Techniques in Orthopaedics最新文献

A Derotational Corrective Osteotomy in a Torsional Malaligned Femoral Shaft Fracture Around a Prior Stuck Intramedullary Nail 对先前髓内钉卡住的扭转错位股骨粗隆骨折进行脱位矫正截骨术

IF 0.2

Techniques in Orthopaedics Pub Date : 2024-07-11 DOI: 10.1097/bto.0000000000000674

Patricia R. Melvin, Conor O’Neill, Logan K. Laubach, J. Satpathy

{"title":"A Derotational Corrective Osteotomy in a Torsional Malaligned Femoral Shaft Fracture Around a Prior Stuck Intramedullary Nail","authors":"Patricia R. Melvin, Conor O’Neill, Logan K. Laubach, J. Satpathy","doi":"10.1097/bto.0000000000000674","DOIUrl":"https://doi.org/10.1097/bto.0000000000000674","url":null,"abstract":"\u0000 \u0000 Femoral torsional malunion following trauma fixed with intramedullary (IM) nailing can necessitate femoral derotational osteotomy based on the symptomatic limitations of the patient. There is a paucity of studies discussing the utility and methods of femoral derotational osteotomy following post-traumatic femoral torsional malunion fixed with IM nailing that is not removable.\u0000 \u0000 \u0000 \u0000 We report a surgical technique in a patient treated with a femoral derotational osteotomy who sustained significant rotational deformity after a femoral shaft fracture initially treated with antegrade IM nailing. A standard inferior patellar approach was performed. The distal interlocking screws of the nail were removed, and a trephine was placed up through the distal femoral canal around the nail to free the nail from the surrounding bone to allow for mobility of the distal femur following osteotomy. Parallel K-wires were placed above and below the cut level for rotational control. A dynamic compression plate was then placed in compression mode on the lateral aspect of the femur, and the distal interlocking screws were placed to lock the IM nail.\u0000 \u0000 \u0000 \u0000 We recommend this technique only be used in cases where the nail is centric in the intramedullary canal and in line with the trochlea to be able to pass the trephine through the knee. We believe this technique to be an effective surgical option to treat post-traumatic torsional deformities of the femur where hardware cannot be removed.\u0000","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141656349","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

Optimizing Femoral Tunnel Placement in ACL Reconstruction: Effect of a 70-degree Arthroscope and Portal Position 前交叉韧带重建中股骨隧道位置的优化：70 度关节镜和门户位置的影响

IF 0.2

Techniques in Orthopaedics Pub Date : 2024-07-01 DOI: 10.1097/bto.0000000000000673

Tanvir Khan, Sami Al-Ali, A. Alvand, William F. M. Jackson, Yusuf O. Hasan, David J. Beard, H. S. Gill, Andrew J. Price

{"title":"Optimizing Femoral Tunnel Placement in ACL Reconstruction: Effect of a 70-degree Arthroscope and Portal Position","authors":"Tanvir Khan, Sami Al-Ali, A. Alvand, William F. M. Jackson, Yusuf O. Hasan, David J. Beard, H. S. Gill, Andrew J. Price","doi":"10.1097/bto.0000000000000673","DOIUrl":"https://doi.org/10.1097/bto.0000000000000673","url":null,"abstract":"\u0000 \u0000 The aim of this study was to assess the accuracy of femoral tunnel placement for anterior cruciate ligament reconstruction (ACLR) using either an accessory medial portal or a 70-degree arthroscope compared with the standard 2-portal technique.\u0000 \u0000 \u0000 \u0000 A computerized 3D model of the femur was obtained with 4 reference points marked around the LFC. Using the simulator, 2 surgeons marked 5 consecutive femoral tunnel points with a 30-degree arthroscope in the lateral portal (30AL), then with a 30-degree arthroscope in an accessory medial portal (30AM), and next with a 70-degree arthroscope in the lateral portal (70AL). This was repeated after one week. Subjects then marked their target femoral tunnel positions (T) on the free femur sawbone model. After each episode, the distances from the marked tunnel point to the 4 reference points (d1, d2, d3, d4) were measured. After mapping to the 3D femur model, the co-ordinates of each marked tunnel position were determined. The distance (r) from T was calculated for each episode.\u0000 \u0000 \u0000 \u0000 The median value of r was 1.27 mm(SE 0.15 mm) using 30AL, 0.54 mm (SE 0.12 mm) using the 30AM portal, and 0.20 mm (SE 0.047 mm) with 70AL. r was significantly smaller with 70AL (P<0.0001). The difference in r between 30AM and 30AL was also statistically significant (P=0.019).\u0000 \u0000 \u0000 \u0000 A 70-degree arthroscope in the lateral portal allows greater accuracy in femoral tunnel placement compared with a 30-degree arthroscope in either the lateral or an accessory medial portal.\u0000","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141689212","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

Intraoperative O-arm Use for Physeal Bar Excision 腓骨骨棒切除术术中使用 O 型臂

IF 0.3

Techniques in Orthopaedics Pub Date : 2024-06-05 DOI: 10.1097/bto.0000000000000670

Brian Richard, Mohammed Abbas, Oluwatobi Odeneye, Tolga Türker

{"title":"Intraoperative O-arm Use for Physeal Bar Excision","authors":"Brian Richard, Mohammed Abbas, Oluwatobi Odeneye, Tolga Türker","doi":"10.1097/bto.0000000000000670","DOIUrl":"https://doi.org/10.1097/bto.0000000000000670","url":null,"abstract":"\u0000 \u0000 Growth arrest caused by physeal bar formation in pediatric patients has posed a longstanding challenge in orthopedics. While growth arrest in pediatric distal radius fractures is relatively uncommon, its downstream consequences impact function, pain, and cosmesis. Physeal bar excision can be used to correct and prevent further growth arrest. The results of bar excision have been unreliable due to the difficulty of balancing complete bar resection while minimizing iatrogenic insult to the physis.\u0000 \u0000 \u0000 \u0000 In this article, we present a method utilizing intraoperative computed tomography O-arm for physeal bar excision.\u0000 \u0000 \u0000 \u0000 A 10-year-old boy sustained an open distal radius fracture that was initially stabilized with plates and screws. Two of these screws were transphyseal and resulted in physeal bars and growth arrest. Due to age and the central location of his bars, bar excision was performed with the addition of intraoperative computed tomography. This resulted in a successful outcome with restoration of longitudinal growth of his distal radius.\u0000 \u0000 \u0000 \u0000 This method offers improved localization of physeal bars intraoperatively and, subsequently, more precise bar excision while minimizing the risk of complications.\u0000","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141382680","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

Rambam Hospital Protocol for Treatment of Early Stages of Legg-Calve-Perthes Disease 兰巴姆医院莱格-卡尔维-珀特斯病早期治疗方案

IF 0.3

Techniques in Orthopaedics Pub Date : 2024-06-05 DOI: 10.1097/bto.0000000000000672

M. Eidelman, D. Keshet, Khaled Abu-Dalu, Nadav Rinott, P. Kotlarsky

{"title":"Rambam Hospital Protocol for Treatment of Early Stages of Legg-Calve-Perthes Disease","authors":"M. Eidelman, D. Keshet, Khaled Abu-Dalu, Nadav Rinott, P. Kotlarsky","doi":"10.1097/bto.0000000000000672","DOIUrl":"https://doi.org/10.1097/bto.0000000000000672","url":null,"abstract":"\u0000 \u0000 The treatment of Leg-Calve-Perthes Disease (LCPD) is an orthopedic enigma without consensus in the literature. Despite all efforts, coxa breva with overgrowth of the greater trochanter (GT) is commonly present in many patients. In 2013, we introduced a protocol that included transepiphyseal drilling of the femoral head, closure of the GT, adductor tenotomy, and 4 months of non–weight-bearing on the affected leg. The purpose of this study was to evaluate midterm results in patients treated by our protocol.\u0000 \u0000 \u0000 \u0000 Over 11 years, we treated 31 patients with LCPD. Average age was 7.1 (range 5 to 10) years. We divided all patients into 2 groups: group A included 18 patients in early fragmentation stage, group B contained 12 patients in late fragmentation and one in reossification stage. All patients underwent the same treatment protocol as described.\u0000 \u0000 \u0000 \u0000 Mean follow-up was 52 months. All patients had a limp before surgery. At the latest follow-up, 22 had no limp, and 23 had substantial improvement in hip range of motion. In group A, 12 patients had Stulberg type 1, 5 Stulberg 2, and 1 Stulberg type 3. In group B, 1 patient had Stulberg type 2, 9 patients had Stulberg type 4, and 3 patients had Stulberg type 5.\u0000 \u0000 \u0000 \u0000 On the basis of our experience, the proposed protocol can be effective in the treatment of the early fragmentation stage of LCPD.\u0000","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141384600","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

Cup and Cage Reconstruction for Metastatic Acetabular Lesions Provides Functional Improvement and Cost-efficiency 针对转移性髋臼病变的髋臼杯和髋臼笼重建术既改善了功能，又节约了成本

IF 0.3

Techniques in Orthopaedics Pub Date : 2024-06-04 DOI: 10.1097/bto.0000000000000671

John W. Krumme, Logan K. Laubach, Viraj Sharma, Gregory Domson

{"title":"Cup and Cage Reconstruction for Metastatic Acetabular Lesions Provides Functional Improvement and Cost-efficiency","authors":"John W. Krumme, Logan K. Laubach, Viraj Sharma, Gregory Domson","doi":"10.1097/bto.0000000000000671","DOIUrl":"https://doi.org/10.1097/bto.0000000000000671","url":null,"abstract":"\u0000 \u0000 Pathologic acetabular lesions have multiple surgical options proposed and no clearly defined optimal solution at this time. In this study, we present our cage and cup reconstruction method and analyze postoperative outcomes against previously published studies.\u0000 \u0000 \u0000 \u0000 Twenty-four patients from 2014 to 2020 with acetabular pathologic lesions treated with an antiprotrusio cage and cup reconstruction were identified. Patient charts were reviewed for operative time, blood loss, Musculoskeletal Tumor Society functional scores, follow-up, and complications.\u0000 \u0000 \u0000 \u0000 The average blood loss was 727 mL, and the average postoperative Musculoskeletal Tumor Society score was 70.3, with an average improvement of 35.2 points from preoperative scores. The average cost of our construct per year was $1177 for patients surviving >1 year after surgery. Eleven (45%) patients had died of disease at an average survival time of 14.2 months.\u0000 \u0000 \u0000 \u0000 Our study compares well with historic reconstruction strategies for metastatic acetabular disease, showing that this cup/cage reconstruction provides a durable and perioperatively safe approach that provides functional improvement while remaining cost-efficient.\u0000 \u0000 \u0000 \u0000 Level IV.\u0000","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141267070","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

Management of Unstable Pediatric Distal Radius Fractures With a 2-Pin External Fixator and a Short Arm Cast: Technique and Case Series 使用双针外固定器和短臂石膏治疗不稳定的小儿桡骨远端骨折：技术和病例系列

IF 0.3

Techniques in Orthopaedics Pub Date : 2024-06-03 DOI: 10.1097/bto.0000000000000669

Andrew D Lachance, Stephan Aynaszyan, M. Giro, Abraham T. Appleton

引用次数: 0

The Bubble Sign of Successful Polyethylene Liner Impaction 聚乙烯衬垫成功嵌入的气泡标志

IF 0.3

Techniques in Orthopaedics Pub Date : 2024-05-07 DOI: 10.1097/bto.0000000000000667

Eilis Fitzgerald, Finbarr Condon

引用次数: 0

Surgical Treatment of Superficial Peroneal Neuroma With Intramuscular Transposition 腓肠肌浅层神经瘤的肌肉内移位手术治疗

IF 0.3

Techniques in Orthopaedics Pub Date : 2024-04-19 DOI: 10.1097/bto.0000000000000664

Mila Scheinberg, Stuart D. Miller, Matthew McCrosson, Ashish Shah

{"title":"Surgical Treatment of Superficial Peroneal Neuroma With Intramuscular Transposition","authors":"Mila Scheinberg, Stuart D. Miller, Matthew McCrosson, Ashish Shah","doi":"10.1097/bto.0000000000000664","DOIUrl":"https://doi.org/10.1097/bto.0000000000000664","url":null,"abstract":"\u0000 \u0000 Peripheral nerve injury with neuroma formation is a painful consequence of surgical interventions and acute trauma. The superficial peroneal nerve (SPN) is susceptible to damage, and neuroma formation is common following lateral ankle surgery. Conservative treatments often fail to provide relief, leading to surgical intervention decisions. Surgical techniques for managing SPN neuromas vary, including nerve excision, transposition, and grafting. This report discusses a technique involving neuroma excision, cauterization, and burial into the peroneus brevis muscle.\u0000 \u0000 \u0000 \u0000 A 29-year-old male experienced pain and paresthesia months after a lower leg injury. Examination and ultrasound confirmed an SPN neuroma. Initial conservative treatments were ineffective, leading to surgical considerations. A 4 to 5 cm incision was made proximal to the lateral malleolus, exposing the SPN. Dissection released the SPN from the crural fascia, and the peroneus brevis muscle was split to accommodate nerve burial. The neuroma was excised, and the terminal SPN stump was cauterized. The proximal nerve was secured within the peroneus brevis muscle, and wound closure was performed.\u0000 \u0000 \u0000 \u0000 The procedure was executed without complications. The patient reported significant improvement in pain and paresthesia following surgery. Over a 3-year follow-up period, the patient experiences no recurrence of symptoms related to the neuroma.\u0000 \u0000 \u0000 \u0000 Transection, cauterization, and intramuscular transposition of the proximal nerve stump offer reliable treatment for symptomatic superficial peroneal neuromas. Cauterizing the terminal nerve end with a bipolar device is a simple adjunctive procedure that warrants consideration for similar cases.\u0000","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140685519","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

A Scaphoid Safety Scapholunate Interosseous Ligament Reconstruction. The Non–Bone Tunnel Technique and Clinical Outcomes 肩胛骨安全肩胛骨间韧带重建术。无骨隧道技术和临床结果

IF 0.3

Techniques in Orthopaedics Pub Date : 2024-04-17 DOI: 10.1097/bto.0000000000000665

Panithan Tuntiyatorn, Chanakarn Rojpitipongsakorn, Kulapat Chulsomlee, Pongsakorn Pittayasoponkij, T. Kanchanathepsak, T. Tawonsawatruk

{"title":"A Scaphoid Safety Scapholunate Interosseous Ligament Reconstruction. The Non–Bone Tunnel Technique and Clinical Outcomes","authors":"Panithan Tuntiyatorn, Chanakarn Rojpitipongsakorn, Kulapat Chulsomlee, Pongsakorn Pittayasoponkij, T. Kanchanathepsak, T. Tawonsawatruk","doi":"10.1097/bto.0000000000000665","DOIUrl":"https://doi.org/10.1097/bto.0000000000000665","url":null,"abstract":"\u0000 \u0000 In the chronic unrepairable scapholunate interosseous ligament (SLIL) injury stage, scapholunate ligament (SL) reconstruction remains the gold standard treatment. However, most surgical techniques are required to make the bone tunnel by drilling through the scaphoid, which may introduce iatrogenic scaphoid fracture as a complication. Thus, the aim of this study was to describe an alternative surgical technique for SLIL reconstruction by using a double anchor suture instead of bone drilling.\u0000 \u0000 \u0000 \u0000 A total of 5 consecutive cases of chronic scapholunate dissociation that underwent the non–bone tunnel technique of SLIL reconstruction were included in the study. The clinical data between the preoperative and postoperative were collected.\u0000 \u0000 \u0000 \u0000 In 5 cases, a ligament reconstruction was achieved successfully. At 12 weeks after the surgery. The average Visual Analog Scale improved from 8.4 to 1.0. The clinical stress test was negative without pain. The mean grip strength improved to 85.4% compared with the normal contralateral hand. The mean Quick Disabilities of the Arm, Shoulder, and Hand score was 8.62 compared with the preoperative score of 70.92. Mean of SL interval in wrist with anteroposterior view and anteroposterior clenched fist view at 2.50 mm and 2.68 mm.\u0000 \u0000 \u0000 \u0000 The scaphoid safety SLIL reconstruction technique is a simple and reliable treatment method, using flexor carpi radialis tendon weave and anchor-ligament-anchor procedure instead of previous bone tunnel techniques. Biomechanical strength of the system demonstrated by postoperative results of scaphoid flexion was corrected, but SL gaps were still remaining in some cases. However, there was no effect on clinical outcomes and patient satisfaction.\u0000","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140691472","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

Extended Use of Proximal Humeral Locking Plates in Pediatric Femur Fractures and Osteotomies 在小儿股骨骨折和截骨手术中推广使用肱骨近端锁定钢板

IF 0.3

Techniques in Orthopaedics Pub Date : 2024-04-16 DOI: 10.1097/bto.0000000000000666

Sanjeev Singh, Tushar Agrawal, Deepak Jain, Ameya Velankar

{"title":"Extended Use of Proximal Humeral Locking Plates in Pediatric Femur Fractures and Osteotomies","authors":"Sanjeev Singh, Tushar Agrawal, Deepak Jain, Ameya Velankar","doi":"10.1097/bto.0000000000000666","DOIUrl":"https://doi.org/10.1097/bto.0000000000000666","url":null,"abstract":"\u0000 \u0000 To assess the extended use of proximal humeral locking plates in paediatric femur fractures and osteotomies.\u0000 \u0000 \u0000 \u0000 Pediatric fractures and deformity correction pose unique challenges in orthopedic surgery. The utilization of the proximal humerus locking plates (PHLPs) in the pediatric population remains a relatively unexplored area. This manuscript presents a case-based analysis of the extended use of PHLP in pediatric femur fractures and osteotomies. Four distinct cases involving the use of PHLP are discussed, demonstrating its versatility and efficacy in addressing a variety of orthopedic conditions in the pediatric age group.\u0000 \u0000 \u0000 \u0000 We retrospectively reviewed the medical records of 4 pediatric patients who underwent surgical interventions utilizing PHLP at our institution. Case 1 involved a 9-year-old girl with a neglected neck of femur fracture, managed with in situ screw fixation and valgus osteotomy and stabilization using a PHLP. Case 2 featured a 10-year-old boy with a distal femur fracture, managed with a PHLP. Case 3 highlighted a 12-year-old girl with genu valgum, who underwent medial closing wedge osteotomy stabilized with a PHLP. Lastly, case 4 presented an 11-year-old boy with a subtrochanteric femur fracture, also managed using a PHLP. Surgical techniques, postoperative care, and outcomes were analyzed.\u0000 \u0000 \u0000 \u0000 All 4 cases maintained satisfactory stability and alignment at final follow-up. All of them returned to preinjury status within 6 months.\u0000 \u0000 \u0000 \u0000 The extended use of proximal humeral locking plates in pediatric femur fractures and osteotomies presents a viable option for orthopedic surgeons. These cases illustrate the versatility and positive outcomes associated with PHLP in the pediatric population.\u0000","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140698007","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