Scholars@Duke
Malcolm R DeBaun

Malcolm R DeBaun

Assistant Professor of Orthopaedic Surgery
Orthopaedic Surgery
Box 104002, DUMC, Durham, NC 27710
311 Trent Drive, Durham, NC 27710

Selected Publications

Exploring versatile applications of a vacuum-assisted bone harvester in orthopedic surgery.

Journal Article BMC Musculoskelet Disord · August 31, 2024 BACKGROUND: Orthopedic procedures often require removing bone or pathological tissue, with traditional methods involving instruments like curettes and rongeurs. However, these methods can be time-consuming and lead to increased blood loss. To mitigate thes ... Full text Link to item Cite

Persistent racial disparities in postoperative management after tibia fracture fixation: A matched analysis of US medicaid beneficiaries.

Journal Article Injury · August 2024 INTRODUCTION: Racial and ethnic disparities in orthopaedic surgery are well documented. However, the extent to which these persist in fracture care is unknown. This study sought to assess racial disparities in the postoperative surgical and medical managem ... Full text Link to item Cite

Racial and Ethnic Disparities in Providing Guideline-Concordant Care After Hip Fracture Surgery.

Journal Article JAMA Netw Open · August 1, 2024 IMPORTANCE: Institutions have adopted protocol-driven standardized hip fracture programs (SHFPs). However, concerns persist regarding bias in adherence to guideline-concordant care leading to disparities in implementing high-quality care for patients recov ... Full text Link to item Cite

Racial Disparities Exist in 90-Day Unplanned Return to the Emergency Department Following Orthopaedic Trauma Surgery.

Journal Article J Orthop Trauma · July 1, 2024 OBJECTIVES: Racial disparities in healthcare outcomes exist, including in orthopaedic trauma care. The aim of this study was to determine the impact of race, social deprivation, and payor status on 90-day emergency department (ED) revisits among orthopaedi ... Full text Link to item Cite

An international learning collaborative phase 2 trial for haploidentical bone marrow transplant in sickle cell disease.

Journal Article Blood · June 20, 2024 In the setting of a learning collaborative, we conducted an international multicenter phase 2 clinical trial testing the hypothesis that nonmyeloablative-related haploidentical bone marrow transplant (BMT) with thiotepa and posttransplant cyclophosphamide ... Full text Link to item Cite

Incidence and Risk Factors for New and Recurrent Infarcts in Adults With Sickle Cell Disease.

Journal Article J Am Heart Assoc · June 18, 2024 BACKGROUND: Most adults with sickle cell disease will experience a silent cerebral infarction (SCI) or overt stroke. Identifying patient subgroups with increased stroke incidence is important for future clinical trials focused on stroke prevention. Our 3-c ... Full text Link to item Cite

Effect of allogeneic hematopoietic stem cell transplantation on sickle cell disease-related organ complications: A systematic review and meta-analysis.

Journal Article Am J Hematol · June 2024 Sickle cell disease (SCD)-related organ complications are a major cause of morbidity and mortality in patients with SCD. We sought to assess whether hematopoietic stem cell transplantation (HSCT) stabilizes, attenuates, or exacerbates organ decline. We per ... Full text Link to item Cite

Multisite Study of the Management of Musculoskeletal Infection After Trauma: The MMUSKIT Study.

Journal Article Open Forum Infect Dis · June 2024 BACKGROUND: The optimal duration and choice of antibiotic for fracture-related infection (FRI) is not well defined. This study aimed to determine whether antibiotic duration (≤6 vs >6 weeks) is associated with infection- and surgery-free survival. The seco ... Full text Link to item Cite

Distribution of Silent Cerebral Infarcts in Adults With Sickle Cell Disease.

Journal Article Neurology · May 2024 BACKGROUND AND OBJECTIVES: Previously we demonstrated that 90% of infarcts in children with sickle cell anemia occur in the border zone regions of cerebral blood flow (CBF). We tested the hypothesis that adults with sickle cell disease (SCD) have silent ce ... Full text Link to item Cite

Successful coil embolization of a ruptured pseudoaneurysm of the superior gluteal artery after a percutaneous awake robot-assisted sacroiliac joint fusion: illustrative case.

Journal Article J Neurosurg Case Lessons · April 8, 2024 BACKGROUND: Robot-assisted sacroiliac joint (SIJ) fusion has gained popularity, but it carries the risk of complications such as injury to the superior gluteal artery (SGA). The authors present the case of an awake percutaneous robot-assisted SIJ fusion le ... Full text Link to item Cite

Distal Femur Fractures

Chapter · March 23, 2024 "AAOS Comprehensive Orthopaedic Review, 4th Edition is a comprehensive three-volume set that covers the spectrum of orthopaedic specialties. ... Cite

3D Topographical Scanning for the Detection of Osteoporosis.

Journal Article J Frailty Sarcopenia Falls · March 2024 OBJECTIVES: Osteoporosis is associated with greater risk of fracture, which can lead to increased morbidity and mortality. DEXA scans are often inaccessible for patients, leaving many cases of osteoporosis undetected. A portable 3D topographical scan offer ... Full text Link to item Cite

Cerebral hemodynamic changes after haploidentical hematopoietic stem cell transplant in adults with sickle cell disease.

Journal Article Blood Adv · February 13, 2024 Preliminary evidence from a series of 4 adults with sickle cell disease (SCD) suggests that hematopoietic stem cell transplant (HSCT) improves cerebral hemodynamics. HSCT largely normalizes cerebral hemodynamics in children with SCD. We tested the hypothes ... Full text Link to item Cite

The association of pre-existing mental health conditions and patient outcomes after lower extremity orthopaedic trauma: a scoping review.

Journal Article Eur J Orthop Surg Traumatol · February 2024 INTRODUCTION: Existing research has established a correlation between post-traumatic mental health conditions, including anxiety and depression, and various aspects of recovery, such as pain exacerbations, reduced functional recovery, and lowered patient s ... Full text Link to item Cite

Ankle and Pilon Fractures

Chapter · January 2, 2024 The OKU® subspecialty series covers most important new developments since the last volume was published in 2019. ... Cite

Management of Intraoperative Acetabular Fractures During Total Hip Arthroplasty.

Journal Article Orthop Clin North Am · January 2024 Intraoperative fractures of the acetabulum are a rare but serious complication during total hip arthroplasty. Acute fractures generally require attention with plating, whereas chronic acetabular fractures may be approached with distraction, a Burch-Schneid ... Full text Link to item Cite

Interfragmentary strain measurement post-fixation to guide intraoperative decision making: a narrative review.

Journal Article Eur J Orthop Surg Traumatol · December 2023 PURPOSE: Interfragmentary strain influences whether a fracture will undergo direct and indirect fracture healing. Orthopedic trauma surgeons modulate strain and create optimal biomechanical environments for specific fracture patterns using fixation constru ... Full text Link to item Cite

Intramedullary nailing vs. open reduction-internal fixation for humeral shaft fractures: a meta-analysis of randomized controlled trials.

Journal Article J Shoulder Elbow Surg · December 2023 BACKGROUND: The purpose of this study was to perform a meta-analysis of randomized controlled trials (RCTs) to compare outcomes following intramedullary nailing (IMN) vs. open reduction-internal fixation (ORIF) for humeral shaft fractures. METHODS: A liter ... Full text Link to item Cite

Bilateral Sacroiliac Joint Dislocation, Discussion and Surgical Strategies: A Case Report.

Journal Article JBJS Case Connect · October 1, 2023 CASE: A 16-year-old male patient presented with isolated bilateral sacroiliac (SI) joint dislocation. In this report, we discuss the presentation and focus on strategies for operative reduction and fixation for this rare injury. CONCLUSION: In conclusion, ... Full text Link to item Cite

Drilling the cement mantle in well-fixed periprosthetic femur fractures is not associated with arthroplasty-related complications.

Journal Article Eur J Orthop Surg Traumatol · July 2023 OBJECTIVE: To determine if screw fixation across a cement mantle is safe and effective during plate fixation of well-fixed periprosthetic femur fractures. DESIGN: Retrospective cohort study. SETTING: Academic Level I Trauma Center. PATIENTS: Twenty-eight p ... Full text Link to item Cite

Updated Blocking Techniques for Lower Extremity Medullary Nailing: Beyond the Concavity of Deformity.

Journal Article J Am Acad Orthop Surg · July 1, 2023 Modern blocking techniques are useful to achieve anatomic alignment and stable fixation during end-segment nailing. Whether with screws or drill bits, blocking implants can correct both angular and translational deformities. Understanding the biomechanics ... Full text Link to item Cite

A Biomechanical Comparison of All-Inside Versus Transtibial Meniscus Root Repair Techniques.

Journal Article Am J Sports Med · July 2023 BACKGROUND: Meniscus root tears are associated with chondral injury, early degenerative change, and a high conversion rate to total knee arthroplasty. It is well-established that meniscus root tears lead to decreased femorotibial contact area, increased pe ... Full text Link to item Cite

Metabolic Syndrome Increases Risk of Readmission and Complications in Operative Fixation of Pilon Fractures.

Journal Article Cureus · July 2023 Background Studies demonstrate that metabolic syndrome (MetS) negatively impacts surgical outcomes. This study sought to identify how metabolic syndrome affects outcomes after open reduction and internal fixation (ORIF) of traumatic pilon fractures. Method ... Full text Link to item Cite

Peripheral Nerve Block Delays Mobility and Increases Length of Stay in Patients With Geriatric Hip Fracture.

Journal Article J Am Acad Orthop Surg · June 15, 2023 INTRODUCTION: Peripheral nerve blocks (PNB) has been increasingly used in the care of patients with geriatric hip fracture to reduce perioperative opiate use and the need for general anesthesia. However, the associated motor palsy may impair patients' abil ... Full text Link to item Cite

Robotic-Assisted Minimally Invasive Spinopelvic Fixation for Traumatic Sacral Fractures: Case Series Investigating Early Safety and Efficacy.

Journal Article World Neurosurg · June 12, 2023 BACKGROUND: High-energy traumatic sacral fractures, particularly U-type or AOSpine classification type C fractures, may lead to significant functional deficits. Traditionally, spinopelvic fixation for unstable sacral fractures was performed with open reduc ... Full text Link to item Cite

Acute External Fixation and Delayed Primary Subtalar Fusion After Comminuted Joint-depression Calcaneus Fracture

Journal Article Techniques in Foot & Ankle Surgery · May 16, 2023 Joint-depression calcaneus fractures, such as Sanders type IV, can be complex injuries to treat surgically due to significant comminution of the posterior facet of the calcaneus. Although nonoperative management is reasonable in a nonsurgical candi ... Full text Cite

Type III Open Tibia Fractures Treated With Single-Stage Immediate Medullary Nailing and Attempted Primary Closure Yield Low Rates of Flap Coverage.

Journal Article J Am Acad Orthop Surg · March 1, 2023 OBJECTIVE: The purpose of this study was to determine whether type III open high-energy tibia fractures treated with immediate intramedullary nailing (IMN) and primary closure yield low rates of flap coverage. METHODS: Patients with high-energy type IIIA o ... Full text Link to item Cite

Use of a Six-Item Modified Frailty Index to Predict 30-day Adverse Events, Readmission, and Mortality in Older Patients Undergoing Surgical Fixation of Lower Extremity, Pelvic, and Acetabular Fractures.

Journal Article J Am Acad Orthop Surg Glob Res Rev · January 1, 2023 INTRODUCTION: This is a retrospective study evaluating the use of a new six-item modified frailty index (MF-6) to predict short-term outcomes of patients receiving surgery for lower extremity fractures. METHODS: Patients older than 65 years undergoing open ... Full text Link to item Cite

A Single Proximal Interlocking Bolt May Be Sufficient for Retrograde Nailing of Extra-articular Femur Fractures.

Journal Article J Orthop Trauma · December 1, 2022 OBJECTIVE: To evaluate whether a single proximal interlocking bolt was sufficient during the treatment of extra-articular femur fractures with retrograde medullary nailing. DESIGN: Retrospective comparative study. SETTING: Academic Level 1 trauma center. P ... Full text Link to item Cite

Is the timing of fixation associated with fracture-related infection among tibial plateau fracture patients with compartment syndrome? A multicenter retrospective cohort study of 729 patients.

Journal Article Injury · November 2022 BACKGROUND: Tibial plateau fractures with an ipsilateral compartment syndrome are a clinical challenge with limited guidance regarding the best time to perform open reduction and internal fixation (ORIF) relative to fasciotomy wound closure. This study aim ... Full text Link to item Cite

A bioactive synthetic membrane improves bone healing in a preclinical nonunion model.

Journal Article Injury · April 2022 OBJECTIVES: High energy long bone fractures with critical bone loss are at risk for nonunion without strategic intervention. We hypothesize that a synthetic membrane implanted at a single stage improves bone healing in a preclinical nonunion model. METHODS ... Full text Link to item Cite

Countersinking the Lag Screw or Blade During Cephalomedullary Nailing of Geriatric Intertrochanteric Femur Fractures: Less Collapse and Implant Prominence Without Increased Cutout Rates.

Journal Article J Am Acad Orthop Surg · January 1, 2022 INTRODUCTION: The lag screw or helical blade of a cephalomedullary nail facilitates controlled collapse of intertrochanteric proximal femur fractures. However, excessive collapse results in decreased hip offset and symptomatic lateral implants. Countersink ... Full text Link to item Cite

Simultaneous Posterolateral and Posteromedial Approaches for Fractures of the Entire Posterior Tibial Plafond: A Safe Technique for Effective Reduction and Fixation

Journal Article Journal of Orthopaedic Trauma · January 2022 Objective:To determine the short-term results of surgical treatment with dual posterolateral and posteromedial approaches for fractures of the entire posterior tibial plafond and secondar ... Full text Cite

Distal Femur Replacement Versus Open Reduction and Internal Fixation for Treatment of Periprosthetic Distal Femur Fractures: A Systematic Review and Meta-Analysis

Journal Article Journal of Orthopaedic Trauma · January 2022 Objective:To compare complications and functional outcomes of treatment with primary distal femoral replacement (DFR) versus open reduction and internal fixation (ORIF). ... Full text Cite

Medial Column Support in Pilon Fractures Using Percutaneous Intramedullary Large Fragment Fixation

Journal Article Journal of Orthopaedic Trauma · December 2021 Summary:Pilon fractures are complex injuries to the tibial plafond requiring stable fixation in the setting of effective soft tissue management, particularly in high-energy injuries, open fractures, or in geriatr ... Full text Cite

Artificial Neural Networks Predict 30-Day Mortality After Hip Fracture: Insights From Machine Learning.

Journal Article J Am Acad Orthop Surg · November 15, 2021 OBJECTIVES: Accurately stratifying patients in the preoperative period according to mortality risk informs treatment considerations and guides adjustments to bundled reimbursements. We developed and compared three machine learning models to determine which ... Full text Link to item Cite

Plafond Malreduction and Talar Dome Impaction Accelerates Arthrosis After Supination-Adduction Ankle Fracture.

Journal Article Foot Ankle Int · October 2021 BACKGROUND: Supination-adduction (SAD) type II ankle fractures can have medial tibial plafond and talar body impaction. Factors associated with the development of posttraumatic arthritis can be intrinsic to the injury pattern or mitigated by the surgeon. W ... Full text Link to item Cite

Modern radial head arthroplasty for terrible triad fracture-dislocations: a retrospective case series with minimum 3-year follow-up

Journal Article Seminars in Arthroplasty JSES · July 1, 2021 Background: To report mid-term clinical outcomes after radial head arthroplasty for terrible-triad fracture dislocations. Methods: Fourteen patients with terrible triad fracture dislocations treated acutely with arthroplasty and minimum 3-year follow-up. M ... Full text Cite

Use of an Intraoperative Limb Positioner for Adjustable Distraction in Acetabulum Fractures with Femoral Head Protrusion

Journal Article JBJS Case Connector · July 2021 Case:Anatomic reduction of acetabular fractures with femoral head protrusion requires lateralization of the medialized femoral head to facilitate reduction and definitive fixation. In thi ... Full text Cite

Incidence and Management of Articular Impaction in Geriatric Olecranon Fractures

Journal Article Journal of the American Academy of Orthopaedic Surgeons · May 17, 2021 Introduction:Olecranon fractures are common in the elderly. Articular impaction is encountered occasionally, but the incidence and outcomes after treatment of this injury pattern have not ... Full text Cite

White-Light Body Scanning Captures Three-Dimensional Shoulder Deformity After Displaced Diaphyseal Clavicle Fracture

Journal Article Journal of Orthopaedic Trauma · April 2021 Objective:We sought to determine if white-light three-dimensional (3D) body scanning can identify clinically relevant shoulder girdle deformity after displaced diaphyseal clavicle fractur ... Full text Cite

How are peri-implant fractures below short versus long cephalomedullary nails different?

Journal Article European Journal of Orthopaedic Surgery & Traumatology · April 2021 Full text Cite

Can Upstream Patient Education Improve Fracture Care in a Digital World? Use of a Decision Aid for the Treatment of Displaced Diaphyseal Clavicle Fractures

Journal Article Journal of Orthopaedic Trauma · March 2021 Background:The increasing proportion of telemedicine and virtual care in orthopaedic surgery presents an opportunity for upstream delivery of patient facing tools, such as decision aids. ... Full text Cite

Frame-Assisted Reduction of a B-Type Pilon Fracture Dislocation: Talar Body Incarceration on an Intact Fibula: A Case Report.

Journal Article JBJS Case Connect · February 11, 2021 CASE: We describe an irreducible anterolateral tibiotalar dislocation with an AO/OTA (Arbeitsgemeinschaft fur Osteosynthesefragen/Orthopaedic Trauma Association) B-type pilon fracture. The injury was initially treated with closed reduction, using a mediali ... Full text Link to item Cite

Lateral Distractor Use During Internal Fixation of Tibial Plateau Fractures Has a Minimal Risk of Iatrogenic Peroneal Nerve Palsy

Journal Article Journal of Orthopaedic Trauma · February 2021 Objectives:To determine the incidence of iatrogenic peroneal nerve palsy after application of an intraoperative lateral distractor during open reduction and internal fixation of tibial pl ... Full text Cite

Motivations and impact of international rotations in low- and middle-income countries for orthopaedic surgery residents: Are we on the same page?

Journal Article Am J Surg · February 2021 BACKGROUND: Despite interest among North American orthopaedic residents to pursue rotations in resource-limited settings, little is known regarding resident motivations and impact on host surgeons. METHODS: Surveys were distributed to North American orthop ... Full text Link to item Cite

Distal Femur Replacement Versus Surgical Fixation for the Treatment of Geriatric Distal Femur Fractures: A Systematic Review

Journal Article Journal of Orthopaedic Trauma · January 2021 Objectives:The management of geriatric distal femur fractures is controversial, and both primary distal femur replacement (DFR) and surgical fixation (SF) are viable treatment options. Th ... Full text Cite

Interlocking screw configuration influences distal tibial fracture stability in torsional loading after intramedullary nailing.

Journal Article Eur J Orthop Surg Traumatol · October 2020 PURPOSE: This study evaluated the influence of fracture obliquity and locking screw configuration on interfragmentary motion during torsional loading of distal metaphyseal tibial fractures fixed by intramedullary (IM) nailing. METHODS: The stability of six ... Full text Link to item Cite

Safety and efficacy of using 2.4/2.4 mm and 2.0/2.4 mm dual mini-fragment plate combinations for fixation of displaced diaphyseal clavicle fractures.

Journal Article Injury · March 2020 PURPOSE: The purpose of this study was to evaluate the safety and efficacy of using lower profile 2.4/2.4 mm and 2.0/2.4 mm dual mini-fragment plate constructs for fixation of diaphyseal clavicle fractures. METHODS: This was a retrospective case series of ... Full text Link to item Cite

Influence of fracture obliquity and interlocking nail screw configuration on interfragmentary motion in distal metaphyseal tibia fractures.

Journal Article Eur J Orthop Surg Traumatol · February 2020 The indications for the use of intramedullary (IM) nails have been extended to include extra-articular distal metaphyseal tibia fractures. We hypothesize that interfragmentary motion during physiologic compressive loading of distal tibia fractures is influ ... Full text Link to item Cite

Biomechanical comparison of bone-screw-fasteners versus traditional locked screws in plating female geriatric bone.

Journal Article Injury · February 2020 OBJECTIVES: To biomechanically compare plated constructs using nonlocking bone-screw-fasteners with interlocking threads versus locking screws with traditional buttress threads in geriatric female bone. METHODS: Eleven matched pairs of proximal and distal ... Full text Link to item Cite

An anatomic classification for heterotopic ossification about the hip.

Journal Article J Orthop · 2020 STUDY DESIGN: Retrospective cohort. SUMMARY OF BACKGROUND DATA: Heterotopic ossification (HO) about the hip is a debilitating condition that can occur after fixation for acetabular fractures, total hip replacement, or polytrauma with closed head injuries. ... Full text Link to item Cite

Deltopectoral Approach for Arthroplasty After Early Failed Proximal Humerus Fixation Via Deltoid Split Heals Uneventfully: A Case Report.

Journal Article JBJS Case Connect · 2020 CASE: A 57-year-old male carpenter sustained a 2-part displaced proximal humerus fracture of his nondominant arm with varus angulation after a fall down the stairs. Fifteen days postinjury, the patient underwent direct reduction and surgical fixation with ... Full text Link to item Cite

Vaso-Occlusive Pain and Menstruation in Sickle Cell Disease: A Focus Group Analysis

Journal Article Women's Health Reports · January 1, 2020 Background: Acute vaso-occlusive pain, herein referred to as acute sickle cell disease (SCD) pain, associated with menstruation has received little attention. Key unanswered questions include how women differentiate acute SCD pain and menstrual cramps, and ... Full text Cite

Pilot study of a novel serum mRNA gene panel for diagnosis of acute septic arthritis.

Journal Article World J Orthop · December 18, 2019 BACKGROUND: Septic arthritis is an orthopedic emergency requiring immediate surgical intervention. Current diagnostic standard of care is an invasive joint aspiration. Aspirations provide information about the inflammatory cells in the sample within a few ... Full text Link to item Cite

Newer perspectives in the treatment of chronic osteomyelitis: A preliminary outcome report.

Journal Article Injury · June 2019 The prevalence of chronic osteomyelitis due to trauma and surgical complications does not seem to be diminishing in our society. In many African Nations, with the urbanization and shift to the larger cities that has been occurring, Trauma has been classifi ... Full text Link to item Cite

Preclinical induced membrane model to evaluate synthetic implants for healing critical bone defects without autograft.

Journal Article J Orthop Res · January 2019 Critical bone defects pose a formidable orthopaedic problem in patients with bone loss. We developed a preclinical model based on the induced membrane technique using a synthetic graft to replace autograft for healing critical bone defects. Additionally, w ... Full text Link to item Cite