European journal of orthopaedic surgery & traumatology : orthopedie traumatologie最新文献

{"title":"Subtalar arthrodesis using a single compression screw: a comparison of results between anterograde and retrograde screwing.","authors":"D Saragaglia,&nbsp;J C Giunta,&nbsp;J Gaillot,&nbsp;Y Tourné,&nbsp;B Rubens-Duval","doi":"10.1007/s00590-021-03141-7","DOIUrl":"https://doi.org/10.1007/s00590-021-03141-7","url":null,"abstract":"<p><strong>Introduction: </strong>The primary objective of this study was to compare the radiological and clinical results of anterograde and retrograde screwing in subtalar arthrodesis using a single compression screw. The secondary objective was to evaluate the subjective results and consolidation of this procedure. The hypotheses were that isolated screw fixation was sufficient to achieve good consolidation and that there was no difference between the two techniques with a similar rate of bone fusion.</p><p><strong>Methods: </strong>This is a monocentric, retrospective, radio-clinical study based on 99 patients (101 feet), 58 males and 41 females, with an average age of 64 years. The main aetiology was post-traumatic osteoarthritis, which represented 51% of cases. Two groups were formed: group A (52 feet) consisting of fixed arthrodesis with ascending (retrograde) screwing and group D (49 feet) consisting of fixed arthrodesis with descending (anterograde) screwing. The two groups were statistically comparable in terms of demographic data as well as aetiologies and comorbidities. Arthrodeses which were not fused at 6 months were reassessed at one year and in the event of any radio-clinical doubt regarding consolidation, an additional CT scan was prescribed. Average post-operative follow-up was 11 ± 5 years (2-27 years).</p><p><strong>Results: </strong>Ninety-two arthrodeses (93%) were fused at one year and 9 were considered to be in non-union, 5 (9.8%) in group A, and 4 (8.3%) in group D. We recorded 30 complications, 22 of which were due to a conflict with the screw head, 18 (34.5%) in group A and 4 (8.3%) in group D (p = 0.03). Conflict between the screw head and the heel led to the removal of the screw after consolidation of the arthrodesis. The clinical results were evaluated using Odom's criteria. Nine per cent of patients described their results as excellent, 29% as good, 51% as satisfactory and 11% found the result to be poor.</p><p><strong>Conclusion: </strong>The fusion rate for isolated compression screw arthrodesis is good, and there is no difference between anterograde and retrograde screws. However, the discomfort caused by the screw head being insufficiently embedded in the retrograde group led to a non-negligible number of additional surgeries to remove the screw.</p>","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"1583-1589"},"PeriodicalIF":1.7,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39500013","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}

{"title":"Retrograde intramedullary nailing of comminuted intra-articular distal femur fractures results in high union rate.","authors":"Samantha Nino,&nbsp;Joshua A Parry,&nbsp;Frank R Avilucea,&nbsp;George J Haidukewych,&nbsp;Joshua R Langford","doi":"10.1007/s00590-021-03140-8","DOIUrl":"https://doi.org/10.1007/s00590-021-03140-8","url":null,"abstract":"<p><strong>Purpose: </strong>Retrograde intramedullary nailing of intra-articular distal femur fractures with metaphyseal and/or epiphyseal comminution is controversial and considered a contraindication to nailing. The purpose of this study was to report union rate, complications, and secondary procedures after open reduction and retrograde intramedullary nailing of comminuted, intra-articular, distal femur fractures.</p><p><strong>Materials and methods: </strong>A retrospective review performed at an urban level one trauma center identified 16 patients AO/Orthopedic Trauma Association (OTA) 33-C2 and 33-C3 femur fractures treated with open reduction, lag screws, and retrograde intramedullary nail fixation. Radiographic union, complications, secondary operations were reviewed.</p><p><strong>Results: </strong>At the 3-month follow-up 12 (86%) of the 14 patients with radiographs had healed. At last follow-up, all 16 femur fractures achieved radiographic union after the index procedure. No patient required a revision procedure for delayed union or nonunion. Complications occurred in 6 (38%) patients, including failed distal interlocking screws (n = 2), knee arthrofibrosis (n = 3), superficial wound infection (n = 1), and wound dehiscence (n = 1). Three (19%) patients required secondary procedures, which included knee manipulation under anesthesia (n = 3), distal interlocking screw removal (n = 2), and closure of a wound dehiscence (n = 1).</p><p><strong>Conclusions: </strong>Comminuted intra-articular distal femur fractures that can be successfully treated with retrograde IMN fixation will reliably go on to union with a complication rate that is favorable to that reported for plate fixation.</p><p><strong>Level of evidence: </strong>Level IV, retrospective case-series.</p>","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"1577-1582"},"PeriodicalIF":1.7,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39500014","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}

{"title":"Inflammatory prognostic scoring systems are risk factors for surgical site infection following wide local excision of soft tissue sarcoma.","authors":"Omer M Farhan-Alanie,&nbsp;Taegyeong Tina Ha,&nbsp;James Doonan,&nbsp;Ashish Mahendra,&nbsp;Sanjay Gupta","doi":"10.1007/s00590-021-03142-6","DOIUrl":"https://doi.org/10.1007/s00590-021-03142-6","url":null,"abstract":"<p><strong>Introduction: </strong>Limb-sparing surgery with negative margins is possible in most soft tissue sarcoma (STS) resections and focuses on maximising function and minimising morbidity. Various risk factors for surgical site infections (SSIs) have been reported in the literature specific to sarcoma surgery. The aim of this study is to determine whether systemic inflammatory response prognostic scoring systems can predict post-operative SSI in patients undergoing potentially curative resection of STS.</p><p><strong>Methods: </strong>Patients who had a planned curative resection of a primary STS at a single centre between January 2010 and December 2019 with a minimum follow-up of 6 months were included. Data were extracted on patient and tumour characteristics, and pre-operative blood results were used to calculate inflammatory prognostic scores based on published thresholds and correlated with risk of developing SSI or debridement procedures.</p><p><strong>Results: </strong>A total of 187 cases were included. There were 60 SSIs. On univariate analysis, there was a statistically significant increased risk of SSI in patients who are diabetic, increasing specimen diameter, American Society of Anaesthesiology (ASA) grade 3, use of endoprosthetic replacement, blood loss greater than 1 L, and junctional tumour location. Modified Glasgow prognostic score, C-reactive protein/albumin ratio and neutrophil-platelet score (NPS) were statistically associated with the risk of SSI. On multivariate analysis, ASA grade 3, junctional tumour location and NPS were independently associated with the risk of developing a SSI.</p><p><strong>Conclusion: </strong>This study supports the routine use of simple inflammation-based prognostic scores in identifying patients at increased risk of developing infectious complications in patients undergoing potentially curative resection of STS.</p>","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"1591-1599"},"PeriodicalIF":1.7,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9587972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39503642","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}

{"title":"Plate osteosynthesis in patellar fractures: a systematic review and meta-analysis.","authors":"Balgovind S Raja,&nbsp;Aakash Jain,&nbsp;Souvik Paul,&nbsp;Arghya Kundu Choudhury,&nbsp;Roop Bhushan Kalia","doi":"10.1007/s00590-021-03143-5","DOIUrl":"https://doi.org/10.1007/s00590-021-03143-5","url":null,"abstract":"<p><strong>Introduction: </strong>To perform a systematic review and assess the indications, outcomes, complications, and union rates associated with plate osteosynthesis in patellar fractures compared to tension band wiring.</p><p><strong>Methods: </strong>The systematic search was conducted for articles in PubMed, Embase Biomedical, Cochrane central, and LILACS databases (date of inception to July 30, 2020). Articles were included if they were randomized control trials, cohort studies, case-control studies, and case series (with more than five cases), which focused on the clinical outcomes of patients with plate osteosynthesis as a treatment for fracture of the patella and had a minimum follow-up of 3 months. All studies were assessed according to their level of evidence, the number of patients, age of patients, fracture patterns described, complications of treatment, and results summarized. Meta-analysis could only be done for two parameters (complications and reoperations) due to the paucity of data and heterogeneity of studies' limited statistical analysis. The data are presented as a review table with the key points summarized.</p><p><strong>Results: </strong>Twenty studies (seven prospective and 13 retrospective articles) identified 533 patients with 534 fractures who had undergone plate osteosynthesis for fracture of the patella. The most common fracture treated with plate osteosynthesis was 34C.</p><p><strong>Conclusion: </strong>Basket plate was most commonly used for inferior pole fractures, while mesh plates were for intra-articular patella fractures. Overall plating was associated with better clinical outcomes, fewer complication rates, and high union rates compared to tension band wiring for patella fractures.</p>","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"1627-1640"},"PeriodicalIF":1.7,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39529560","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}

{"title":"Associated factors of patients with spinal stenosis who undergo reoperation after a posterior lumbar spinal fusion in a Hispanic-American population.","authors":"José C Pérez-López,&nbsp;Gerardo Olivella,&nbsp;Miguel Cartagena,&nbsp;Christian Nieves-Ríos,&nbsp;José Acosta-Julbe,&nbsp;Norman Ramírez,&nbsp;José Massanet-Volrath,&nbsp;José Montañez-Huertas,&nbsp;Enrique Escobar","doi":"10.1007/s00590-021-03127-5","DOIUrl":"https://doi.org/10.1007/s00590-021-03127-5","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate the associated factors of patients with LSS who undergo reoperation after a PLSF in a Hispanic-American population.</p><p><strong>Methods: </strong>A retrospective single-center review was performed from all non-age-related Hispanic-Americans with LSS who underwent one or two-level PLSF from 2008 to 2018. Baseline characteristics were analyzed between the reoperation and no-reoperation group using a bivariate and multivariate analyses.</p><p><strong>Results: </strong>Out of 425 patients who underwent PLSF, 38 patients underwent reoperation. At a two-year follow-up, the reoperation rate was 6.1% (26/425), mostly due to pseudoarthrosis (39.5%), recurrent stenosis (26.3%), new condition (15.8%), infection (10.5%), hematoma (5.3%), and dural tear (2.6%). Patients who underwent reoperation were more likely to have a preoperative history of epidural steroid injection (ESI) (OR 5.18, P = 0.009), four or more comorbidities (OR 2.69, P = 0.028), and operated only with a posterolateral fusion without intervertebral fusion (OR 2.15, P = 0.032). Finally, the multivariable analysis showed that ESI was the only independent associated factor in patients who underwent reoperation after a PLSF in our group.</p><p><strong>Conclusion: </strong>Among this population who underwent surgery, a reoperation rate at two years of follow-up was less than ten percent. Our study did not find any associated factor inherent to Hispanic-Americans, as ethnic group, who were reoperated after LSS.</p>","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"1491-1499"},"PeriodicalIF":1.7,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39438639","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}

{"title":"Correction to: Acute distal biceps tendon rupture: retrospective analysis of two different approaches and fixation techniques.","authors":"Marco Distefano,&nbsp;Lorenzo Sensi,&nbsp;Leonardo di Bella,&nbsp;Raffaele Tucci,&nbsp;Efisio Bazzucchi,&nbsp;Luigi Zanna","doi":"10.1007/s00590-021-03152-4","DOIUrl":"https://doi.org/10.1007/s00590-021-03152-4","url":null,"abstract":"","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"1553"},"PeriodicalIF":1.7,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9587924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39540565","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}

{"title":"Cemented radial head arthroplasty: Does radiographic loosening have an effect on clinical and functional outcomes? Average 10 years' results.","authors":"Tuna Pehlivanoglu,&nbsp;Ali Erşen,&nbsp;Serkan Bayram,&nbsp;Ata Can Atalar,&nbsp;Mehmet Demirhan","doi":"10.1007/s00590-021-03129-3","DOIUrl":"https://doi.org/10.1007/s00590-021-03129-3","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate the possible effect of radiographic loosening on clinical and functional outcomes, while presenting the mid-term radiographic and functional outcomes of cemented, monopolar RHA applied to patients with comminuted radial head fractures.</p><p><strong>Methods: </strong>We performed a retrospective study by evaluating the records of patients who were diagnosed in a single center with radial head fractures between 2001 and 2013. Twenty-six patients with comminuted radial head fractures with a mean age of 48.9 and a mean follow-up time of 132.2 months were included. The radiographic evaluation was performed by assessing peri-prosthetic radiolucent lines around the stem to evaluate loosening, while the clinical evaluation was performed by utilizing elbow range of motion (ROM), Mayo elbow performance score (MEPS), Oxford elbow score (OES) and quick-DASH scores.</p><p><strong>Results: </strong>13 patients (Group 1) with peri-prosthetic stem lucency were defined as radiographic loosening (50%), while the remaining 13 patients (Group 2) were not detected to have stem lucency. One patient in group 1 also had concomitant pain and underwent removal of the prosthesis, while 12 patients (92.3%) remained pain-free. On the latest follow-up visit, there was no significant difference between the groups regarding ROM, MEPS, OES and quick-DASH scores.</p><p><strong>Conclusions: </strong>Within ten years following surgery, half of the patients with radial head prostheses were noted to show radiographic signs of loosening which did not have any major negative effect in terms of clinical-functional outcomes and quality of life, except requiring the removal of the implant in one patient.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"1517-1524"},"PeriodicalIF":1.7,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39454911","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}

{"title":"Radiographic detection of lateral plateau involvement in medial tibial plateau fractures (AO/OTA 41-B1.2, 1.3, 3.2 and 3.3).","authors":"Mary Kate Erdman,&nbsp;Stephen J Gibbs,&nbsp;Douglass W Tucker,&nbsp;Adam K Lee,&nbsp;Mark E Fleming,&nbsp;Geoffrey S Marecek","doi":"10.1007/s00590-021-03117-7","DOIUrl":"https://doi.org/10.1007/s00590-021-03117-7","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the accuracy of radiographs in detecting the lateral plateau involvement of medial tibial plateau fractures as well as describe the impact of CT on preoperative planning for this specific fracture morphology.</p><p><strong>Methods: </strong>Radiograph and CT imaging of patients with a Schatzker type IV tibial plateau fractures (AO/OTA 41-B1.2, B1.3 h, B2.2. B3.2, and B3.3) between January 2013 and July 2017 were reviewed by three trauma fellowship-trained orthopedic surgeons to identify fractures of the medial condyle with an intact anterolateral articular surface.</p><p><strong>Results: </strong>Lateral plateau involvement was identified in 16 (37%) radiographs and 26 (61%) CT images (p = 0.051). Radiographic detection of lateral plateau involvement demonstrated a sensitivity of 62% and specificity of 100%, and radiographs were able to predict the recommendation for surgical intervention for lateral plateau involvement with a positive predictive value (PPV) of 75% and a negative predictive value (NPV) of 60% compared to recommendations based on CT imaging. Radiographs predicted a need for a separate surgical approach with PPV of 63% and NPV of 70% when compared to recommendations based on CT images.</p><p><strong>Conclusions: </strong>Radiographs are reliable in ruling in lateral plateau involvement of medial plateau fractures, but occult lateral articular extension may only be identified in CT imaging for some cases. Surgical planning may be impacted by CT imaging for this fracture morphology, but further study is warranted to evaluate the correlation between preoperative planning and clinical outcomes.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"1501-1508"},"PeriodicalIF":1.7,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39444690","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}

{"title":"Opioid requirements in primary versus revision reverse shoulder arthroplasty.","authors":"B Gage Griswold,&nbsp;L Fielding Callaway,&nbsp;Matthew R I Meng,&nbsp;Cameron S Murphy,&nbsp;Daniel W Paré,&nbsp;Jessica Amero,&nbsp;Michael J Steflik,&nbsp;Frank D Lewis,&nbsp;Lynn A Crosby,&nbsp;Stephen A Parada","doi":"10.1007/s00590-021-03121-x","DOIUrl":"https://doi.org/10.1007/s00590-021-03121-x","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to evaluate the inpatient pain medication use of patients who had a revision shoulder arthroplasty procedure performed and compare them to a cohort of patients who had a primary reverse total shoulder arthroplasty (rTSA) performed to determine whether revision shoulder arthroplasty requires more pain medication..</p><p><strong>Methods: </strong>A retrospective review was performed on patients undergoing revision arthroplasty (n = 75) and primary rTSA (n = 340). Inpatient medication records were reviewed to tabulate the visual analog pain (VAS) all narcotic medication use, and total morphine equivalent units (MEUs) were calculated for the duration of the inpatient stay.</p><p><strong>Results: </strong>There was no significant difference between groups regarding age, sex, body mass index, Charlson Comorbidity Index, American Society of Anesthesiologists score, preoperative narcotic pain medication use, tobacco use, postoperative VAS scores or hospital length of stay. There were no predictors of total postoperative MEUs identified. Overall, patients in the revision arthroplasty group received significantly less total MEUs than those in the primary rTSA group, 134.96 MEUs vs. 69.79 MEUs, respectively (p < .0005).</p><p><strong>Conclusion: </strong>The perceived notion that revision shoulder arthroplasty is more painful may cause providers to be more inclined to increase narcotic use, or use more invasive pain control techniques. Based on these data, we found that revision shoulder arthroplasty did not require an increased opioid requirement, longer length of stay or increase VAS, suggesting that these patients can often be managed similarly to primary rTSA.</p>","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"1509-1515"},"PeriodicalIF":1.7,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39445588","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}

{"title":"Is releasing pulleys during flexor tendon repair \"part and parcel\"? Narrative review of the current evidence.","authors":"Amir Abdelmalek,&nbsp;John McFarlane","doi":"10.1007/s00590-021-03128-4","DOIUrl":"https://doi.org/10.1007/s00590-021-03128-4","url":null,"abstract":"<p><strong>Background: </strong>The complex hand flexors pulleys system is essential in achieving efficient flexor tendons' function. Previous cadaveric studies demonstrated that A2 and A4 are the crucial pulleys in maintaining normal digits biomechanics. Realistically, the preservation of A2 and A4 pulleys during repairing flexor tendon laceration in zones one and two can be extremely challenging. We review the current published evidence in this article to answer the question of whether releasing the pulleys cause bowstringing or affects clinical outcomes.</p><p><strong>Methods: </strong>Literature search of the available databases.</p><p><strong>Results: </strong>There was no published comparative evidence. Retrospective case series have reported that no clinical bowstringing was noted after releasing flexor pulleys during flexor tendon repairs. Outcomes have been reported according to Tang and or Strickland criteria to assess range of motion (ROM). No functional hand scores or patients' satisfactions scores have been reported.</p><p><strong>Conclusion: </strong>Releasing flexor pulleys during tendon repair to allow access or prevent impingement of the repaired tendon does not seem to cause bowstringing or affect outcome based on the limited available evidence. Future research is needed.</p><p><strong>Level of evidence: </strong>Level 4.</p>","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"1451-1457"},"PeriodicalIF":1.7,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39476145","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}