Adam D. Soyer, D.O.

Fractures of the base of the first metacarpal: current treatment options
Soyer, A D
1999 Nov-Dec;7(6):403-412, Journal of the American Academy of Orthopaedic Surgeons
Fractures of the thumb metacarpal occur most frequently at the base. These fractures can be subdivided into intra-articular and extra-articular types. Intra-articular fractures present treatment challenges because they have a tendency to displace due to deforming forces acting at the base of the thumb. An understanding of the anatomy, biomechanics, and fracture pattern will aid in deciding on the best treatment option for each fracture type. Surgical treatment is recommended for unstable fractures. Anatomic restoration of the articular surface in Bennett and Rolando fractures is not essential to obtain a good functional result. However, reduction should be 1 mm or less to reduce the risk of radiographic arthritis. Malunion of these fractures may result in long-term disability. Closed reduction and percutaneous Kirschner-wire fixation is generally the appropriate treatment for a Bennett fracture. Rolando fractures can be treated with either open reduction and internal fixation or external fixation, depending on the size of the fracture fragments. In the case of severely comminuted intra-articular fractures, articular impaction has been implicated as one of the causes of posttraumatic arthritis. It is difficult to restore the articular surface in these injuries. Therefore, external fixation can be considered when the fracture fragments are small and there is significant soft-tissue injury
— id: 90549, year: 1999, vol: 7, page: 403, stat: Journal Article,

Optimal position for plate fixation of complex fractures of the proximal radius: a cadaver study
Soyer, A D; Nowotarski, P J; Kelso, T B; Mighell, M A
1998 May;12(4):291-293, Journal of orthopaedic trauma
OBJECTIVE: To determine the optimal postion for plate fixation in complex fractures of the proximal radius in which head and neck dissociation occurs. DESIGN: Technical study. SETTING: Tertiary referral center, teaching hospital, U.S. military. SUBJECTS: Five preserved cadavers. MAIN OUTCOME MEASURE: Radioulnar impingement and proximity to neurovascular structures were directly measured in elbows plated in each of three positions: neutral, full pronation, and full supination. RESULTS: Application of the 2.0-millimeter T-plate to the lateral aspect of the radial head and neck with the forearm in neutral position had no impingement, whereas application in full pronation resulted in loss of the last 30 degrees of supination. Plate application in full supination resulted in the loss of the last 10 degrees of pronation. In addition, there was no impingement when the 2.7-millimeter plate was applied similarily in the neutral position. None of these positions resulted in increased risk to neurovascular structures. CONCLUSIONS: The optimal position for plate fixation of complex proximal radius fractures is with the forearm in neutral position, with the plate applied directly lateral. A larger implant, 2.7 millimeters, may be used if this technique is followed without further risk of impingement and loss of motion
— id: 90565, year: 1998, vol: 12, page: 291, stat: Journal Article,

Progressive scoliosis in Dubowitz syndrome
Soyer, A D; McConnell, J R
1995 Nov 1;20(21):2335-2337, Spine
STUDY DESIGN. This case report describes a 17-year-old male with Dubowitz syndrome in whom a progressive left thoracic scoliosis developed that required surgical correction. OBJECTIVE. Scoliosis associated with Dubowitz syndrome had not been previously described among the orthopedic manifestations of this rare syndrome. A review of the literature and the surgical treatment of this patient is presented. SUMMARY OF BACKGROUND DATA. Dubowitz syndrome is a rare autosomal recessive disorder characterized by microcephaly, craniofacial abnormalities, eczematous skin rash, delayed skeletal maturation, and shortness of stature. The orthopedic manifestations of this condition primarily involve the hands and feet with brachyclinodactyly of the fifth finger and syndactyly of the second and third toes. Spinal deformity in these individuals is not well described in the literature. METHODS. Over a 2-year period, the patient's scoliosis progressed to 88 degrees, resulting in severe truncal imbalance without neurologic sequelae. A posterior spinal fusion with segment instrumentation alone was used to correct the deformity. RESULTS. After surgery, excellent restoration of spine sagittal and coronal plane alignment was achieved, resulting in improved sitting and standing balance. CONCLUSION. Patients with Dubowitz syndrome may be at risk of having a progressive, rigid scoliosis. These individuals may need to be observed over a prolonged period for the development of spinal deformity because of the potential for extended delay in skeletal maturation
— id: 90564, year: 1995, vol: 20, page: 2335, stat: Journal Article,

Closed posteromedial dislocation of the tibiotalar joint without fracture or diastasis: a case report
Soyer, A D; Nestor, B J; Friedman, S J
1994 Nov;15(11):622-624, Foot & ankle international
Tibiotalar dislocation without fracture is an unusual injury. Seventy-three cases have been reported in the literature. Closed posteromedial dislocation of the tibiotalar joint without fracture or diastasis is a very rare phenomenon. Eight cases have been reported. A case of this unique injury is presented, along with a literature review of purely ligamentous ankle dislocations. The proposed mechanism and classification of these injuries are summarized
— id: 90563, year: 1994, vol: 15, page: 622, stat: Journal Article,