Techniques in Shoulder and Elbow Surgery最新文献_第4页

Core Decompression for Class I Avascular Necrosis of Humeral Head 肱骨头ⅰ类缺血性坏死的核心减压治疗

Techniques in Shoulder and Elbow Surgery Pub Date : 2019-12-01 DOI: 10.1097/bte.0000000000000180

Andrew P. Wroblewski, Anthony T Machi, D. Klaus, S. Frangiamore

{"title":"Core Decompression for Class I Avascular Necrosis of Humeral Head","authors":"Andrew P. Wroblewski, Anthony T Machi, D. Klaus, S. Frangiamore","doi":"10.1097/bte.0000000000000180","DOIUrl":"https://doi.org/10.1097/bte.0000000000000180","url":null,"abstract":"Supplemental Digital Content is available in the text. Avascular necrosis of the humeral head is a diagnosis of multiple etiologies and unclear prognosis. Prompt diagnosis and treatment are essential to prevent head collapse and avoid resurfacing or joint replacement procedures. Imaging modalities including standard radiography and magnetic resonance imaging establish the diagnosis and stage it according to the degree of necrosis, head collapse, or extension into the glenoid. If the patient stays persistently symptomatic despite conservative treatments and is still in the early stages of the disease course, humeral head core decompression is a reasonable option as it has been shown to decrease disease progression and provide symptomatic relief. Here, we present a case of a 52-year-old female with a history of adhesive capsulitis status postmanipulation and arthroscopic lysis of adhesions, now presenting with Cruess Stage I avascular necrosis of the humeral head. This technique (Supplemental Video, Supplemental Digital Content 1, http://links.lww.com/TSES/A36) demonstrates core decompression and grafting of the humeral head using a percutaneous expandable reamer. Level of Evidence: Level V (expert opinion).","PeriodicalId":44224,"journal":{"name":"Techniques in Shoulder and Elbow Surgery","volume":"20 1","pages":"134 - 135"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/bte.0000000000000180","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44120106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reconstruction of Chronic Distal Biceps Tendon Rupture With Autogenous Semitendinosis Graft Using the “Anatomic Length Method” and Concomitant Bicipital Aponeurosis Repair “解剖长度法”自体半腱膜移植重建慢性二头远端肌腱断裂并同时修复二头腱膜

Techniques in Shoulder and Elbow Surgery Pub Date : 2019-12-01 DOI: 10.1097/BTE.0000000000000177

W. Albishi, J. Lam, A. Elmaraghy

引用次数: 2

Clinical Outcomes of Lateral Ulnar Collateral Ligament Repair of the Elbow Using a Cortical Button 应用皮质按钮修复尺骨外侧副韧带的临床疗效

Techniques in Shoulder and Elbow Surgery Pub Date : 2019-12-01 DOI: 10.1097/BTE.0000000000000178

C. Zale, H. Kim

{"title":"Clinical Outcomes of Lateral Ulnar Collateral Ligament Repair of the Elbow Using a Cortical Button","authors":"C. Zale, H. Kim","doi":"10.1097/BTE.0000000000000178","DOIUrl":"https://doi.org/10.1097/BTE.0000000000000178","url":null,"abstract":"The purpose of this retrospective case series was to report a new surgical technique for lateral ulnar collateral ligament (LUCL) repair using a cortical button and the clinical results. Twenty patients underwent a LUCL repair using a cortical button at a single institution were included for evaluation of the demographic, radiologic, and clinical examination data. Nine patients returned for a separate study visit for further clinical examination and outcome surveys. Eighteen patients (mean age: 48 y, 10 males) received at least 1 additional procedure other than a LUCL repair. For the 9 patients who returned for a study visit (average follow-up: 27 mo), the mean QuickDASH score was 22.4 and the mean Mayo Elbow Performance Score 90. Six patients reported no pain, 1 moderate, and 2 mild. All 9 patients were satisfied. Average flexion-extension and supination-pronation arc of motion was 91% and 89% of the contralateral elbow, respectively. LUCL repair using a cortical button resulted in satisfactory clinical outcomes and can be a viable surgical option in acute elbow instability, especially in elderly patients with osteopenic bone.","PeriodicalId":44224,"journal":{"name":"Techniques in Shoulder and Elbow Surgery","volume":"20 1","pages":"109 - 115"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/BTE.0000000000000178","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43268560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Mini-open Plication of Medial Collateral Ligament of the Elbow: A New Arthroscopically Assisted Technique 肘关节内侧副韧带小开口扩张术:一种关节镜辅助下的新技术

Techniques in Shoulder and Elbow Surgery Pub Date : 2019-12-01 DOI: 10.1097/BTE.0000000000000176

J. Lesman, F. Luceri, M. Domzalski, P. Randelli, P. Arrigoni

{"title":"The Mini-open Plication of Medial Collateral Ligament of the Elbow: A New Arthroscopically Assisted Technique","authors":"J. Lesman, F. Luceri, M. Domzalski, P. Randelli, P. Arrigoni","doi":"10.1097/BTE.0000000000000176","DOIUrl":"https://doi.org/10.1097/BTE.0000000000000176","url":null,"abstract":"The stability of the medial elbow compartment is not only important for everyday life but also plays a key role in throwing gestures. Valgus stress is a fundamental part of popular sport activities (baseball, squash, tennis, and volleyball). Even the isolated medial collateral ligament (MCL) lesion might develop symptomatic medial instability, which interrupts everyday life. This instability may be symptomatic and patients may refer medial elbow pain. Several techniques for MCL treatment have been described. Most of them are reconstructions in which there are tunnels and free cylindrical grafts. The aim of our study is to describe step-by-step a new surgical procedure for minimally invasive plication of aMCL arthroscopically assisted. This procedure should be performed after 6 months of conservative treatment failure. After arthroscopic MCL laxity diagnosis, the standard bioabsorbable double-loaded anchor with high resistance sutures was inserted into the anteroinferior surface of the medial epicondyle. After adequate restraint and preparation of proximal aMCL, 2 bioresorbable sutures were passed through the ligament considering 1 to 1.5 cm of tissue to be plicated. The procedure is considered less invasive and safe in comparison with graft reconstructions of MCL.","PeriodicalId":44224,"journal":{"name":"Techniques in Shoulder and Elbow Surgery","volume":"20 1","pages":"121 - 124"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/BTE.0000000000000176","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42622203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

High-grade Common Extensor Tendon Tears Maintaining Chronic Lateral Epicondylitis: Clinical and Structural Outcome Following Knotless Suture Anchor Repair 高级别总伸肌撕裂维持慢性外侧上髁炎：无结缝合锚修复后的临床和结构结果

Techniques in Shoulder and Elbow Surgery Pub Date : 2019-12-01 DOI: 10.1097/BTE.0000000000000179

M. Glanzmann, J. Gleich, Dominik Rickenbacher, Jürg Oswald, C. Kolling, L. Audigé

{"title":"High-grade Common Extensor Tendon Tears Maintaining Chronic Lateral Epicondylitis: Clinical and Structural Outcome Following Knotless Suture Anchor Repair","authors":"M. Glanzmann, J. Gleich, Dominik Rickenbacher, Jürg Oswald, C. Kolling, L. Audigé","doi":"10.1097/BTE.0000000000000179","DOIUrl":"https://doi.org/10.1097/BTE.0000000000000179","url":null,"abstract":"We describe the reconstruction of high-grade extensor tendon tears using a knotless suture anchor and hypothesize that this will result in improved elbow pain and function with a high healing rate. Twenty chronic lateral epicondylitis patients with magnetic resonance imaging–confirmed high-grade extensor tendon tears underwent surgery using a knotless suture anchor technique. All underwent clinical and ultrasound assessments and completed the quick Disabilities of the Arm, Shoulder, and Hand and patient-rated tennis elbow evaluation questionnaires at final follow-up. Preoperative and postoperative Mayo Elbow Performance Scores were also determined. Mean patient age at surgery was 48 years with 11 women and 7 men available at final follow-up. Diagnostic arthroscopy was performed for all patients before repair; cartilage lesions were found in 8 patients. Mayo Elbow Performance Score improved from 55 to 100 points. At final follow-up, the median grip strength was 100% (range, 52 to 114) of the nonaffected side and patient-rated scores were almost 0. We did not observe any retears. Some tennis elbow patients may present with high-grade tears that contribute to chronic symptoms. Our repair technique resulted in a satisfactory outcome for these patients and may reduce the risk of secondary posterolateral instability following complete tendon release.","PeriodicalId":44224,"journal":{"name":"Techniques in Shoulder and Elbow Surgery","volume":"20 1","pages":"116 - 120"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/BTE.0000000000000179","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44462207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An Approach to the Management of Bilateral Posterior Shoulder Dislocations Following Seizure: Case Report, Literature Review, and Proposed Treatment Algorithm 癫痫发作后双侧肩关节后脱位的治疗方法:病例报告、文献回顾和建议的治疗方法

Techniques in Shoulder and Elbow Surgery Pub Date : 2019-12-01 DOI: 10.1097/BTE.0000000000000175

A. Ravindra, J. Barlow, E. Klag, Andrew S. Neviaser, J. Bishop

{"title":"An Approach to the Management of Bilateral Posterior Shoulder Dislocations Following Seizure: Case Report, Literature Review, and Proposed Treatment Algorithm","authors":"A. Ravindra, J. Barlow, E. Klag, Andrew S. Neviaser, J. Bishop","doi":"10.1097/BTE.0000000000000175","DOIUrl":"https://doi.org/10.1097/BTE.0000000000000175","url":null,"abstract":"Bilateral posterior shoulder dislocations in patients with seizure disorders are an uncommon injury that is difficult to treat. Surgery is typically required and impaction lesions often require bone reconstruction procedures. Seizures in the early postoperative period can have disastrous consequences when bone restoration procedures are disrupted. However, delaying treatment of persistent instability can cause further joint damage and bone loss potentially leading to the need for humeral head replacement. Our purpose is to introduce an approach to treating the young patient who presents with bilateral posterior dislocations related to a seizure. We report a case, describe the surgical techniques used, and propose an algorithm for managing the treatment of a young patient who presents with bilateral posterior dislocations related to a seizure. At her most recent follow-up (57 mo postoperative for the left shoulder and 41 mo postoperative for the right shoulder), she denied any apprehension or instability in either shoulder and had no further dislocations. She reported mild chronic pain in both shoulders, worse in the right than the left. She has a smooth passive range of motion with no crepitus in either shoulder. Her range of motion in forward elevation/external rotation/internal rotation is 150/45/L3 on the left and 50/150/L3 on the right. Strength is 5/5 in all planes and her subscapularis is clinically intact bilaterally. Our case illustrates the importance of early surgical intervention, resulting in functional, stable shoulders even in the face of medically and surgically intractable epilepsy. This algorithm highlights the importance of multidisciplinary cooperation and early surgical intervention to minimize bone loss and avoid joint replacement.","PeriodicalId":44224,"journal":{"name":"Techniques in Shoulder and Elbow Surgery","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73074262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Reconstruction of the Acromioclavicular Joint With 360-degree Control 360度控制重建肩锁关节

Techniques in Shoulder and Elbow Surgery Pub Date : 2019-09-01 DOI: 10.1097/BTE.0000000000000167

G. Hoy, Matthew A Yalizis, Mitchell L Smith, H. Anderson, S. Warby

{"title":"Reconstruction of the Acromioclavicular Joint With 360-degree Control","authors":"G. Hoy, Matthew A Yalizis, Mitchell L Smith, H. Anderson, S. Warby","doi":"10.1097/BTE.0000000000000167","DOIUrl":"https://doi.org/10.1097/BTE.0000000000000167","url":null,"abstract":"Supplemental Digital Content is available in the text. Background: The TightRope/Endobutton techniques achieve good vertical reduction of the acromioclavicular joint, however anteroposterior and mediolateral stability may persist. Aims: The primary aim is to present our modification of the twin-tailed Dog Bone technique, using FibreTape and divergent clavicular limbs. The secondary aim is to report postsurgical outcomes. Hypothesis: By separating these divergent limbs widely the overall stability of the construct will be improved, limiting undesired mobility in all planes and assisting favorable postoperative outcomes. Materials and Methods: Included participants sustained acute Rockwood III to V acromioclavicular joint dislocations. Outcomes included the Oxford Shoulder Score (OSS), Nottingham Clavicle Score (NCS), the Specific Acromioclavicular Score (SACs), and return to sport time frames. Data were analyzed with descriptive statistics. Results: Forty-nine patients underwent this technique. Twenty-six patients returned their postoperative outcomes. Favorable results were shown by all outcomes after surgery (mean score: OSS, 46.3; NCS, 81.8; SACs, 15.9). The mean return to sport time was 17.5 weeks (contact sport) and 32.7 weeks (noncontact sport). There were no infections, no fractures, and 3 complications. Discussion/Conclusion: This modification of the twin-tailed Dog Bone technique using FibreTape resulted in a high patient self-rating of their shoulder function and a low rate of complications.","PeriodicalId":44224,"journal":{"name":"Techniques in Shoulder and Elbow Surgery","volume":"20 1","pages":"103 - 96"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/BTE.0000000000000167","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42516879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Glenoid Fractures Treated by Percutaneous Osteosynthesis Under Arthroscopic Control 关节镜控制下经皮骨融合术治疗关节盂骨折

Techniques in Shoulder and Elbow Surgery Pub Date : 2019-09-01 DOI: 10.1097/BTE.0000000000000171

F. Anger, Samir Chaouche, A. Ecalle, L. Gaubert, Paul Tannyeres, M. Nguyen

引用次数: 1

Treatment of Sagittal Split Olecranon Fractures Using Dorsal Plates Combined With Tension Band Wiring or Cerclage Wires 背侧钢板联合张力带钢丝或环扎钢丝治疗鹰嘴矢状劈裂骨折

Techniques in Shoulder and Elbow Surgery Pub Date : 2019-09-01 DOI: 10.1097/BTE.0000000000000173

G. Kıyak

{"title":"Treatment of Sagittal Split Olecranon Fractures Using Dorsal Plates Combined With Tension Band Wiring or Cerclage Wires","authors":"G. Kıyak","doi":"10.1097/BTE.0000000000000173","DOIUrl":"https://doi.org/10.1097/BTE.0000000000000173","url":null,"abstract":"We evaluated the results of olecranon fractures with an intra-articular sagittal plane fracture treated by dorsal plates in combination with tension band wiring or cerclage wires. We included patients with comminuted olecranon fractures with sagittal split treated with combination fixation. Postoperative functional assessment, Mayo Elbow Performance Score (MEPS) and complications were recorded. The mean age of patients was 52 years (SD±16). There were 7 female and 5 male patients. There were 2 1B, 7 2B, and 3 3B fractures according to Mayo classification. All patient’s fractures healed satisfactorily. There was one minor skin breakdown, which we managed conservatively. The most common problem was symptomatic hardware, which led us to implant removal surgery (33%). Mean loss of motion for the elbow and forearm were as follows: extension 7.5 degrees (SD±5.8 degrees), flexion 9.5 degrees (SD±3.9 degrees), pronation 4.5 degrees (SD±3.3 degrees), and supination 5 degrees (SD±3.7 degrees). The mean MEPS score was 93.7 (SD±7.7). We successfully treated these challenging fractures with our combination fixation technique in our case series. Level of Evidence: Level IV—diagnostic case series.","PeriodicalId":44224,"journal":{"name":"Techniques in Shoulder and Elbow Surgery","volume":"20 1","pages":"75 - 79"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/BTE.0000000000000173","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44949762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anterior Capsular Reconstruction of the Shoulder for Chronic Instability Using a Dermal Allograft 同种异体皮肤移植重建肩关节前囊膜治疗慢性不稳定

Techniques in Shoulder and Elbow Surgery Pub Date : 2019-09-01 DOI: 10.1097/BTE.0000000000000172

T. Zink, J. Triplet, Devon M. Myers, Benjamin C. Taylor, Stephen P. Wiseman, Nathaniel K. Long

引用次数: 3