M., Warner, W.C. Retrospective chart and x-ray review of Intramedulary Nailing of Pediatric Femur Fractures in Children Less Than Twelve Years of Age. Presented at Pediatric Orthopaedic Society of North America, Denver, Colo., May 2012.Sawyer, J.R., Beaty, J., Brey, J., Conoley, J., Canale, S.T., Warner, W.C., Kelly, D.M. Tibial tuberosity fractures in adolescents: is a posterior metaphyseal fracture component a predictor of complica-tions? Presented at Pediatric Orthopaedic Society of North America, Denver, Colo., May 2012.Sawyer, J.R., Backstrom, I.C., Maclennan, P.A., Creek, A.T., Rue, L.W., Gilbert, S.R. Pediatric obesity and traumatic lower-extremity long-bone fracture outcomes. Presented at American Academy of Orthopaedic Surgeons, San Francisco, Calif., February 2012. Sawyer, J.R., Beaty, J., Brey, J., Conoley, J., Canale, S.T., Warner, W.C., Kelly, D.M. Tibial tuberosity fractures in adolescents: is a posterior metaphyseal fracture component a predictor of complications? Presented at American Academy of Orthopaedic Surgeons, San Francisco, Calif., February 2012. Sawyer JR, Kelly DM, Canale, ST, Brey, Jennifer, Conoley, J (May 2012): Salter Harris Ii Fractures of the Posterior Tibia Associated with Tibial Tuberosity Fractures: A Marker for Potentially SeriousComplications. Pediatric Orthopaedic Society of North AmericaSawyer JR, Kelly DM,Canale, ST, Brey, Jennifer, Conoley, J (February 2012): Salter Harris Ii Fracturesof the Posterior Tibia Associated with Tibial Tuberosity Fractures: A Marker for Potentially SeriousComplications. American Academy of Orthopaedic Surgeons.Sawyer JR, Kelly DM, Warner Jr, WC, NAN, TCannon (2012): “Characterization of Radiation Exposurein Early Onset Scoliosis Patients treated with the Vertical Expandable Prosthetic Titanium Rib(VEPTR). Scoliosis Research Society.Sawyer JR, Kelly DM, Warner Jr, WC, Guevara BG, Thompson NB (2011) High Prevalence ofAssociated Injuries in Children with Spinal Fractures. American Academy of Orthopaedic Surgeons.Sawyer JR, Beaty JH (2011) Staying Out of Trouble in Pediatric Orthopaedics. AmericanAcademy of Orthopaedic Surgeons.Sawyer JR, Kelly DM, Warner Jr, WC, Beaty JH, Canale ST (2011) The Kickstand Technique toPromote Elevation and Wound Care in Pediatric Lower Extremity Injuries. American Academyof Orthopaedic Surgeons.Sawyer JR, Guevara B, Thompson N, Dawkins R, Kelly DM, Warner Jr, WC (2011) HighPrevalence of Associated Injuries in Children with Spinal Fractures. American Academy ofOrthopaedic Surgeons.Sawyer JR, Beebe M, Thompson N, Creek A, Kelly DM, Warner Jr, WC, Beaty JH (2011)Age-Related Patterns of Spine Injuries Following ATV Accidents in Children. American Academyof Orthopaedic Surgeons.Sawyer JR, Warner Jr, WC, Kelly DM, Rachel JN, Williams JB (2011) Is Radiographic EvaluationNecessary in Children with a Clinical Diagnosis of Calcaneal Apophysitis (Sever Disease)?American Academy of Orthopaedic Surgeons.Sawyer JR, Guevara B, Thompson N, Dawkins R, Kelly DM, Warner Jr WC (2011) HighPrevalence of Associated Injuries in Children with Spinal Fractures. International Meeting onAdvanced Spinal Techniques.Sawyer JR, Warner Jr WC, Freeman B, Jaquith BJ, Flinn PO, Chase A, Kelly DM (2011) Cost Comparison of Thoracic Pedicle Screw Fixation vs Hook Construct for Deformity Correction in Adolescent Idiopathic Scoliosis. International Meeting on Advanced Spinal Techniques.Sawyer, Jeff. AO Basic Spinal Surgery for Operating Room Personnel. Houston, Texas, January 2011.Sawyer, Jeff. AAOS Orthopaedic Board Review: Infections, Congenital, Miscellaneous.San Diego, Calif., February 2011.Sawyer, Jeff. AAOS Instructional Course Lecture: Staying out of Trouble in Pediatric Orthopaedics.San Diego, Calif., February 2011.Sawyer, Jeff. POSNA Specialty Day: Hip Fractures in Children. San Diego, Calif., February 2011.Sawyer JR, Kelly DM, Warner Jr, WC, Beaty JH, Canale ST (2011) The Kickstand Technique toPromote Elevation and Wound Care in Pediatric Lower Extremity Injuries. American Academyof Orthopaedic Surgeons.Sawyer JR, Guevara B, Thompson N, Dawkins R, Kelly DM, Warner Jr WC (2011) HighPrevalence of Associated Injuries in Children with Spinal Fractures. American Academy ofOrthopaedic Surgeons.Sawyer JR, Beebe M, Thompson N, Creek A, Kelly DM, Warner Jr. WC, Beaty JH (2011)“Age-Related Patterns of Spine Injuries Following ATV Accidents in Children”. AmericanAcademy of Orthopaedic Surgeons Rachel JN, Williams JB, Sawyer JR, Warner Jr WC, KellyDM (2011) Is Radiographic Evaluation Necessary in Children with a Clinical Diagnosis ofCalcaneal Apophysitis (Sever Disease)? American Academy of Orthopaedic Surgeons.Sawyer JR, Kelly DM, Warner Jr, WC, Guevara BG, Thompson NB. (2011) High Prevalence of Associated Injuries in Children with Spinal Fractures. American Academy of OthopaedicSurgeons.Sawyer JR, Beaty JH. (2011) Staying Out of Trouble in Pediatric Orthopaedics. AmericanAcademy of Orthopaedic Surgeons.Sawyer JR, Kelly DM, Warner Jr, WC, Beaty JH, Canale ST (2011) The Kickstand Techniqueto Promote Elevation and Wound Care in Pediatric Lower Extremity Injuries. AmericanAcademy of Orthopaedic Surgeons.Sawyer JR, Guevara B, Thompson N, Dawkins R, Kelly DM, Warner Jr, WC. (2011) HighPrevalence of Associated Injuries in Children with Spinal Fractures. American Academy ofOrthopaedic Surgeons.Sawyer JR, Beebe M, Thompson N, Creek A, Kelly DM, Warner Jr, WC, Beaty JH. (2011)“Age-Related Patterns of Spine Injuries Following ATV Accidents in Children”. AmericanAcademy of Orthopaedic SurgeonsSawyer JR, Warner Jr, WC, Kelly DM, Rachel JN, Williams JB. (2011) Is RadiographicEvaluation Necessary in Children with a Clinical Diagnosis of Calcaneal Apophysitis(Sever Disease)? American Academy of Orthopaedic Surgeons.Sawyer JR, Bernard M, Kelly DM, Warner Jr, WC, Beaty JH. (2010) “Trends in Spine InjuryCaused by All-Terrain Vehicle Accidents”. Orthopaedic Trauma Association.Sawyer JR, Ivie C, Shroeder J, Beaty JH, Kelly DM, Warner Jr, WC, Canale ST, Huff A.(2009) Unplanned Return to the Emergency Room Following Treatment in a BusyFracture Clinic. Orthopaedic Trauma Association.Sawyer JR, Bernard M, Kelly DM, Warner Jr, WC, Beaty JH. (2010) “Trends in Spine InjuryCaused by All-Terrain Vehicle Accidents”. American Academy of Orthopaedic Surgeons.Sawyer J, Pershad J, Williams S, Wan J. (2010) “Closed Manipulation and CastImmobilization of Distal Radius Fractures by Pediatric Emergency Room Physicians.American Academy of Orthopaedic Surgeons.Sawyer JR, Rhodes L, Beaty JH, Canale ST, Kelly DM, Warner Jr, WC. (2010) Diagnosis andTreatment of Perthes Disease. American Academy of Orthopaedics – National Association ofOrthopaedic Nurses Section.Sawyer JR, Bernard M, Kelly DM, Warner Jr, WC, Beaty JH: (2010) “Trends in Spine InjuryCause by All-Terrain Vehicle Accidents”. Pediatric Orthopaedic Society of North America.Sawyer J, Pershad J, Williams S, Wan J, (2010) “Closed Manipulation and CastImmobilization of Distal Radius Fractures by Pediatric Emergency Room Physicians.Pediatric Orthopaedic Society of North America.Sawyer JR, Beebe M, Thompson N, Creek A, Kelly DM, Warner Jr, WC, Beaty JH (2010)“Age-Related Patterns of Spine Injuries Following ATV Accidents in Children”. PediatricOrthopaedic Society of North America.Sawyer JR, Rhodes LN, Kelly DM, Messman L, Warner Jr, WC, (2010) Pediatric FractureClinics: Current Status and Future Directions. Pediatric Orthopaedic Practitioners Society.Sawyer JR, Rhodes L, Beaty JH, Canale ST, Kelly DK, Warner Jr, WC (2010) Classification,Diagnosis and Treatment of Perthes Disease. Pediatric Orthopaedic Practitioners Society.Sawyer JR, Smith JT, Wade J, D’Amato C, Campbell R, Vitale M (2010) Does Rib-BasedDistraction Control Curve Progression and Prevent Parasol Deformity of the Chest inScoliosis Associated with Congenital Myopathy? 4th International Congress onEarly Onset Scoliosis.Sawyer JR, Conoley J, Beaty JH, Warner Jr, WC, Canale ST (2009) “Surgically Treated TibialTuberosity Fractures in Adolescents”. Pediatric Orthopaedic Society of North America.

Sawyer JR, Ivie C, Shroeder J, Beaty JH, Kelly DM, Warner Jr, WC, Canale ST, Huff A.(2009) Unplanned Return to the Emergency Room Following Treatment in a BusyFracture Clinic. Pediatric Orthopaedic Society of North America.Sawyer JR, Rudloff M, Shroeder J, Gehrig, J (2009) “Are Fracture Patterns Sustainedby Children Involved in Motor Vehicle Accidents Affected by Age or Obesity?” PediatricOrthopaedic Society of North America.Sawyer JR, Younas S, Benz CA, Warner Jr, WC, Kelly DM, (2009) “Factors InfluencingBlood Loss in Adolescent Idiopathic Scoliosis Patients Undergoing Posterior SpinalFusion with Instrumentation. International Meeting of Advanced Spinal Techniques.Sawyer JR, Crenshaw WC, Younas S, Kelly DM, Warner Jr, WC, Muhlbauer MS (2009)“Characterization of Spine Injuries from a Regional Trauma Center” InternationalMeeting of Advanced Spinal Techniques.Sawyer JR, Bernard M, Kelly DM, Warner Jr, WC, Beaty JH: (2009) “Trends in Spine InjuryCaused by All-Terrain Vehicle Accidents 1997-2006”. International Meeting for AdvancedSpinal Techniques.Sawyer JR, Conoley J, Beaty JH, Warner Jr, WC, Canale ST (2009) “Surgically Treated TibialTuberosity Fractures in Adolescents”. Orthopaedic Trauma Association.

Derek Kelly, MDKelly, D.M., Sawyer, J.R., Warner, W.C., Rush, Scott, S. Magnetic Resonance and Computed Tomography Roles in Spondylolysis Diagnosis. Presented at the American Academy of Orthopaedic Surgeons, Chicago, Ill., March 2013. Kelly, D.M., Sawyer, J.R., Warner, W.C., Beaty, J.H., Larsen, Moisan, Witte, Elzey. Medial Ulnar Collateral Ligament Origin on the Medial Epicondylar Apophysis in the Skeletally Immature Elbow: An MRI Anatomical Study. Presented at the American Academy of Orthopaedic Surgeons, Chicago, Ill., March 2013. Kelly, D.M., Sawyer, J.R., Warner, W.C., Beaty, J.H., Larsen, Moisan, Witte, Elzey. Medial Ulnar Collateral Ligament Origin on the Medial Epicondylar Apophysis in the Skeletally Immature Elbow: An MRI Anatomical Study. Poster presented at POSNA annual meeting, Toronto, Ontario, May 2013.Kelly, D.M., Sawyer, J.R., Warner, W.C., Rush, Scott, S. Magnetic Resonance and Computed Tomography Roles in Spondylolysis Diagnosis. ePoster presented at POSNA annual meeting, Toronto, Ontario, May 2013.Kelly, D.M., Sawyer, J.R., Warner, W.C., Spence, D., Beaty, J.H., Pretell, Murphy, Moisan. Surgical Treatment of Symptomatic Accessory Navicular in Children and Adolescent: Is Simple Excision Enough? ePoster presented at POSNA annual meeting, Toronto, Ontario, May 2013.Kelly, Sawyer, Warner, W.C., Astur, Klimo, Muhlbauer. Traumatic Atlanto-Occipital Dislocation in Children: Evaluation, Treatment and Outcomes. ePoster presented at POSNA annual meeting, Toronto, Ontario, May 2013.Kelly, D., Warner, W.C., Astur, N., Flynn, J.M., Glotzbecker, M., Van Bosse, H.J., Hoashi, J.S., d’Amato, C.R., Moisan, A., Sawyer, J.R. The Efficacy of VEPTR in Treating Patients with EOS and TIS and Arthrogryposis. Presented at International Meeting on Advanced Spine Techniques, Istanbul, Turkey, Summer 2012.Kelly, D. M., Warner, W. C., Sawyer, J.R., Murphy, R. Case report of 2 subjects with broken SCFE screws. Presented at the American Academy of Pediatrics, New Orleans, La., October 2012.Kelly, D., Beaty, J., Sawyer, J.R., Warner, W.C., Grear, B. Factors Affecting Research Subject Return Rate in Pediatric Orthopaedic Retrospective Review Studies. Presented at American Academy of Pediatrics, New Orleans, La., October 2012.Kelly, D.M., Beaty, J., Spence, D., Stranch, E., Miller, J., Sawyer, J.R., Warner, W.C. Retrospective chart and x-ray review of Intramedulary Nailing of Pediatric Femur Fractures in Children Less Than Twelve Years of Age. Presented at Pediatric Orthopaedic Society of North America, Denver, Colo., May 2012.Kelly, D.M., Beaty, J., Brey, J., Conoley, J., Canale, S.T., Warner, W.C., Sawyer, J.R. Tibial tuberosity fractures in adolescents: is a posterior metaphyseal fracture component a predictor of complications? Presented at Pediatric Orthopaedic Society of North America, Denver, Colo., May 2012.Kelly, D.M., Beaty, J., Brey, J., Conoley, J., Canale, S.T., Warner, W.C., Sawyer, J.R. Tibial tuberosity fractures in adolescents: is a posterior metaphyseal fracture component a predictor of complications? Presented at American Academy of Orthopaedic Surgeons, San Francisco, Calif., February 2012.Kelly, DM, Sawyer, JR., Canale, ST, Brey, Jennifer, Conoley, J (May 2012): Salter Harris IiFractures of the Posterior Tibia Associated with Tibial Tuberosity Fractures: A Marker forPotentially Serious Complications. Pediatric Orthopaedic Society of North AmericaKelly, DM, Sawyer, JR., Canale, ST, Brey, Jennifer, Conoley, J (February 2012): Salter HarrisIi Fractures of the Posterior Tibia Associated with Tibial Tuberosity Fractures: A Marker forPotentially Serious Complications. American Academy of Orthopaedic Surgeons.Kelly DM, Sawyer JR, , Warner Jr, WC, NAN, TCannon (2012): “Characterization of RadiationExposure in Early Onset Scoliosis Patients treated with the Vertical Expandable ProstheticTitanium Rib (VEPTR). Scoliosis Research Society.Kelly, Derek. Newborn Foot Deformities: Emerging Systems of Care for Children. Presented atthe Etteldorf Symposium., Memphis, Tenn., May 21, 2011.Kelly, Derek. Five Pediatric Orthopedic Problems That Should Get You Out of Bed at Night.Septic Hip. Presented at the AAOS/POSNA Webinar, Oct. 18, 2011.Kelly, Derek. Pediatric Sports Injuries: Which Injuries Should Sideline Your Kids. Presented at the 10thAnnual Update Acute and Emergency Care Pediatrics, Memphis, Tenn., Oct. 21-22, 2011.Kelly, Derek. Newborn Flatfeet: What to Treat and What to Refer. Presented at the Le BonheurPediatric Orthopedic Update, Memphis, Tenn., November 2011.Kelly, Derek. Hip Preservation in the Adolescent: Surgical Dislocation and Ganz Periacetabular Osteotomy. Presented at the Le Bonheur Pediatric Orthopedic Update, Memphis, Tenn., November 2011.Katz, D. E., Herring, J. A., Browne, R.H., Kelly, D. M., & Birch, J. G. Brace TreatmentControls Progression in Adolsecent Idiopathic Scoliosis. Best Clinical Paper Award.Presented at POSNA, Waikoloa, Hawaii, 2010.Herring, J. A., Sucato, D.J., Larson, A. N., DeLaRocha, A., Adolfsen, S., Kelly, D.M.,Martus, J.E., & Lovejoy, J.F. Prospective Multicenter Study of Legg-Calve- Perthes Disease:Functional and Radiographic Outcomes of Nonoperative Treatment in the Third Decade.Presented at POSNA, Waikoloa, Hawaii, 2010.Sawyer, J. R., Beebe, M. J., Creek, A. T., Thompson, N., Yantis, M. G., Kelly, D. M., &Warner, W. C. Age-Related Patterns of Spine Injury Following All-Terrain Vehicle Accidents inChildren and Adolsecents (E-Poster). Presented at POSNA, Waikoloa, Hawaii, 2010.Kelly, Derek. Scoliosis. Presented at the National Meeting of the ASOPA/NAOT (AmericanSociety of Orthopedic Physician Assistants and National Association of OrthopedicTechnicians). Memphis, Tenn., August 2009.

David Spence, MD Spence, D., Kelly, D.M., Sawyer, J.R., Warner, W.C., Beaty, J.H., Pretell, Murphy, Moisan. Surgical Treatment of Symptomatic Accessory Navicular in Children and Adolescent: Is Simple Excision Enough? ePoster presented at POSNA annual meeting, Toronto, Ontario, May 2013.David D. Spence, MD; Jon Paul DiMauro, MD; Patricia Miller, MS; Michael P. Glotzbecker, MD; Daniel Hedequist, MD; Benjamin J. Shore, MD. Avascular Necrosis after Femoral Neck Fracture: Analysis of Risk Factors. Presented at POSNA annual meeting, Toronto, Ontario, May 2013.David D. Spence, MD; Jon Paul DiMauro, MD; Michael P. Glotzbecker, MD; Samantha A. Spencer, MD; Daniel Hedequist, MD; Benjamin J. Shore, MD, FRCSC. External Fixation for Pediatric Diaphyseal Tibia Fractures: A Comparison between Taylor Spatial Frame and Uniplanar External Fixation. ePoster presented at POSNA annual meeting, Toronto, Ontario, May 2013. Spence, D., Beaty, J., Stranch, E., Miller, J., Kelly, D.M., Sawyer, J.R., Warner, W.C. Retrospective chart and x-ray review of Intramedulary Nailing of Pediatric Femur Fractures in Children Less Than Twelve Years of Age. Presented at Pediatric Orthopaedic Society of North America, Denver, Colo., May 2012.

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