Techniques in Orthopaedics最新文献_第3页

Open Reduction of Pediatric Femur Fracture: A Technical Trick 儿童股骨骨折切开复位术:一个技术技巧

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Techniques in Orthopaedics Pub Date : 2023-04-21 DOI: 10.1097/bto.0000000000000632

Dana A. Perim, Tyra Swanson, Ernest N. Chisena

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Intramedullary Fibular Strut Allograft and a Small Fragment Nonlocking T-plate for Periprosthetic Lateral Femoral Condyle Fracture: A Case Report 同种异体腓骨支架髓内移植和小碎片非锁定t型钢板治疗股骨外侧髁假体周围骨折1例报告

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Techniques in Orthopaedics Pub Date : 2023-04-11 DOI: 10.1097/bto.0000000000000627

V. Shur, S. Yacovelli

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Surgical Correction of Posttraumatic Varus Deformity of the Distal Tibia Due to Medial Growth Arrest in Children and Adolescents: Surgical Technique 儿童和青少年内侧生长停止所致胫骨远端外伤性内翻畸形的外科矫正:外科技术

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Techniques in Orthopaedics Pub Date : 2023-04-01 DOI: 10.1097/BTO.0000000000000629

R. Schwartz, P. Kotlarsky, M. Eidelman

{"title":"Surgical Correction of Posttraumatic Varus Deformity of the Distal Tibia Due to Medial Growth Arrest in Children and Adolescents: Surgical Technique","authors":"R. Schwartz, P. Kotlarsky, M. Eidelman","doi":"10.1097/BTO.0000000000000629","DOIUrl":"https://doi.org/10.1097/BTO.0000000000000629","url":null,"abstract":"Background: Varus deformity of the distal tibia secondary to epiphyseal fracture and partial growth arrest is relatively common. Growth arrest of the medial part of the epiphysis leads to varus deformity of the distal tibia and fibular overgrowth. If the deformity is left untreated, the malalignment may lead to irreversible damage and early ankle joint osteoarthritis in the long term. Several surgical techniques have been described in the literature to achieve correction and prevent late complications. These include the closure of the remaining epiphysis and various osteotomies around the ankle, using internal and external fixation. Materials and Methods: We report a technique that includes medial open wedge supramalleolar osteotomy, insertion of a structural cortical allograft and fixation with an anatomically contoured locking plate, completion of closure of the distal tibial physis, and distal fibular epiphysiodesis to prevent tibiofibular relations distortion. Part of this protocol is osteotomy of the distal fibula to prevent excessive pressure on the talus, and at the end of the operation, fibular fixation should be performed as well. In children with open physis and potential for significant leg length discrepancy, we recommend closure of the contralateral physis of the distal tibia and fibula. To the best of our knowledge, precise details of this protocol have not been described. Conclusion: We believe that this protocol is a reliable, accurate, and relatively simple method that provides not only anatomic correction and restoration of the ankle joint to prevent early ankle and subtalar arthritis but also addresses late complications, such as ipsilateral fibular overgrowth and limb length discrepancy.","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"36 1","pages":"135 - 140"},"PeriodicalIF":0.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90548814","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

Creating 2 Unique Platelet-rich Plasma Products From a Single Batch of Whole Blood With a Single Processing Kit 用单一处理试剂盒从单批全血中生成2种独特的富血小板血浆产品

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Techniques in Orthopaedics Pub Date : 2023-03-27 DOI: 10.1097/BTO.0000000000000628

M. M. Michael R. Baria, M. M. Alex C. DiBartola, MD Karen Woods, MD Lok Valentas, MD W. Kelton Vasileff, BVSc Sushmitha Durgam

{"title":"Creating 2 Unique Platelet-rich Plasma Products From a Single Batch of Whole Blood With a Single Processing Kit","authors":"M. M. Michael R. Baria, M. M. Alex C. DiBartola, MD Karen Woods, MD Lok Valentas, MD W. Kelton Vasileff, BVSc Sushmitha Durgam","doi":"10.1097/BTO.0000000000000628","DOIUrl":"https://doi.org/10.1097/BTO.0000000000000628","url":null,"abstract":"Introduction: Platelet-rich plasma (PRP) is effective for knee osteoarthritis (OA) and certain tendinopathies. Current recommendations support the use of leukocyte-poor PRP for OA and leukocyte-rich PRP for tendinopathy. If a patient presents with both OA and tendinopathy, very few systems can create multiple PRP products in the same treatment session. The Angel device processes multiple cycles to produce different PRP products. Methods: Ten healthy volunteers donated 156 mL whole blood (WB) that was mixed with 24 mL of anticoagulant citrate dextrose solution, solution A. The first PRP was produced by processing 120 mL at the 0% hematocrit setting and the second PRP was created by processing the remaining 60 mL at the 15% hematocrit setting. WB and PRP underwent complete blood counts and growth-factor analysis. Results: Ten patients donated WB for processing. The 0% setting yielded 3.7 ± 0.15 mL PRP, whereas the 15% setting produced 4.7 ± 0.33 mL. The 0% and 15% settings both concentrated platelets significantly more than WB (1101.5 ± 281.7 K/uL and 1357.8 ± 363.7 vs 184.3 ± 39.1 K/uL, P = 0.000). The 0% setting reduced total leukocytes, but this was not statistically significant. The 15% setting concentrated total leukocytes to 24 ± 8.72 K/uL, which was significantly higher than WB (P = 0.000). Neutrophil concentration was significantly reduced in the 0% PRP compared with 15% (0.032 ± .02 vs 6.75 ± 5.76 K/uL, P = 0.000). Discussion: Two unique PRP products were created from the same batch of WB using a single commercial kit by processing aliquots at different settings.","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"15 1","pages":"144 - 148"},"PeriodicalIF":0.3,"publicationDate":"2023-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74256880","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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Medial Locking Plate Can Increase the Fixation Stability of Vertical Femoral Neck Fracture in Young Adults? 内侧锁定钢板能提高青壮年股骨颈垂直骨折的固定稳定性?

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Techniques in Orthopaedics Pub Date : 2023-02-28 DOI: 10.1097/BTO.0000000000000623

V. Zanardi, J. A. M. Guimarães, João Victor Silveira Möller, C. Roesler

{"title":"Medial Locking Plate Can Increase the Fixation Stability of Vertical Femoral Neck Fracture in Young Adults?","authors":"V. Zanardi, J. A. M. Guimarães, João Victor Silveira Möller, C. Roesler","doi":"10.1097/BTO.0000000000000623","DOIUrl":"https://doi.org/10.1097/BTO.0000000000000623","url":null,"abstract":"Introduction: Vertical femoral neck fractures in young adults are usually caused by high-energy trauma. These injuries are difficult to stabilize due to significant shear forces acting on the fracture site. Their treatment is challenging and with high risks of complications, such as fixation failure, malunion, nonunion, and avascular necrosis of the femoral head. Material and Methods: It compared the biomechanical stability provided by 3 different fixation methods: (1) dynamic hip screw with derotation screw, (2) cannulated screws with a conventional medial bone plate, and (3) cannulated screws with a locked medial bone plate. These fixation structures were applied on fourth-generation medium-sized synthetic bones, with a 17 pound per cubic foot cellular foam core and cervico-diaphyseal angle of 120 degrees were used. The comparison was performed through biomechanical tests under cyclic loading followed by an ultimate load. The interfragmentary movement at the fracture site was the main variable for the cyclical phase. Results: The biomechanical comparison showed no statistical differences (P > 0.05) in stiffness, micromovement level, and mechanical resistance among the fixation techniques evaluated. Discussion: To stabilize the vertical femoral neck fracture in young patients, the use of a medial bone plate associated with cannulated screws on a “tie-rod” assembly is an option that supports the mechanical demand until the fracture healing. The locked medial plate did not provide an advantage compared with the conventional bone plate.","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"4 1","pages":"126 - 130"},"PeriodicalIF":0.3,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72907798","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

Maintaining Skeletal Traction During CT Scans: A Novel and Reproducible Setup 在CT扫描期间维持骨骼牵引:一种新的可重复的设置

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Techniques in Orthopaedics Pub Date : 2023-02-23 DOI: 10.1097/BTO.0000000000000626

J. Cross, Michael Rasmussen, Phillip J. Stokey, Jason C. Tank

{"title":"Maintaining Skeletal Traction During CT Scans: A Novel and Reproducible Setup","authors":"J. Cross, Michael Rasmussen, Phillip J. Stokey, Jason C. Tank","doi":"10.1097/BTO.0000000000000626","DOIUrl":"https://doi.org/10.1097/BTO.0000000000000626","url":null,"abstract":"Introduction: Skeletal traction is an integral technique in orthopedic fracture management, used primarily in the acute preoperative setting, but in many parts of the world, is still considered for definitive management. Maintenance of skeletal traction during imaging procedures can be a large burden on providers, and releasing traction even for a short period of time can have significant adverse outcomes for patients. There is currently no practical technique for accomplishing this in the literature. Materials and Methods: We describe here a novel and easily reproducible setup that allows for the maintenance of traction during computed tomography scans. Results: The described technique is versatile as it can be used with different computed tomography scanners, easily assembled in a few minutes, and accommodates up to 25 lbs. Conclusions: This technical design offers a safe and quickly reproducible setup for skeletal traction in unique situations where traction is required during imaging. The apparatus has implications for advanced diagnostic and research-based imaging as well, and all materials should be readily available at any institution frequently performing skeletal traction.","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"25 1","pages":"131 - 134"},"PeriodicalIF":0.3,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80164073","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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Letter to Editor Regarding Intramedullary Delivery of Autologous Bone Graft to Long Bone Defects Using Reamer Irrigator Aspirator 2 System: Technical Trick 致编者的信:关于利用铰刀冲洗器和吸引器系统髓内输送自体骨移植物治疗长骨缺损的技术技巧

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Techniques in Orthopaedics Pub Date : 2023-02-20 DOI: 10.1097/bto.0000000000000625

R. Rajfer

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Indications and Outcomes of a Tibial Turn-up Procedure: A Case Series and Review of the Literature 胫骨恢复手术的适应症和结果:病例系列和文献回顾

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Techniques in Orthopaedics Pub Date : 2023-02-20 DOI: 10.1097/BTO.0000000000000624

Ryan T. Voskuil, Eric Welder, Steven A. Schulz, J. Mayerson, T. Scharschmidt

{"title":"Indications and Outcomes of a Tibial Turn-up Procedure: A Case Series and Review of the Literature","authors":"Ryan T. Voskuil, Eric Welder, Steven A. Schulz, J. Mayerson, T. Scharschmidt","doi":"10.1097/BTO.0000000000000624","DOIUrl":"https://doi.org/10.1097/BTO.0000000000000624","url":null,"abstract":"Background: Treatment options for distal femoral bone loss resulting from malignancy, infection, or trauma can be grouped into limb salvage techniques versus amputation. A vascularized osteomyocutaneous flap using the ipsilateral tibia—a tibial turn-up procedure—can be used to restore femoral length for high above-knee amputations in both the primary and revision setting. We report 3 patients treated with this procedure. Purpose: To describe the treatment algorithm and functional outcomes of patients who have undergone a tibial turn-up procedure and to highlight its viability when considering surgical options for the treatment of distal femoral primary bone and soft tissue malignancy and in cases of severe trauma, infection, or implant failure. Patients and Methods: Three patients ages 21 to 56 years old treated with tibial turn-up as a salvage procedure for failed limb sparing techniques were followed for 1.5 to 3.5 years postoperatively. One was treated for recalcitrant chronic distal femur osteomyelitis, 1 for aseptic loosening of distal femoral replacement, and 1 for infected distal femoral replacement. Radiographic and functional outcomes including prosthetic use, ambulatory status, and current activity level were reported. Results: At a minimum 1.5-year follow-up, all 3 patients achieved bony union and were ambulatory with prosthetics without the use of additional gait aids. Conclusions: Tibial turn-up is an effective treatment option in the setting of distal femoral bone loss and/or limb salvage complications, providing good functional outcomes with a single durable surgery.","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"35 1","pages":"120 - 125"},"PeriodicalIF":0.3,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84933670","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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A Modified Reverse Planning Method for Correction of Distal Femoral Valgus Deformity: Surgical Technique and Early Results 一种改良的反向规划方法矫正股骨远端外翻畸形:手术技术和早期结果

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Techniques in Orthopaedics Pub Date : 2023-02-07 DOI: 10.1097/BTO.0000000000000621

C. Iobst, A. Bafor

{"title":"A Modified Reverse Planning Method for Correction of Distal Femoral Valgus Deformity: Surgical Technique and Early Results","authors":"C. Iobst, A. Bafor","doi":"10.1097/BTO.0000000000000621","DOIUrl":"https://doi.org/10.1097/BTO.0000000000000621","url":null,"abstract":"Background: A reverse planning method is an option for distal femur deformity correction. However, the accuracy of the technique hinges on the precision of the initial guidewire placement. This study describes a modification to the reverse planning method designed to simplify the surgical procedure for retrograde femoral nailing to correct valgus deformities. The steps of the surgical technique and the early results are presented. Materials and Methods: After IRB approval, patients with distal femoral valgus deformity treated with retrograde nails using the modified reverse planning method were identified. Data obtained retrospectively included basic demographics, pre and postsurgery mechanical lateral distal femoral angle, the magnitude of limb length discrepancy if present, the duration of surgery, and the occurrence of any complications. Results: We analyzed 17 limbs in 15 patients (10 females). The mean age at surgery was 18 years. Four patients had an additional limb length discrepancy (mean value of 2.8 ± 0.9 cm). The mean pre and postoperative mechanical lateral distal femoral angle was 83 degrees and 90 degrees, respectively (P < 0.0001). The mean duration of surgery was 90 minutes. Conclusions: This study demonstrates that the modified reverse planning concept can be applied successfully to achieve accurate correction and healing of distal femoral valgus deformities. Furthermore, by adjusting the level of the osteotomy, this modified approach simplifies the surgical technique in several ways: (1) it creates a reproducible visual cue for the surgeon, (2) it decreases the surgical time by eliminating the need for fixator assistance, and (3) it reduces the need for multiple coronal planes blocking screws.","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"10 1","pages":"149 - 155"},"PeriodicalIF":0.3,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84020203","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 Laparoscopic Irrigator Aspirator: A Time and Cost Saving Alternative Irrigation Method for Open Fractures 腹腔镜冲洗器:一种既省时又省钱的开放性骨折的替代冲洗方法

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Techniques in Orthopaedics Pub Date : 2023-02-07 DOI: 10.1097/bto.0000000000000622

José George, C. M. Hoshino, S. Shymon

{"title":"The Laparoscopic Irrigator Aspirator: A Time and Cost Saving Alternative Irrigation Method for Open Fractures","authors":"José George, C. M. Hoshino, S. Shymon","doi":"10.1097/bto.0000000000000622","DOIUrl":"https://doi.org/10.1097/bto.0000000000000622","url":null,"abstract":"Introduction: At our institution, the laparoscopic irrigator aspirator (LIA) is used as the primary means of irrigation in open fractures, as it allows for quicker and more efficient irrigation. The purpose of this technical trick is to evaluate the cost and time savings between gravity tubing, pulse lavage, and LIA methods. Materials and Methods: The 3 different methods of irrigation, gravity tubing, pulse lavage, and LIA, were set up, and the time to use one 3 L bag of normal saline was recorded for each. The list prices for each method of irrigation were obtained, and the time and cost saved per 3 L bag was multiplied by 3 for the total time and cost 9 L of irrigation. Results: The LIA was the most efficient irrigation method and saved 303 seconds over gravity and 534 seconds saved over pulse lavage over 9 L. For cost, the laparoscopic resulted in $156.15 saved over gravity and $332.80 saved over pulse lavage over 9 L when accounting for cost of operating room time and cost of implant. At our institution, 34 open tibia fractures were treated in 2019, which results in 2.86 hours and $5309.10 saved over gravity and 5.04 hours and $11,315.2 saved over pulse lavage by using the LIA. Conclusions: Lap irrigation is a viable alternative to gravity tubing and pulse lavage for open fracture irrigation and results in both time and cost savings.","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"2001 1","pages":"141 - 143"},"PeriodicalIF":0.3,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91314644","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