Modern Ortho of NJ - In the OR

Modern Ortho of NJ - In the OR caution: GRAPHIC CONTENT

Modern Ortho of NJ In the OR brings you into our OR and gives you a birds-eye view of exactly what we do!

Humerus fractureThis woman had fallen the year before and broke her elbow. She had recovered well but fell again with a...
10/18/2024

Humerus fracture
This woman had fallen the year before and broke her elbow. She had recovered well but fell again with a new fracture over the plate. After a trial of nonop which failed, she had the humerus fixed top to bottom and one of the distal plates removed. I used cables up top around her shoulder replacement. The radial nerve was identified and I slid the plate under it. You can see the nerve in the photo.

Fracture healed well with no pain, and the radial nerve works! She is thrilled with the result.




Lacertus Syndrome can sneak up on you!You’ve probably heard of carpal tunnel syndrome, but do you know about lacertus sy...
12/14/2023

Lacertus Syndrome can sneak up on you!

You’ve probably heard of carpal tunnel syndrome, but do you know about lacertus syndrome? Sometimes also referred to as pronator syndrome, this proximal median nerve compression at the elbow can be a reason why a carpal tunnel release alone doesn’t fully alleviate symptoms of numbness and tingling in the thumb, index, and middle fingers.

Additionally, this more proximal median nerve compression higher “upstream” can result in weakness in thumb and index finger flexion.

With a simple lacertus release procedure (picture 2 & 3), the weakness and numbness will typically resolve entirely!!




This is a young woman with a severe wrist injury at work. Fracture-dislocation of the wrist and very unstable after red...
12/06/2023

This is a young woman with a severe wrist injury at work. Fracture-dislocation of the wrist and very unstable after reduction.

I opened it up and the palmar ligaments sheared off the rim of bone with little fragments. I repaired the capsular shear and held the bone/capsule in place with suture anchors. Because of the damage, I wanted to protect the ligament repairs so I added a temporary wrist spanning plate to support the reduction and the repairs for healing. I took the plate out after a few months.

Last photo is 5.5 months from the injury and she has no pain!

Dr. David Ratliff

07/29/2023

Total Elbow Replacement 💪

WARNING: Surgical video at END!

This is one of the more uncommon joint replacements, but for the right indications, it can greatly improve a person’s quality of life!

My patient here was ecstatic with his results within a week or so post-op. His arthritis was gone immediately, and at 4+ months out he feels like he has a brand new lease on life!🙌❤️

Peter DeNoble, MD
Modern Orthopaedics of New Jersey

Music: Beach
Musician: Jeff Kaale

06/16/2023

Trigger finger Release!

Peter DeNoble, MD

“Will my carpal tunnel come back?”ANSWER: Not usually - but the most common cause of “recurrent carpal tunnel syndrome” ...
04/28/2023

“Will my carpal tunnel come back?”

ANSWER: Not usually - but the most common cause of “recurrent carpal tunnel syndrome” is actually incomplete release! 😳

In this case, my patient had a general orthopedic surgeon release her carpal tunnel several years ago, but now she was suffering from a recurrence of her CTS symptoms. I noticed that her initial surgeon used an incision that more proximal than usual.

In this picture, take a look at what I found in her hand - AN INCOMPLETELY RELEASED CARPAL TUNNEL. You can actually see the advancing nerve that got caught up on the unreleased distal edge of the carpal tunnel!

As a patients, please understand that surgical expertise, whether it is hand/wrist surgery, nerve surgery, or hip and knee replacement is NOT a commodity skill. The “system” will tell you that, but use this type of case as a learning lesson! It is truly a speciality with tremendous risk with a spectrum of quality.

Carpal tunnel release surgery, while common, is highly risky, and can result in subpar results, possibly requiring re-operations.

If you have carpal tunnel syndrome, my recommendation is to find a dedicated hand surgeon who has added board-certification in surgery of the hand. This will likely maximize your chance of a having a great result, and will minimize the risks.




When will robotics and AI make their entry into hand surgery??This case made me wonder.This is a 16-year-old baseball pl...
04/08/2023

When will robotics and AI make their entry into hand surgery??

This case made me wonder.

This is a 16-year-old baseball player who took an errant hop to the throwing hand ring finger while fielding the ⚾️. He sustained this terrible intra-articular PIP fracture.

I percutaneously reduced the impacted intra-articular fracture and crafted an all-wire dynamic ex-fix ( technique).

But this made me wonder 🤔 - when will we see robotics make an entry into hand surgery?

During my career, will we see a robot that can reduce a fractured/displaced joint and meticulously apply this complex construct?

My knee-jerk reaction says no, but my better instincts tell me yes.

Thoughts??





**New orthopedic term**The “Pseudo Grashey view”Defined as: When the glenohumeral joint line can be visualized in an art...
02/24/2023

**New orthopedic term**

The “Pseudo Grashey view”

Defined as: When the glenohumeral joint line can be visualized in an arthritic shoulder on a standard AP shoulder X-ray (taken perpendicular to the plane of the body), indicating a severely retroverted glenoid (~40-45 degrees).

Pre-operative planning with software using the patient’s own pre-op CT scan is super helpful in achieving a great result in cases like these!

Augmented reality folks, should I become a deciple?




Rotator Cuff Tears can come in all shapes and sizes! ⏹️🔼⏺️This patient suffers from an anterosuperior rotator cuff tear-...
01/28/2023

Rotator Cuff Tears can come in all shapes and sizes! ⏹️🔼⏺️

This patient suffers from an anterosuperior rotator cuff tear-a combination of a supraspinatus tear with a subscapularis tear. This patient sustained this injury during a car accident.

Here is a great look at the subscapularis tear during the arthroscopic repair. Notice the frayed fibers and the red inflammation surrounding it.

Second pic is of the repaired subscapularis - done all through the scope via several 1cm incisions!




Lacertus Syndrome is REAL!- If your carpal tunnel release didn’t fully relieve your symptoms, or your carpal tunnel symp...
01/28/2023

Lacertus Syndrome is REAL!

- If your carpal tunnel release didn’t fully relieve your symptoms, or your carpal tunnel symptoms have returned after a release, make sure a hand surgeon takes a look at your median nerve “upstream” at your elbow!

- This tight band courses directly over the median nerve at the elbow and puts a squeeze on it!

- Compression from this tight band can sometimes cause weakness in the thumb and index finger, and numbness in the palm and the fingers (thumb, index, middle, ring).

- Releasing this tight band often results in INSTANT relief of weakness and numbness! 😎





ANGRY SHOULDERYou are looking at an IMPRESSIVE amount of shoulder synovitis surrounding the subscapularis tendon attachm...
10/20/2022

ANGRY SHOULDER

You are looking at an IMPRESSIVE amount of shoulder synovitis surrounding the subscapularis tendon attachment to the humeral head - seen best on a dry scope. 😳

When I first enter the shoulder joint during an arthroscopy, I like to look at the condition of the joint WITHOUT insufflating it with fluid. This shows me the inflammation in “full bloom”! 🌸

Once there is pressure inside the joint from fluid, the extent of the inflammation may not be so apparent.

This also helps me explain to my patients afterward why they had so much pain in their shoulder for so long!

In this case, the patient has a high-grade partial thickness supraspinatus tear that was causing this reactive inflammation throughout the front of the joint. The inflammation was removed, and the tendon repaired with a suture bridge construct.




Address

2025 Hamburg Turnpike, Ste C
Wayne, NJ
07470

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Monday 8:30am - 5pm
Tuesday 8:30am - 5pm
Wednesday 8:30am - 5pm
Thursday 8:30am - 5pm
Friday 8:30am - 5pm

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+19738985999

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