Dr. Mark Brinker, Houston Orthopedic Surgeon Articles RSS Feed

Case Report Calcaneogenesis

Fri, 01 May 2009 05:00:00 GMT

The Journal of Bone and Joint Surgery , Vol. 91-B, No. 5, May 2009

Author: M. R. Brinker, D. P. Loncarich, E. G. Melissinos, D. P. O’Connor

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1-May-09 0:00 AM

Management of Falls After Total Knee Arthroplasty

Sat, 01 Mar 2008 06:00:00 GMT

Orthopedics, Vol 31, No.3, March 2008

Author: Richard J. Kearns,MD, Mark R. Brinker,MD and Daniel P. O'Connor, PhD

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This study evaluated 78 patients who fell after total knee arthroplasty. Eight patients (10.3%) had soft-tissue injuries that led to a poor clinical course (deep infection, unplanned return to the operating room, temporary or permanent resection arthroplasty, or knee arthrodesis).

Factors related to a poor clinical course included copious bleeding from the surgical wound immediately after falling, falling within 8 weeks of arthroplasty, and rupturing the parapatellar surgical wound and quadriceps repair. Patients who fall and have bleeding from their surgical wound should receive emergency surgical irrigation and debridement. A treatment protocol for patients who fall after total knee arthroplasty is presented.

1-Mar-08 0:00 AM

Ilizarov Distraction Before Revision Hip Arthroplasty After Resection Arthroplasty With Profound Limb Shortening

Tue, 01 Jan 2008 06:00:00 GMT

The Journal of Arthroplasty Vol. 00 No. 0 2008

Author: Mark R. Brinker, MD, Daniel P. O'Connor, PhD, Vasilios Mathews, MD

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1-Jan-08 0:00 AM

Outcomes of Tibial Nonunion in Older Adults Following Treatment Using the Ilizarov Method

Mon, 01 Oct 2007 05:00:00 GMT

J Orthop Trauma, Vol. 2, No. 9, October 2007

Author: M.R. Brinker, MD and Daniel P.O O'Conner, PhD

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Objectives: To describe the functional outcomes of treatment using the Ilizarov method for tibial nonunions in older patients (.60 years of age).

Design: Prospective case series. Setting: Tertiary referral center.

Patients: Twenty-three consecutive patients with an average age of 72 years (61 to 92) who had tibial nonunions for an average duration of 13 months (3 to 46). Fourteen patients had an associated deformity and eight patients had infection.

Intervention: Ilizarov deformity correction, compression, or bone transport.

Main Outcome Measurements: Brief Pain Inventory, American Academy of Orthopaedic Surgeons (AAOS) Lower Limb Core Scale, Short Form (SF)-12, quality-adjusted life years.

Results: Three patients did not complete treatment: two patients died of cardiovascular disease during the treatment period and one patient demanded early removal of the Ilizarov device against medical advice. All 20 patients who completed treatment achieved bony union. Two of the 20 patients died before final follow-up, one patient was unable to participate in follow-up, and one patient was lost. At an average follow-up of 38 months (18 to 61), all of the remaining 16 patients were bearing full weight. AAOS Lower Limb Core Scale scores improved from 39 to 78 points (P , 0.001), pain intensity decreased from 3.6 to 0.9 (P = 0.001), SF-12 Physical Component Summary scores improved from 26.5 points to 35.3 points (P = 0.030), and SF-12 Mental Component Summary scores improved from 41.6 points to 48.7 points (P = 0.011). The improvement in quality of life is equivalent to 5.3 quality-adjusted life years per patient, which was larger than the average improvement in quality of life following total hip arthroplasty reported in published series.

Conclusions: Treatment using the Ilizarov method restored function and had a profoundly positive effect on quality of life in these elderly patients with tibial nonunions.

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1-Oct-07 0:00 AM

Metabolic and Endocrine Abnormalities in Patients With Nonunions

Sat, 01 Sep 2007 05:00:00 GMT

J Orthop Trauma, Vol 21, No.8, Sept 2007

Author: Mark R. Brinker, MD, Daniel P. O'Connor, PhD, Yomna T. Monla, MD, and Thomas P. Earthman, MD

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Objectives: To determine whether patients with unexplained nonunions, patients with a history of multiple low-energy fractures with at least one progressing to a nonunion, and patients with a nonunion of a nondisplaced pubic rami or sacral ala fracture would have an underlying metabolic or endocrine abnormality that had not been previously diagnosed.

Design: Case series.

Setting: Tertiary referral center. Patients and Intervention: From a larger series of 683 consecutive patients with nonunion seen by us between January 1998 and December 2005, 37 patients were referred to 1 of 2 clinically practicing endocrinologists to undergo an evaluation for metabolic and endocrine abnormalities. The screening criteriawere: 1) an unexplained nonunion that occurred despite adequate reduction and stabilization (and debridement in initially infected cases) without obvious technical error and without any other obvious etiology; 2) a history of multiple low-energy fractures with at least one progressing to a nonunion; or 3) a nonunion of a nondisplaced pubic rami or sacral ala fracture.

Results: In all, 31 of the 37 patients (83.8%, 95% CI: 71.3% to 93.8%) who met our screening criteria had one or more new diagnoses of metabolic or endocrine abnormalities. The most common newly diagnosed abnormality was vitamin D deficiency (25 of 37 patients; 68%). Other newly diagnosed abnormalities included calcium imbalances, central hypogonadism, thyroid disorders, and parathyroid hormone disorders. All newly diagnosed abnormalities were treated medically. Eight patients who underwent no operative intervention following the diagnosis and treatment of a new metabolic or endocrine abnormality achieved bony union in an average of 7.6 months (range, 3 to 12 months) following their first visit to the endocrinologist.

Conclusions: Although our study does not prove a causal link between metabolic and endocrine abnormalities and either the development or healing of nonunions, 84% of the patients who met our screening criteria were found to have metabolic or endocrine abnormalities, and eight of our patients achieved bony union following medical treatment alone. All patients with nonunion who meet our screening criteria should be referred to an endocrinologist for evaluation because they are likely to have undiagnosed metabolic or endocrine abnormalities that may be interfering with bone healing.

KeyWords: fractures, ununited, bone, hormone, calcium, vitamin D, hypogonadism

1-Sep-07 0:00 AM

Ilizarov Treatment of Infected Nonunions of the Distal Humerus After Failure of Internal Fixation: An Outcomes Study

Thu, 01 Mar 2007 06:00:00 GMT

J Orthop Trauma ,Vol. 21, Number 3, March 2007

Author: Mark R. Brinker,MD, Daniel P. O'Connor,PhD, C. Craig Crouch,MD, Thomas L. Mehlhoff,MD, and James B. Bennett,MD

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1-Mar-07 0:00 AM

Payer Type Has Little Effect on Operative Rate and Surgeons’ Work Intensity

Sun, 01 Oct 2006 05:00:00 GMT

Clinical Orthopaedics and Related Research, No. 451, pp.257-262 Oct 2006

Author: Mark R. Brinker,MD, Daniel P. O'Connor,PhD, Peggy Pierce,FACMPE and James Weston Spears,BCE

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1-Oct-06 0:00 AM

Nonunions of the Femoral Shaft and Distal Femur

Fri, 11 Aug 2006 05:00:00 GMT

Rozbruch, Vol. 11

Author: Mark R. Brinker,MD and Daniel P. O'Connor

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11-Aug-06 0:00 AM

CT Scan Helps Delineate Cervical Osteoid Osteoma and Atypical Nidus

Sat, 17 Sep 2005 22:00:00 GMT

The Journal of Bone and Joint Surgery

Robert L. Barrack, MD, Mark R. Brinker, BA, Stephen W. Burke, MD; and John M. Roberts, MD

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17-Sep-05 5:00 PM

Bilateral Femoral Neck Fractures After Pelvic Irradiation

Fri, 17 Sep 2004 22:00:00 GMT

The American Journal of Orthopedics

Howard R. Epps, MD, Mark R. Brinker, MD, and Daniel P. O'Connor, PhD

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17-Sep-04 5:00 PM

IIizarov Correction of Malrotated Femoral Shaft Fracture Initially Treated With an Intramedullary Nail: A Case Report

Fri, 17 Sep 2004 22:00:00 GMT

The American Journal of Orthopedics

Mark R. Brinker,MD,Joseph J. Gugenheim, MD, Daniel P. O'Connor, PhD,
and Jeffrey c. London,. MD

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17-Sep-04 5:00 PM

The Incidence of Fractures and Dislocations Referred for Orthopaedic Services in a Capitated Population

Sun, 01 Feb 2004 06:00:00 GMT

The Journal of Bone and Joint Surgery, Vol 86-A, No.2, Feb 2004

Author: Mark R. Brinker,MD and Daniel P. O'Connor, PhD

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1-Feb-04 0:00 AM

The Incidence of Fractures and Dislocations Referred for Orthopaedic Services in a Capitated Population

Sun, 01 Feb 2004 06:00:00 GMT

The Journal of Bone and Joint Surgery, Vol. 86-A, No. 2, February 2004

Author: M.R. Brinker, MD, and Daniel P. O'Conner, PhD

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Background: The purpose of this study was to determine the annual incidence rates of non-work-related traumatic fractures and dislocations (excluding head and facial injuries) referred for orthopaedic services in a large population enrolled under a capitated insurance contract.

Methods: The number of fractures and dislocations that were referred for orthopaedic services were recorded prospectively from among an average of 135,333 persons per year who were enrolled under a capitated insurance contract during the three-year study period. These data were used to determine the gender-specific and age-specific incidence rates of fractures and dislocations referred for orthopaedic services.

Results: A total of 3440 fractures and 422 dislocations were referred for orthopaedic services during the three-year study period. The incidence rate of fractures referred for orthopaedic services was 8.47 per 1000 member-years, with a significantly (p < 0.0001) higher rate among males. Members between the ages of ten and fourteen years had the highest rate of fractures referred for orthopaedic services (21.52 per 1000 member-years). The lifetime risk of a traumatic fracture referred for orthopaedic services to the age of sixty-five years was one in two for both males and females. The incidence rate of dislocations referred for orthopaedic services was 1.04 per 1000 member-years, which did not differ significantly (p = 0.75) between genders. Members between the ages of fifteen and nineteen years had the highest rate of dislocations referred for orthopaedic services (2.75 per 1000 member-years). The lifetime risk of a traumatic dislocation referred for orthopaedic services to the age of sixty-five years was one in sixteen for both male and female members.

Conclusions: Young males had the highest rate of traumatic fractures referred for orthopaedic services. Adolescents of both genders had high rates of traumatic dislocations referred for orthopaedic services. The lifetime risk of a nonwork- related fracture referred for orthopaedic services to the age of sixty-five years is approximately equal to that of coronary artery disease.

Level of Evidence: Prognostic study, Level II-1 (retrospective study). See Instructions to Authors for a complete descriptionof levels of evidence.

1-Feb-04 0:00 AM

The Effects of Femoral Shaft Malrotation on Lower

Thu, 01 Jan 2004 06:00:00 GMT

Journal of Orthopaedic Trauma, Vol. 18, No. 10, 2004

Author: Joseph J. Gugenheim, MD, Robert A. Probe, MD, and Mark R. Brinker, MD

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Objective: To determine how axial rotation around the anatomic axis of the femur, as would occur with malrotation of a femoral fracture, affects frontal and sagittal plane alignment and knee joint orientation. Design: Computer-generated models of the lower extremity were constructed using standardized dimensions. To simulate a malrotated fracture, these models were rotated in the shaft around the anatomic axis in 15° increments from 60° internal to 60° external rotation. Rotation was performed at the proximal fourth, mid-shaft, and distal fourth.

Main Outcome Measurements: At each rotational position, the mechanical axis deviation in millimeters and the changes in mechanical lateral distal femoral angle in degrees were measured to quantify frontal plane malalignment and malorientation, respectively. The mechanical axis deviation in millimeters in the sagittal plane was also measured at each rotatory position.

Results: Femoral shaft malrotation greater than 30° internal rotation of a subtrochanteric fracture or more than 45° of a midshaft fracture or external rotation of 30° or greater of a supracondylar fracture resulted in frontal plane malalignment. External rotation of a supracondylar fracture of 45° or more results in knee joint malorientation. Any external rotation at all 3 fracture levels caused posterior displacement of the weight-bearing axis in the sagittal plane.

Conclusions: Malrotation of a femoral shaft fracture is not just a cosmetic problem. Internal and external rotation causes malalignment and malorientation in the frontal plane, depending on the level of the fracture and the magnitude of malrotation. External rotation of any degree at the proximal fourth, mid-shaft, and distal fourth causes a posterior shift of the weight-bearing axis in the sagittal plane.

Key Words: malrotation, femur fracture, intramedullary nailing, malunion

1-Jan-04 0:00 AM

Ilizarov Compression Over a Nail for Aseptic Femoral Nonunions That Have Failed Exchange Nailing: A Report of Five Cases

Sat, 01 Nov 2003 05:00:00 GMT

J Orthop Trauma Volume 17, Number 10, November/December 2003

Author: Mark R. Brinker,MD, and Daniel P. O'Connor,PhD

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1-Nov-03 0:00 AM

Case Controversy: Proximal Tibia Fractur

Mon, 01 Sep 2003 05:00:00 GMT

Journal of Orthopaedic Trauma, Vol. 17, No. 8, September 2003

Author: M.R. Brinke, MD, Paul J. Duwelius, MD, William M. Ricci, MD

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Case Profile: Submitted by Paul Tornetta, III, MD
A 38-year-old man presents 48 hours after a motor vehicle accident in which he sustained a proximal tibia fracture (Fig. 1); it is a Tscherne type I closed fracture. The patient's neurovascular system is intact, and he has soft compartments

1-Sep-03 0:00 AM

Bone Realignment with Use of Temporary External Fixation for Distal Femoral Valgus and Varus Deformities

Tue, 01 Jul 2003 05:00:00 GMT

The Journal of Bone and Joint Surgery, Vol. 85-A, No. 7, July 2003

Author : Joseph J. Gugenheim Jr., MD, M.R. Brinker, MD

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Background:

Correction of a distal femoral deformity may prevent or delay the onset of osteoarthritis or mitigate its effects. Accurate correction of deformity without production of a secondary deformity depends on precise localization and quantification of the deformity. We report a technique to correct distal femoral deformities in the coronal plane.

Methods:

Fourteen femora in thirteen skeletally mature patients with a distal femoral deformity underwent operative reconstruction. The preoperative deviation of the mechanical axis ranged from 90 mm laterally (genu valgus) to 120 mm medially (genu varus). The mechanical lateral distal femoral angle was abnormal in all fourteen knees. The technique consisted of application of an external fixator, performance of a percutaneous distal femoral dome osteotomy, correction of the deformity, and locking of the external fixator. A statically locked retrograde intramedullary nail was inserted following reaming, and the external fixator was removed. The mean duration of follow-up was thirty-three months (range, six to forty-seven months).

Results:

The mean time until healing was thirteen weeks (range, six to thirty-nine weeks). Nine of the thirteen patients reported an improvement in walking, and none needed an assistive device. All nine patients with preoperative knee pain were free of tibiofemoral pain at the most recent follow-up evaluation. The mechanical lateral distal femoral angle was within the normal range in twelve of the fourteen knees. The mechanical axis was within the normal range in ten lower extremities. In three of the four remaining limbs, the residual abnormal deviation of the mechanical axis was due to a residual tibial deformity.

Conclusions:

Percutaneous dome osteotomy combined with temporary external fixation and insertion of an intramedullary nail can correct distal valgus and varus femoral deformities. We attributed the early mobilization of patients and the rapid bone-healing to the limited soft-tissue dissection, the low-energy corticotomy, and the use of intramedullary fixation in our surgical technique. Level of Evidence: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.

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1-Jul-03 0:00 AM

Utilization of Orthopaedic Services in a Capitated Population

Fri, 01 Nov 2002 05:00:00 GMT

The Journal of Bone & Joint Surgery Vol. 84-A No. 11 Nov 2002

Author: Mark R. Brinker, MD,Daniel P. O'Connor, MS, PT, ATC, Peggy Pierce, BBA, G. William Woods, MD, and Marc N. Elliot, PhD

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Background: The utilization rate for orthopaedic services (office visits and surgery) is not well known. The purpose of this study was to determine the utilization rates for orthopaedic office visits and surgical procedures in a large population of captured lives.

Methods: The study population comprised an average of 134,902 persons per month who were enrolled under a capitated insurance plan between January 1999 and December 1999. This plan was serviced by an independent physician association of sixty-two orthopaedic surgeons who were responsible for all orthopaedic care. Data were collected prospectively and stored in a centralized database. All analyses were conducted with use of monthly averages. Poisson regression was used to compare utilization rates and to calculate odds ratios in order to determine whether the utilization rates varied by age and gender.

Results: The highest proportions of office visits were due to fractures (21%), osteoarthritis (4%), meniscal tears (4%), and low-back pain or sciatica (4%). Knee arthroscopy (30%), foot and ankle procedures (10%), and spine procedures (9%) accounted for the highest proportions of surgical procedures. The overall utilization rates were 6.96 office visits and 1.99 surgical procedures per 1000 covered lives per month. Across all age groups, males and females did not differ with respect to the utilization rate for office visits (p = 0.42) or surgery (p = 0.09). Increased age was significantly related to increased utilization rates for office visits (p ≤ 0.0002) and surgery (p ≤ 0.002).

Conclusions: These data may be used to determine the size of a capitated population that an orthopaedic practice can accommodate, to determine the number of orthopaedic providers that is needed to provide services for a capitated population, and to estimate the expenses associated with providing orthopaedic services for a capitated population in an orthopaedic practice.

1-Nov-02 0:00 AM

The Use of Ilizarov External Fixation Following Failed Internal Fixation

Fri, 01 Nov 2002 05:00:00 GMT

Techniques in Orthopaedics, Vol. 17, No. 4, 2002

Author: M.R. Brinker, MD, and Daniel P. O'Conner, PhD

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Summary: Failure of internal fixation following treatment of a fracture or fracture nonunion presents a challenging clinical situation. In certain cases, Ilizarov external fixation may be the preferred method to treat bony injuries that have failed to unite following one or more attempts at internal fixation. This paper reviews the modes of failure following internal fixation, revision internal fixation as an option, and the application of the Ilizarov method following failure of internal fixation. Key Words: Ilizarov—Nonunion—Delayed union—Revision surgery.

1-Nov-02 0:00 AM

Utilization of Orthopaedic Services in a Capitated Population

Tue, 01 Oct 2002 05:00:00 GMT

The Journal of Bone and Joint Surgery, Vol. 84-A, No. 11, November 2002

Author: M.R. Brinker, MD, Daniel P. O'Conner, MS, PT, ATC, Peggy Pierce, BBA, B. William Woods, MD, and Marc N. Elliott, PhD

Click here to read the entire published article by Dr Brinker

Background: The utilization rate for orthopaedic services (office visits and surgery) is not well known. The purposeof this study was to determine the utilization rates for orthopaedic office visits and surgical procedures ina large population of captured lives.

Methods: The study population comprised an average of 134,902 persons per month who were enrolled undera capitated insurance plan between January 1999 and December 1999. This plan was serviced by an independentphysician association of sixty-two orthopaedic surgeons who were responsible for all orthopaedic care.Data were collected prospectively and stored in a centralized database. All analyses were conducted with useof monthly averages. Poisson regression was used to compare utilization rates and to calculate odds ratios in order to determine whether the utilization rates varied by age and gender.

Results: The highest proportions of office visits were due to fractures (21%), osteoarthritis (4%), meniscaltears (4%), and low-back pain or sciatica (4%). Knee arthroscopy (30%), foot and ankle procedures (10%), and spine procedures (9%) accounted for the highest proportions of surgical procedures. The overall utilizationrates were 6.96 office visits and 1.99 surgical procedures per 1000 covered lives per month. Across all age groups, males and females did not differ with respect to the utilization rate for office visits (p = 0.42) or surgery (p = 0.09). Increased age was significantly related to increased utilization rates for office visits (p ≤ 0.0002) and surgery (p ≤ 0.002).

1-Oct-02 0:00 AM

Dr. Mark Brinker, Houston Orthopedic Surgeon Articles RSS Feed

Case Report Calcaneogenesis

The Journal of Bone and Joint Surgery , Vol. 91-B, No. 5, May 2009

Author: M. R. Brinker, D. P. Loncarich, E. G. Melissinos, D. P. O’Connor

Management of Falls After Total Knee Arthroplasty

Orthopedics, Vol 31, No.3, March 2008

Author: Richard J. Kearns,MD, Mark R. Brinker,MD and Daniel P. O'Connor, PhD

Ilizarov Distraction Before Revision Hip Arthroplasty After Resection Arthroplasty With Profound Limb Shortening

The Journal of Arthroplasty Vol. 00 No. 0 2008

Author: Mark R. Brinker, MD, Daniel P. O'Connor, PhD, Vasilios Mathews, MD

Outcomes of Tibial Nonunion in Older Adults Following Treatment Using the Ilizarov Method

J Orthop Trauma, Vol. 2, No. 9, October 2007

Author: M.R. Brinker, MD and Daniel P.O O'Conner, PhD

Metabolic and Endocrine Abnormalities in Patients With Nonunions

J Orthop Trauma, Vol 21, No.8, Sept 2007

Author: Mark R. Brinker, MD, Daniel P. O'Connor, PhD, Yomna T. Monla, MD, and Thomas P. Earthman, MD

Ilizarov Treatment of Infected Nonunions of the Distal Humerus After Failure of Internal Fixation: An Outcomes Study

J Orthop Trauma ,Vol. 21, Number 3, March 2007

Author: Mark R. Brinker,MD, Daniel P. O'Connor,PhD, C. Craig Crouch,MD, Thomas L. Mehlhoff,MD, and James B. Bennett,MD

Payer Type Has Little Effect on Operative Rate and Surgeons’ Work Intensity

Clinical Orthopaedics and Related Research, No. 451, pp.257-262 Oct 2006

Author: Mark R. Brinker,MD, Daniel P. O'Connor,PhD, Peggy Pierce,FACMPE and James Weston Spears,BCE

Nonunions of the Femoral Shaft and Distal Femur

Rozbruch, Vol. 11

Author: Mark R. Brinker,MD and Daniel P. O'Connor

CT Scan Helps Delineate Cervical Osteoid Osteoma and Atypical Nidus

The Journal of Bone and Joint Surgery

Robert L. Barrack, MD, Mark R. Brinker, BA, Stephen W. Burke, MD; and John M. Roberts, MD

Bilateral Femoral Neck Fractures After Pelvic Irradiation

The American Journal of Orthopedics

Howard R. Epps, MD, Mark R. Brinker, MD, and Daniel P. O'Connor, PhD

IIizarov Correction of Malrotated Femoral Shaft Fracture Initially Treated With an Intramedullary Nail: A Case Report

The American Journal of Orthopedics

Mark R. Brinker,MD,Joseph J. Gugenheim, MD, Daniel P. O'Connor, PhD, and Jeffrey c. London,. MD

The Incidence of Fractures and Dislocations Referred for Orthopaedic Services in a Capitated Population

The Journal of Bone and Joint Surgery, Vol 86-A, No.2, Feb 2004

Author: Mark R. Brinker,MD and Daniel P. O'Connor, PhD

The Incidence of Fractures and Dislocations Referred for Orthopaedic Services in a Capitated Population

The Journal of Bone and Joint Surgery, Vol. 86-A, No. 2, February 2004

Author: M.R. Brinker, MD, and Daniel P. O'Conner, PhD

The Effects of Femoral Shaft Malrotation on Lower

Journal of Orthopaedic Trauma, Vol. 18, No. 10, 2004

Author: Joseph J. Gugenheim, MD, Robert A. Probe, MD, and Mark R. Brinker, MD

Ilizarov Compression Over a Nail for Aseptic Femoral Nonunions That Have Failed Exchange Nailing: A Report of Five Cases

J Orthop Trauma Volume 17, Number 10, November/December 2003

Author: Mark R. Brinker,MD, and Daniel P. O'Connor,PhD

Case Controversy: Proximal Tibia Fractur

Journal of Orthopaedic Trauma, Vol. 17, No. 8, September 2003

Author: M.R. Brinke, MD, Paul J. Duwelius, MD, William M. Ricci, MD

Bone Realignment with Use of Temporary External Fixation for Distal Femoral Valgus and Varus Deformities

The Journal of Bone and Joint Surgery, Vol. 85-A, No. 7, July 2003

Author : Joseph J. Gugenheim Jr., MD, M.R. Brinker, MD

Background:

Methods:

Results:

Conclusions:

Utilization of Orthopaedic Services in a Capitated Population

The Journal of Bone & Joint Surgery Vol. 84-A No. 11 Nov 2002

Author: Mark R. Brinker, MD,Daniel P. O'Connor, MS, PT, ATC, Peggy Pierce, BBA, G. William Woods, MD, and Marc N. Elliot, PhD

The Use of Ilizarov External Fixation Following Failed Internal Fixation

Techniques in Orthopaedics, Vol. 17, No. 4, 2002

Author: M.R. Brinker, MD, and Daniel P. O'Conner, PhD

Utilization of Orthopaedic Services in a Capitated Population

The Journal of Bone and Joint Surgery, Vol. 84-A, No. 11, November 2002

Author: M.R. Brinker, MD, Daniel P. O'Conner, MS, PT, ATC, Peggy Pierce, BBA, B. William Woods, MD, and Marc N. Elliott, PhD

Mark R. Brinker,MD,Joseph J. Gugenheim, MD, Daniel P. O'Connor, PhD,
and Jeffrey c. London,. MD