Orthopedics, Pediatric Services, Spine

Myelomeningocele and severe kyphosis: Multidisciplinary team achieves closure in a high-risk neonate

The patient A neonate was born with a prenatally diagnosed myelomeningocele, the most severe type of spina bifida, and severe associated myelokyphosis. Due to the extent of the bony deformity, prenatal surgery was deemed too high risk. At birth, the patient presented with a large open neural tube defect with exposed spinal cord and abnormal…

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Adult Services, Orthopedics

Case Study: Posterior Interosseous Nerve Palsy Caused by Elbow Ganglion Cyst Successfully Treated With Surgical Decompression

The patient An 81-year-old male presented to the hand surgery clinic reporting a sudden onset of weakness in his right hand’s ability to extend the middle, ring and small fingers. The index and thumb also were affected, to a lesser extent. There was no history of trauma; the symptoms began following a session of pushups…

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Adult Services, Orthopedics

A Practical Primary Care Approach to Evaluating and Managing Knee and Shoulder Pain

A standardized primary care approach to knee and shoulder conditions — X-rays, a couple months of physical therapy followed by possible MRI and maybe referral to orthopedics — can prevent chronic disability as well as unnecessary imaging and referrals, according to Nyagon G. Duany, M.D., an orthopedic surgeon and sports medicine specialist with Norton Orthopedic…

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Case Study, Orthopedics, Pediatric Services

Persistent shin pain in a teen athlete: A case study in pediatric exertional compartment syndrome

The patient A 13-year-old female presented with bilateral shin pain that began after she increased her gymnastics training from nine to 21 hours per week around nine months prior. Her right leg pain was worse than left. She was seen by an outside sports medicine specialist clinic in August of 2024 and treated with rest…

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Orthopedics, Pediatric Services

Advancing pediatric ACL care: Jennifer M. Brey, M.D., leads growth plate-sparing innovations

Pediatric board-certified orthopedic surgeon Jennifer M. Brey, M.D., brings nationally recognized expertise in youth anterior cruciate ligament (ACL) injury management to Norton Children’s Orthopedics of Louisville, affiliated with the UofL School of Medicine. Specializing in physeal-sparing and physeal-respecting ACL reconstruction, Dr. Brey offers referring providers a trusted partner for managing complex sports injuries in skeletally…

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Adult Services, Orthopedics

Norton Orthopedic Institute surgeon performs new robotic-assisted shoulder replacement

New robotic technology has arrived at Norton Brownsboro Hospital. Justin M. Givens, M.D., orthopedic surgeon with Norton Orthopedic Institute, is among the first five surgeons in the country — and the first in Kentucky — to perform a new groundbreaking, robotic-arm assisted reverse shoulder replacement surgery with Mako SmartRobotics. This procedure hopes to offer a higher degree…

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Case Study, Orthopedics, Pediatric Services

Case Study: Guided growth heads off Blount’s disease bowing in 12-year-old

The patient A 12-year-old male initially was seen for significant bowing of the right tibia, causing knee pain — and his mom noted increasing deformity as he was growing older. There was concern for continued bowing of the leg, causing long-term issues with the right knee. He was having mild to moderate knee pain, which…

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Adult Services, Case Study, Orthopedics

Innovative Thumb Joint Arthroplasty Restores Function in Bilateral Arthritis Case Study

The patient A 45-year-old man with bilateral thumb carpometacarpal joint arthritis for several years (Figures 1 and 2): He tried bracing and steroid injections, which eventually provided diminishing relief. He works as a mechanic for UPS but was having an increasingly difficult time at work due to pain and loss of pinch and grip strength….

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Adult Services, Orthopedics

Advances in total knee replacement technology

The goal of total knee replacement surgery has not changed in the 50 years since the procedure’s inception, but new technology available to surgeons allows for more precision and customization than traditional knee replacement. Advances in technology and surgical technique, along with enhanced perioperative pain control, also have driven a shift to outpatient total knee…

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Orthopedics, Pediatric Services, Sports Health

Treating the most common pediatric sports overuse injuries

As more children are participating in organized sports at younger ages, often specializing in a single sport with high levels of competition, overuse injuries have become increasingly common among young athletes. It is important for providers to recognize common overuse injuries and their accompanying symptoms for proper diagnosis and management. Some common pediatric sports overuse…

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Adult Services, Orthopedics, Sports Health

Zain Z. Rahman, M.D., sports medicine specialist at Norton Orthopedic Institute

Zain Z. Rahman, M.D., is a nonsurgical orthopedist specializing in sports medicine and practicing at Norton Orthopedic Institute offices in Jeffersonville, New Albany and Scottsburg in Southern Indiana. Dr. Rahman, team physician for Indiana University Southeast in New Albany and athletic teams at Floyd Central High School in Floyds Knobs, Indiana, and New Albany High…

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Adult Services, Orthopedics

Nonsurgical management of knee pain

Nonsurgical management can be effective for many patients with chronic knee pain. Physical therapy combined with oral analgesics can be used to treat typical causes of chronic knee pain in adults, including knee osteoarthritis, patellofemoral pain syndrome, and meniscal, tendon and ligament injuries, according to the American Academy of Family Physicians (AAFP). The AAFP also…

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