Techniques in Orthopaedics最新文献_第8页

Achilles Tendon-Bone Allograft is Advantageous for Chronic Patellar Tendon Ruptures Using a Modified Fixation Technique 采用改良固定技术，跟腱-骨同种异体移植治疗慢性髌骨断裂是有利的

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Techniques in Orthopaedics Pub Date : 2022-06-28 DOI: 10.1097/BTO.0000000000000595

S. Keyhani, M. Movahedinia, Farzad Amouzadeh, Naser Ghanbari

{"title":"Achilles Tendon-Bone Allograft is Advantageous for Chronic Patellar Tendon Ruptures Using a Modified Fixation Technique","authors":"S. Keyhani, M. Movahedinia, Farzad Amouzadeh, Naser Ghanbari","doi":"10.1097/BTO.0000000000000595","DOIUrl":"https://doi.org/10.1097/BTO.0000000000000595","url":null,"abstract":"Objectives: A patellar tendon rupture is an extremely disabling extensor mechanism injury. This follow-up study describes the clinical and radiologic outcomes of a new modified technique for reconstructing chronic patellar tendon ruptures. Materials and Methods: From 2014 to 2018, we reconstructed 15 chronic patellar tendon ruptures using Achilles tendon-bone allograft. Clinical and radiologic outcomes were evaluated preoperatively and during the final follow-up, 2 to 7 years after reconstruction. Assessments involved the International Knee Documentation Committee (IKDC), Lysholm, and Kujala scores, as well as quadriceps muscle strength and extension lag. Radiologic results were evaluated using the Insall-Salvati index on plain radiography and allograft integration through magnetic resonance imaging. Results: At the final follow-up, the Lysholm, IKDC, and Kujala scores improved by 57, 58, and 54 points, respectively (P<0.001). The average quadriceps muscle strength improved from 2.6 (2 to 3) before the operation to 4.6 (4 to 5) at the final follow-up (P<0.001). The extension lag also improved significantly from 31.7 degrees (25 to 40) to 0.6 degrees (0 to 10). The preoperative Insall-Salvati index was 1.6 (1.5 to 1.9), which improved significantly to 1.2 (1 to 1.3) postoperatively (P<0.001). Two years after the operation, magnetic resonance imaging showed good allograft integration in all pateints. Conclusion: Combining an Achilles tendon-bone allograft with a robust fixation method led to favorable clinical and radiologic outcomes. Level of Evidence: Level IV.","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79812149","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

Technical Trick: T-Bar External Fixator for Definitive Management of Periarticular and Metadiaphyseal Tibial Fractures 技术诀窍:t -棒外固定架用于胫骨关节周和干骺端骨折的最终治疗

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Techniques in Orthopaedics Pub Date : 2022-06-03 DOI: 10.1097/BTO.0000000000000594

Samuel J Mease, Hallie R. Bradley, D. R. Thota, A. Starr, Drew T. Sanders

{"title":"Technical Trick: T-Bar External Fixator for Definitive Management of Periarticular and Metadiaphyseal Tibial Fractures","authors":"Samuel J Mease, Hallie R. Bradley, D. R. Thota, A. Starr, Drew T. Sanders","doi":"10.1097/BTO.0000000000000594","DOIUrl":"https://doi.org/10.1097/BTO.0000000000000594","url":null,"abstract":"Purpose: Tibia fractures with soft tissue compromise present are challenging to manage. For fractures with significant swelling or open injury not amenable to internal stabilization, external fixators provide sufficient stability for bony healing. Ring fixators and hybrid constructs provide adequate stability for healing but are costly, and challenging to apply and maintain. We present the “T-bar” external fixator, a novel construct that can be maintained until bony union and allows for range of motion of adjacent joints. We also report the demographics, clinical, and radiographic outcomes of 34 patients treated definitively with this construct. Materials and Methods: The T-bar external fixator uses standard pins and bars in a novel arrangement. It can be applied for Arbeitsgemeinshaft fur Osteosynthesefragen/Orthopaedic Trauma Association-type 41/42/43 type injuries, with or without supplemental fixation for intra-articular patterns. Results: Between 2008 and 2015, 34 patients were treated for tibia fracture with T-bar external fixation, with intention to treat in a definitive manner. Twenty-nine were male, and average age was 44.3 years. Thirty-one sustained high energy mechanisms of injury. Twenty were Gustilo-type 2 or 3 fractures. Of 14 closed fractures, 12 were Tscherne-type 2 or 3. Conclusions: The T-bar external fixator offers an alternative to ring and hybrid external fixator constructs in treatment of tibia fractures with significant soft tissue compromise. Of 28 patients with complete follow up, only 1 case of osteomyelitis was reported. All patients were managed without amputation. Three required revision for nonunion, all Arbeitsgemeinshaft fur Osteosynthesefragen/Orthopaedic Trauma Association-type 43.","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88001114","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

“Turning The Tables”: A Technical Tip to Overcome Anatomic Constraints While Distal Locking During Femur Intramedullary Nailing “扭转局面”:在股骨髓内钉期间远端锁定时克服解剖限制的技术技巧

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Techniques in Orthopaedics Pub Date : 2022-05-26 DOI: 10.1097/BTO.0000000000000593

S. Mittal, Tanya Trikha, A. Karpe, Pulak Vatsya, V. Trikha

{"title":"“Turning The Tables”: A Technical Tip to Overcome Anatomic Constraints While Distal Locking During Femur Intramedullary Nailing","authors":"S. Mittal, Tanya Trikha, A. Karpe, Pulak Vatsya, V. Trikha","doi":"10.1097/BTO.0000000000000593","DOIUrl":"https://doi.org/10.1097/BTO.0000000000000593","url":null,"abstract":"Introduction: Interlocking nailing for femoral shaft fractures is one of the most common surgeries by orthopedic traumatologists. With the advent of cephalon-medullary nailing, a center-center position of the head screw has become mandatory. With retroversion or reduced anteversion of neck, a center placement needs internal rotation of the nail. This makes distal locking problematic, as now making a perfect circle is difficult due to the physical constraints of C-arm rotation. Objective: To describe a novel technique to overcome the anatomic constraints and get a perfect circle for quick distal locking. Material and Methods: We used a novel technique in our routine femur nailing cases. Here, in cases with reduced anteversion of the neck, distal locking was tenuous due to difficulty in making a perfect circle. Thus, we have used a new technique called “Turning the table” where we externally rotate the table, which allows us to get a perfect circle for locking in almost a single exposure. Results: This is a useful technique in cases where getting a perfect circle is difficult due to anatomic constraints and variations and can help in getting a perfect circle with limited radiation exposure.","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91241598","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

All-cementless Revision Total Knee Arthroplasty Using a Constrained Condylar Design With Porous Tantalum: Technique and Clinical Results 多孔钽约束髁设计全无骨水泥翻修全膝关节置换术:技术和临床结果

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Techniques in Orthopaedics Pub Date : 2022-05-23 DOI: 10.1097/BTO.0000000000000592

Erik Y. Tye, J. Bryman, R. Kay, Adam J. Taylor, J. Andrawis, L. Kwong

{"title":"All-cementless Revision Total Knee Arthroplasty Using a Constrained Condylar Design With Porous Tantalum: Technique and Clinical Results","authors":"Erik Y. Tye, J. Bryman, R. Kay, Adam J. Taylor, J. Andrawis, L. Kwong","doi":"10.1097/BTO.0000000000000592","DOIUrl":"https://doi.org/10.1097/BTO.0000000000000592","url":null,"abstract":"Introduction: Contemporary differences exist with regards to revision total knee arthroplasty (TKA) fixation philosophy. The use of an all-cementless constrained condylar knee (CCK) design for revision TKA with porous tantalum has not been described in the recent peer-reviewed literature. Our rationale for using an all-cementless design in the revision setting includes the theoretical decrease in aseptic loosening and enhanced preservation of bone stock. Methods: We report the surgical technique and clinical results of 28 patients who underwent revision TKA utilizing an all-cementless CCK design and review the complications, rerevisions, and survivorship free of aseptic loosening. All subjects were included in the survivorship analysis. Results: The mean age of patients was 62.8 years. The average length of follow-up was 3.6 years (range: 2 to 6 y). Seventeen patients underwent revision TKA for periprosthetic joint infection as the second stage of a 2-stage reconstruction, 7 for aseptic loosening, and 4 for instability. There were 6 failures defined as the removal of any components for any reason; 5 of the 6 failures were due to recurrent periprosthetic joint infection. There were no failures that were revised for aseptic loosening. Discussion: If we consider those patients lost to follow-up to represent a failure (5/28), our series would have an 82.1% survivorship free from aseptic loosening and a failure rate 17.9% at an average of 3.6 years. Early results suggest the use of an all-cementless CCK design with porous tantalum for revision TKA may provide an acceptable alternative to cemented and hybrid techniques in selected patients.","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81102160","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 Cutaneous Transposition Inversion Flap to Treat Symptomatic Subcutaneous Trochanteric or Soft Tissue Defects After Hip Arthroplasty: A Technical Note 皮肤转位反转皮瓣治疗髋关节置换术后症状性皮下粗隆或软组织缺损:技术说明

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Techniques in Orthopaedics Pub Date : 2022-05-17 DOI: 10.1097/BTO.0000000000000591

Jonas Liebe, Aude Lehnen, A. Jandali, C. Meier, P. Wahl

引用次数: 0

A Humble Periodontal Probe Can Help Implant Removal During Revision Total Joint Arthroplasty: A Technical Note 一个不起眼的牙周探针可以帮助在全关节置换术翻修期间去除种植体:一个技术说明

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Techniques in Orthopaedics Pub Date : 2022-05-16 DOI: 10.1097/BTO.0000000000000590

A. Khalifa, A. Abdelaal, Mohamed M. A. Moustafa, M. Mahran

{"title":"A Humble Periodontal Probe Can Help Implant Removal During Revision Total Joint Arthroplasty: A Technical Note","authors":"A. Khalifa, A. Abdelaal, Mohamed M. A. Moustafa, M. Mahran","doi":"10.1097/BTO.0000000000000590","DOIUrl":"https://doi.org/10.1097/BTO.0000000000000590","url":null,"abstract":"R evision total joint (hip and knee) arthroplasty is a complex procedure that usually necessitates implant removal, which, if done correctly, will ease the subsequent reconstruction.1 Preoperative planning is of paramount importance in the revision of total joint arthroplasty surgeries; the surgeon should make sure that he/she has both the skills and the equipment needed for the surgery, an integral part of this plan is how the surgeon is going to remove the implants with the minimal force (to avoid soft tissue disruption) and with the least bone loss possible.2,3 Various tools had been introduced to facilitate fixed knee or hip implants removal, such as drills, oscillating saws, Gigli saws, reciprocating saws, thin flexible osteotomes, high-speed metal cutting burrs, punches, impactors, and universal distraction devices for cement removal, hooks, curettes, flag splitter, and ultrasonic devices could be used.1–4 In this technical note, we described how a humble periodontal probe (from dental surgery tools) could be a helpful tool for removing fixed implants in revision total joint arthroplasty surgery. TECHNIQUE","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79424638","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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The “Flying V”: A Novel Construct to Address Concurrent Lateral Ankle and Syndesmotic Instability “飞行V”:一种解决踝关节外侧和韧带联合不稳定的新构造

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Techniques in Orthopaedics Pub Date : 2022-05-05 DOI: 10.1097/bto.0000000000000589

Kevin D. Martin, Reid Palumbo, Jesse H. Morris

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Percutaneous Removal of a Foreign Body From the Distal Phalanx Using a 14 Gauge Needle and Fluoroscopy 使用14号针和透视从远端指骨经皮取出异物

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Techniques in Orthopaedics Pub Date : 2022-05-04 DOI: 10.1097/bto.0000000000000588

J. Schwarz, Yiyang Zhang, J. Dieterich, M. Hausman

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Intramedullary Delivery of Autologous Bone Graft to Long Bone Defects Using Reamer Irrigator Aspirator 2 System: Technical Trick 用扩孔器灌吸系统髓内移植自体骨修复长骨缺损:技术技巧

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Techniques in Orthopaedics Pub Date : 2022-04-08 DOI: 10.1097/bto.0000000000000584

Joshua N. Speirs, M. Wilson, Joey P Johnson

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Technique Tip: Bicortical Fixation of Medial Malleolus Fractures With 2.7 mm Screws 技术提示:2.7 mm螺钉内固定内踝骨折双皮质

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Techniques in Orthopaedics Pub Date : 2022-04-05 DOI: 10.1097/bto.0000000000000585

A. Dimitroulias, Ryhor Harbacheuski, N. Gougoulias, D. Murphy, M. Sen

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