Operative Techniques in Orthopaedics最新文献

Operative Treatment of Chronic Pediatric Patellar Instability 小儿慢性髌骨不稳的手术治疗

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Operative Techniques in Orthopaedics Pub Date : 2024-06-01 DOI: 10.1016/j.oto.2024.101109

{"title":"Operative Treatment of Chronic Pediatric Patellar Instability","authors":"","doi":"10.1016/j.oto.2024.101109","DOIUrl":"10.1016/j.oto.2024.101109","url":null,"abstract":"<div><p><span>Chronic patellar instability in the pediatric<span> population presents early in life and can present as a permanent irreducible dislocation or a habitual dislocation<span> with knee flexion. Congenital patellar dislocation<span> tends to present at birth, with a knee flexion contracture, </span></span></span></span>valgus<span> malalignment of the lower limb and external tibial torsion<span>. Habitual dislocation may present later. The pathoanatomy of congenital and habitual dislocation<span> differentiate. Accurate diagnosis of the underlying pathology is important as the operative management of these conditions is based on addressing these underlying pathologies and so a thorough history and clinical exam is vital. Plain radiographs generally provide the information required to make a diagnosis and plan operatively. Nonoperative management tends to lead to poor long-term outcomes but there is poor consensus in the literature regarding the operative treatment of these conditions. The evaluation and operative treatment of these conditions is described in detail here, addressing the extensor mechanism rotation or attachment abnormalities, the lateral position of the patellar tendon insertion and the laxity of the medial soft tissues.</span></span></span></p></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141714045","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

Transphyseal ACL Reconstruction: A Safe Option Even in Prepubescent Tanner I, II, and III Children 经前交叉韧带重建：即使是青春期前的坦纳一期、二期和三期儿童，也是一种安全的选择

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Operative Techniques in Orthopaedics Pub Date : 2024-06-01 DOI: 10.1016/j.oto.2024.101111

引用次数: 0

Arthroscopic-Assisted Fixation of Tibial Spine Fractures 关节镜辅助固定胫骨脊柱骨折。

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Operative Techniques in Orthopaedics Pub Date : 2024-06-01 DOI: 10.1016/j.oto.2024.101113

{"title":"Arthroscopic-Assisted Fixation of Tibial Spine Fractures","authors":"","doi":"10.1016/j.oto.2024.101113","DOIUrl":"10.1016/j.oto.2024.101113","url":null,"abstract":"<div><p>Tibial spine fractures (TSF) are an avulsion injury of the anterior cruciate ligament (ACL) at the insertion on the tibial plateau. These injuries predominantly affect the pediatric population and are important to treat appropriately as they act similarly to complete ACL injuries. The decision to pursue surgical management is dictated mostly by fracture displacement, but also by various factors such as concomitant injuries, age and level of activity. Multiple fixation strategies are available, ranging from transosseous suture and suture anchors to the use of screws, staples, or absorbable nails.</p><p>This technique paper describes the author's preferred technique involving an arthroscopic assisted reduction of the tibial spine fracture and transosseous suture fixation. High tensile nonabsorbable sutures are passed through the base of the ACL which are then passed through two 2.4 mm transosseous tunnels tied over a bone bridge on the anterior medial tibia.</p><p>An arthroscopic approach has been reported to have similar positive outcomes when compared to open reductions. Furthermore, the transosseous suture construct has been described to be advantageous biomechanically and to yield satisfactory results when compared to alternative fixation options.</p></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141691384","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}

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Editorial Board (pick up from previous issue w/updates) 编辑委员会（接续上期内容并进行更新）

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Operative Techniques in Orthopaedics Pub Date : 2024-06-01 DOI: 10.1053/S1048-6666(24)00030-2

引用次数: 0

Operative Treatment of Discoid Meniscus 盘状半月板的手术治疗

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Operative Techniques in Orthopaedics Pub Date : 2024-06-01 DOI: 10.1016/j.oto.2024.101116

引用次数: 0

Operative Techniques: Osteochondritis Dissecans of the Pediatric Knee 手术技术：小儿膝关节骨软骨软化症

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Operative Techniques in Orthopaedics Pub Date : 2024-06-01 DOI: 10.1016/j.oto.2024.101110

{"title":"Operative Techniques: Osteochondritis Dissecans of the Pediatric Knee","authors":"","doi":"10.1016/j.oto.2024.101110","DOIUrl":"10.1016/j.oto.2024.101110","url":null,"abstract":"<div><p>Osteochondritis dissecans (OCD) of the knee is a relatively rare condition with multifactorial etiology. OCD of the knee most commonly presents in children and adolescents; therefore, timely and appropriate treatment is necessary to prevent long-term cartilage damage and osteoarthritis. The clinical presentation of OCD may vary depending on the location and stability of the lesion. Radiographic and magnetic resonance imaging (MRI) is essential to further classify the lesion and guide treatment. Depending on the lesion's characteristics, nonoperative or operative treatment may be recommended. Nonoperative treatment is recommended for stable lesions in patients with open physes. A period of activity restriction, decreased weight-bearing and immobilization may be recommended. Operative treatment is recommended for stable lesions in patients with closed physes, unstable lesions or failure of nonoperative treatment. A variety of operative techniques are utilized based on stability of the lesion and articular surface integrity. Given the varied presentation of knee OCD lesions, it is critical for clinicians to maintain a high index of suspicion in the at-risk age group. It is also necessary to maintain an in depth understanding of recommended evaluation and treatment techniques to optimize prognosis for healing and minimize long-term sequelae.</p></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1048666624000193/pdfft?md5=9165f4ad107e549a562ac3c7dd7a95e9&pid=1-s2.0-S1048666624000193-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141691580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Operative Treatment of Patellofemoral Instability: Osteotomies for Torsional and Coronal Malalignment 髌骨股骨不稳的手术治疗：扭转和冠状错位的截骨术

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Operative Techniques in Orthopaedics Pub Date : 2024-06-01 DOI: 10.1016/j.oto.2024.101114

{"title":"Operative Treatment of Patellofemoral Instability: Osteotomies for Torsional and Coronal Malalignment","authors":"","doi":"10.1016/j.oto.2024.101114","DOIUrl":"10.1016/j.oto.2024.101114","url":null,"abstract":"<div><p>Patellofemoral instability (PFI) is a prevalent orthopedic issue that leads to significant morbidity and functional limitation. It has a notable incidence, specifically higher amongst adolescent females, and a recurrence rate ranging from 17% to 33%. Recurrent PFI significantly increases the risk of degenerative changes and early-onset osteoarthritis. Patients with multiple risk factors have a remarkably increased rate of recurrence, and thus identifying and managing anatomical risk factors is an effective strategy for patients. These include: trochlear dysplasia, patella alta, increased tibial tubercle-to-trochlear groove (TT-TG) distance, increased femoral anteversion, external tibial torsion, and valgus limb alignment. This study outlines a comprehensive evaluation and surgical approach focusing on PFI associated with torsional or coronal malalignments. The evaluation includes a detailed patient history, clinical examination, and diagnostic imaging. Surgical interventions are selected based on an algorithmic approach tailored to the specific pathoanatomy of the instability, focusing on both bony and soft-tissue procedures. Surgical techniques for addressing PFI in the presence of malalignment include proximal and distal bony procedures. Specific techniques detailed in this study include femoral torsional osteotomy over an intramedullary nail, distal femur opening and closing wedge osteotomies, and torsional tibial osteotomies fixated with an intramedullary nail or plate.</p></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141702008","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

Operative Treatment of Pediatric ACL Tear, Iliotibial Band Reconstruction 小儿前交叉韧带撕裂的手术治疗，髂胫束重建术

IF 0.2

Operative Techniques in Orthopaedics Pub Date : 2024-06-01 DOI: 10.1016/j.oto.2024.101115

{"title":"Operative Treatment of Pediatric ACL Tear, Iliotibial Band Reconstruction","authors":"","doi":"10.1016/j.oto.2024.101115","DOIUrl":"10.1016/j.oto.2024.101115","url":null,"abstract":"<div><p>Pediatric anterior cruciate ligament (ACL) tears are rising due to increased youth sport participation, often prompting early surgical interventions. Over-the-top ACL reconstruction with iliotibial band (ITB) autograft, aimed at minimizing growth disturbances, is a preferred technique for prepubescent patients (Tanner Stage I or II). Surgical technique involves harvest of the ITB with passage in the over-the-top position into the knee, extra-articular tenodesis at the femoral condyle, and tibial fixation distal to the physis and medial to the tubercle. Outcomes include excellent function, high return-to-sport rates, and low graft rupture rates, comparable to alternatives. Systematic reviews support ITB reconstruction, showing high return-to-activity rates and low growth disturbance incidences. Biomechanical studies affirm satisfactory kinematic restoration postsurgery and superior rotatory control. ITB reconstruction offers a promising technique for pediatric ACL tears, warranting further research on long-term efficacy and refined patient selection.</p></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1048666624000247/pdfft?md5=4763a8974f3b5d15d22c42ccc8b4d2bc&pid=1-s2.0-S1048666624000247-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141692084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Contributors (pick up from previous issue w/updates) 投稿人（接上期内容/更新）

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Operative Techniques in Orthopaedics Pub Date : 2024-06-01 DOI: 10.1053/S1048-6666(24)00032-6

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Table of Contents (pick up from previous issue w/updates) 目录（接上一期/更新内容）

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Operative Techniques in Orthopaedics Pub Date : 2024-06-01 DOI: 10.1053/S1048-6666(24)00031-4

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