Abdelkader Shekhbihi, W. Reichert, Mohammad A Masoud
The outdated ‘bag of bones’ concept for managing intraarticular distal humerus fractures (IDHF) has historically given way to precise articular reduction made possible by modern implant designs and the option of joint replacement as a last resort for unreconstructable fractures. Several posterior approaches to the distal humerus have been described since the last century, among which the olecranon osteotomy is considered the most invasive yet the most employed approach in cases of intraarticular distal humerus fractures. The advantages and reported complications of the triceps fascial tongue approach, the triceps reflecting anconeus pedicle (TRAP) approach, and the olecranon osteotomy in cases of intraarticular distal humerus fractures were the subjects of a thorough literature search in the PubMed, SCOPUS, Cochrane Library, and Google Scholar databases. This literature review made use of all pertinent data.
在处理肱骨远端关节内骨折（IDHF）时，过时的 "骨袋 "概念已被现代植入物设计所实现的精确关节复位以及关节置换术所取代。自上个世纪以来，已经有多种肱骨远端后路手术方法被描述，其中肩胛骨截骨术被认为是创伤最大但在关节内肱骨远端骨折病例中使用最多的方法。 我们在 PubMed、SCOPUS、Cochrane Library 和 Google Scholar 数据库中对肱骨远端关节内骨折病例中的肱三头肌筋膜舌入路、肱三头肌反射肱骨椎弓根入路（TRAP）和肩胛骨截骨术的优势和并发症进行了全面的文献检索。该文献综述使用了所有相关数据。
{"title":"Are olecranon osteotomies preferred to triceps-elevating approaches in intraarticular distal humerus fractures? A literature review","authors":"Abdelkader Shekhbihi, W. Reichert, Mohammad A Masoud","doi":"10.4103/eoj.eoj_80_23","DOIUrl":"https://doi.org/10.4103/eoj.eoj_80_23","url":null,"abstract":"\u0000 \u0000 \u0000 The outdated ‘bag of bones’ concept for managing intraarticular distal humerus fractures (IDHF) has historically given way to precise articular reduction made possible by modern implant designs and the option of joint replacement as a last resort for unreconstructable fractures. Several posterior approaches to the distal humerus have been described since the last century, among which the olecranon osteotomy is considered the most invasive yet the most employed approach in cases of intraarticular distal humerus fractures.\u0000 \u0000 \u0000 \u0000 The advantages and reported complications of the triceps fascial tongue approach, the triceps reflecting anconeus pedicle (TRAP) approach, and the olecranon osteotomy in cases of intraarticular distal humerus fractures were the subjects of a thorough literature search in the PubMed, SCOPUS, Cochrane Library, and Google Scholar databases. This literature review made use of all pertinent data.\u0000","PeriodicalId":171084,"journal":{"name":"The Egyptian Orthopaedic Journal","volume":"124 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140090673","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}
Ayman A A Samad, Emad G. K. EL-BANNA, Tarek M Makhlouf, Ahmed G Mostafa
Degenerative spondylolisthesis and lumbar disk degeneration are common degenerative diseases of the spine that may lead to lower back pain and radicular leg pain. The perfect surgical treatment remains a point of debate; interbody fusion has been recognized as having a ‘golden role’ in the treatment of lumbar degenerative diseases, but spinal interbody fusion with polyetheretherketone (PEEK) cage surgery often incurs numerous complications such as cage retropulsion, nonunion, and high cost. We hypothesize that the autologous strut laminar graft will show clinical and radiological results similar to those obtained using a PEEK cage. To compare the primary outcome (clinical pain relief) and the secondary outcome (radiological signs of union and rate of fusion) when using strut laminar graft versus PEEK cage in posterior lumbar interbody fusion (PLIF) technique in the surgical management of degenerative lumbar diseases. Forty patients with single-level lumbar degenerative disk disease and/or degenerative spondylolisthesis grades 1 or 2 underwent PLIF surgery between November 2017 and December 2020. All patients were randomly divided into two groups according to the method of fusion (group A: laminar strut graft and group B: PEEK cage). Single-level PLIF was performed in all patients. Clinical, radiological, functional, and perioperative data were recorded and compared. The mean follow-up was 22 ± 6 months. Clinical improvement and radiological fusion were significantly documented in each group (P>0.05). However, no significant difference existed between the two groups regarding demographic, radiological, and functional outcomes. The results suggest that the laminar strut graft when used instead of the cage seems to be an equally safe and low-priced method of interbody fusion.
{"title":"Comparative study of posterior lumbar interbody fusion by strut laminar autograft versus cage in degenerative lumbar spine diseases","authors":"Ayman A A Samad, Emad G. K. EL-BANNA, Tarek M Makhlouf, Ahmed G Mostafa","doi":"10.4103/eoj.eoj_138_23","DOIUrl":"https://doi.org/10.4103/eoj.eoj_138_23","url":null,"abstract":"\u0000 \u0000 \u0000 Degenerative spondylolisthesis and lumbar disk degeneration are common degenerative diseases of the spine that may lead to lower back pain and radicular leg pain. The perfect surgical treatment remains a point of debate; interbody fusion has been recognized as having a ‘golden role’ in the treatment of lumbar degenerative diseases, but spinal interbody fusion with polyetheretherketone (PEEK) cage surgery often incurs numerous complications such as cage retropulsion, nonunion, and high cost. We hypothesize that the autologous strut laminar graft will show clinical and radiological results similar to those obtained using a PEEK cage.\u0000 \u0000 \u0000 \u0000 To compare the primary outcome (clinical pain relief) and the secondary outcome (radiological signs of union and rate of fusion) when using strut laminar graft versus PEEK cage in posterior lumbar interbody fusion (PLIF) technique in the surgical management of degenerative lumbar diseases.\u0000 \u0000 \u0000 \u0000 Forty patients with single-level lumbar degenerative disk disease and/or degenerative spondylolisthesis grades 1 or 2 underwent PLIF surgery between November 2017 and December 2020. All patients were randomly divided into two groups according to the method of fusion (group A: laminar strut graft and group B: PEEK cage). Single-level PLIF was performed in all patients. Clinical, radiological, functional, and perioperative data were recorded and compared.\u0000 \u0000 \u0000 \u0000 The mean follow-up was 22 ± 6 months. Clinical improvement and radiological fusion were significantly documented in each group (P>0.05). However, no significant difference existed between the two groups regarding demographic, radiological, and functional outcomes.\u0000 \u0000 \u0000 \u0000 The results suggest that the laminar strut graft when used instead of the cage seems to be an equally safe and low-priced method of interbody fusion.\u0000","PeriodicalId":171084,"journal":{"name":"The Egyptian Orthopaedic Journal","volume":"122 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139842193","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}
Acromioclavicular joint (ACJ) dislocation is a common injury, which accounts for ~9% of all shoulder injuries. Surgical techniques for reconstructing or repairing ACJ dislocation have evolved over the last decades. Recent surgical techniques focus on reconstruction of the coracoclavicular ligament to recover the stability of ACJ. This was a prospective case series study that included 23 patients with acute ACJ dislocation, admitted to the Department of Orthopaedic Surgery and Traumatology, Faculty of Medicine, Kafr El Sheikh and Benha University. All cases were treated by coracoclavicular repair using Double Endobutton technique and Ethibond suture. The follow-up period ranged from 18 to 24 months postoperatively. Outcomes were assessed using Constant score and DASH score at of 6 weeks, 3, 6, 12 months, and final follow up. Radiological assessment was done using Zanca view and stress anteroposterior radiographs of both shoulders to compare acromiohumeral interval at the end of follow up. This study included 23 patients that were admitted to our department. Their mean age were 34.2 ± 2.3 years. The average time between injury and surgery was 5.2 ± 1.4 days. There were 20 men and three females. Regarding DASH score it improved from preoperative value of 88.3 ± 11.2 points to 14.3 ± 2.4 points. Regarding Constant score, it improved significantly from preoperative value of 45.3 ± 2.2 points to a postoperative value of 92.3 ± 3.6 points. Regarding acromiohumeral interval, the mean distance was 9.3 mm immediate postoperative period, and it was 10.1 at the end of follow up (P>0.05). ACJ reconstruction using Double Endobutton technique is safe, easy, and effective technique in cases with acute ACJ dislocation with little postoperative complications and excellent clinical and radiological outcomes.
{"title":"Evaluation of the results of acute acromioclavicular joint reconstruction using Double Endobutton technique","authors":"Hossam M. Gad, H. Gawish, El Sayed Bayomy","doi":"10.4103/eoj.eoj_122_21","DOIUrl":"https://doi.org/10.4103/eoj.eoj_122_21","url":null,"abstract":"\u0000 \u0000 \u0000 Acromioclavicular joint (ACJ) dislocation is a common injury, which accounts for ~9% of all shoulder injuries. Surgical techniques for reconstructing or repairing ACJ dislocation have evolved over the last decades. Recent surgical techniques focus on reconstruction of the coracoclavicular ligament to recover the stability of ACJ.\u0000 \u0000 \u0000 \u0000 This was a prospective case series study that included 23 patients with acute ACJ dislocation, admitted to the Department of Orthopaedic Surgery and Traumatology, Faculty of Medicine, Kafr El Sheikh and Benha University. All cases were treated by coracoclavicular repair using Double Endobutton technique and Ethibond suture. The follow-up period ranged from 18 to 24 months postoperatively. Outcomes were assessed using Constant score and DASH score at of 6 weeks, 3, 6, 12 months, and final follow up. Radiological assessment was done using Zanca view and stress anteroposterior radiographs of both shoulders to compare acromiohumeral interval at the end of follow up.\u0000 \u0000 \u0000 \u0000 This study included 23 patients that were admitted to our department. Their mean age were 34.2 ± 2.3 years. The average time between injury and surgery was 5.2 ± 1.4 days. There were 20 men and three females. Regarding DASH score it improved from preoperative value of 88.3 ± 11.2 points to 14.3 ± 2.4 points. Regarding Constant score, it improved significantly from preoperative value of 45.3 ± 2.2 points to a postoperative value of 92.3 ± 3.6 points. Regarding acromiohumeral interval, the mean distance was 9.3 mm immediate postoperative period, and it was 10.1 at the end of follow up (P>0.05).\u0000 \u0000 \u0000 \u0000 ACJ reconstruction using Double Endobutton technique is safe, easy, and effective technique in cases with acute ACJ dislocation with little postoperative complications and excellent clinical and radiological outcomes.\u0000","PeriodicalId":171084,"journal":{"name":"The Egyptian Orthopaedic Journal","volume":"51 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139844943","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}
Avulsion fractures of the tibial eminence during childhood are infrequent yet significant knee injuries. Given that the injury is equivalent to a rupture of the anterior cruciate ligament. The treatment strategy necessitates anatomic reduction to reestablish joint stability and reduce the risk of anterior impingement and flexion deformity. The aim of the study was to evaluate short-term results of arthroscopyassisted suture anchor fixation of tibial eminence avulsion in children. This study included 11 injured children with type III avulsion tibial eminence. The average age was 8.55 years. The study included nine boys and two girls. The mechanism of trauma was bicycle accident in seven children, twisting injury in two children, falling downstairs in one child, and jumping from a height in one case. All patients were able to return to their everyday activities within 6 months following the injury. The range of motion at the end of follow up was full in 10 (90.9%) patients and functional range in one (9.1%) patient. The knee stability was excellent by clinical examination. The successful application of this approach in preserving knee function following type III avulsion tibial eminence in pediatric patients has been demonstrated.
{"title":"Suture anchor fixation of displaced tibial eminence avulsion fracture in children","authors":"Elsayed Elforse, Ayman El-Tabbaa","doi":"10.4103/eoj.eoj_140_23","DOIUrl":"https://doi.org/10.4103/eoj.eoj_140_23","url":null,"abstract":"\u0000 \u0000 \u0000 Avulsion fractures of the tibial eminence during childhood are infrequent yet significant knee injuries. Given that the injury is equivalent to a rupture of the anterior cruciate ligament. The treatment strategy necessitates anatomic reduction to reestablish joint stability and reduce the risk of anterior impingement and flexion deformity. The aim of the study was to evaluate short-term results of arthroscopyassisted suture anchor fixation of tibial eminence avulsion in children.\u0000 \u0000 \u0000 \u0000 This study included 11 injured children with type III avulsion tibial eminence. The average age was 8.55 years. The study included nine boys and two girls. The mechanism of trauma was bicycle accident in seven children, twisting injury in two children, falling downstairs in one child, and jumping from a height in one case.\u0000 \u0000 \u0000 \u0000 All patients were able to return to their everyday activities within 6 months following the injury. The range of motion at the end of follow up was full in 10 (90.9%) patients and functional range in one (9.1%) patient. The knee stability was excellent by clinical examination.\u0000 \u0000 \u0000 \u0000 The successful application of this approach in preserving knee function following type III avulsion tibial eminence in pediatric patients has been demonstrated.\u0000","PeriodicalId":171084,"journal":{"name":"The Egyptian Orthopaedic Journal","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139784602","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}
Ankle fractures are one of the most common fractures affecting both the young and old. they are the third most common fracture in elderly patients. The appropriate method of fixation of those fractures is debatable especially for osteoporotic patients, osteoprosis renders commonly used internal fixation methods technically demanding and prone to failure. To compare distal fibula locked plate to nonlocked plate for treatment of Danis Weber type B fracture regarding union rate, union time, operation time, failure rate, and other complications. This study was conducted on 100 patients classified as a Weber B traumatic fracture. Fifty patients were undergoing open reduction internal fixation (ORIF) using locking plates (group A) and patients underwent ORIF using nonlocking plates (group B). The following parameters were assessed in both groups range of motion, union rate, union time, complications, operation time, American orthopedic foot and ankle society and failure rate. There was no statistically significant difference between both groups in operation time and blood loss. Length of hospital stays (days) and Time to full weight bearing, union time was lower in group A than group B. American orthopedic foot and ankle society was higher in group A than in group B. There was no statistically significant difference in range of motion (extension, flexion) between both groups. The rate of loosening of the distal screw and implant removal was higher in group B than in group A. No statistically significant difference was found between both groups regarding functional, radiological outcomes, and complications in patients less than or equal to 60 years old. Therefore, one-third plate is preferred in a young age in terms of cost-effectiveness. In patients over 60 years old, using the locking plates yields better stability, and functional and radiological outcome than non-locking plates.
踝关节骨折是影响年轻人和老年人的最常见骨折之一，在老年患者中占第三位。这些骨折的适当固定方法尚有争议，尤其是对于骨质疏松的患者，骨质增生使常用的内固定方法技术要求高且容易失败。 目的：比较腓骨远端锁定钢板和非锁定钢板治疗 Danis Weber B 型骨折的结合率、结合时间、手术时间、失败率和其他并发症。 这项研究针对 100 名被归类为韦伯 B 型创伤性骨折的患者进行。其中 50 名患者使用锁定钢板进行开放复位内固定术（ORIF）（A 组），另一名患者使用非锁定钢板进行开放复位内固定术（ORIF）（B 组）。对两组患者的活动范围、结合率、结合时间、并发症、手术时间、美国骨科足踝协会和失败率进行了评估。 两组在手术时间和失血量方面没有统计学差异。A 组的住院时间（天数）和完全负重时间、结合时间均低于 B 组；A 组的美国足踝矫形学会评分高于 B 组。在小于或等于 60 岁的患者中，两组在功能、放射学结果和并发症方面的差异无统计学意义。因此，就成本效益而言，三分之一钢板在年轻患者中更受欢迎。对于 60 岁以上的患者，使用锁定钢板比非锁定钢板具有更好的稳定性、功能和放射学效果。
{"title":"Distal fibula locked plate versus nonlocked plate for treatment of Danis Weber type B fracture comparative prospective study","authors":"Tameem M Elkateb, Islam Koriem, Abraam N Mourice","doi":"10.4103/eoj.eoj_143_23","DOIUrl":"https://doi.org/10.4103/eoj.eoj_143_23","url":null,"abstract":"\u0000 \u0000 \u0000 Ankle fractures are one of the most common fractures affecting both the young and old. they are the third most common fracture in elderly patients. The appropriate method of fixation of those fractures is debatable especially for osteoporotic patients, osteoprosis renders commonly used internal fixation methods technically demanding and prone to failure.\u0000 \u0000 \u0000 \u0000 To compare distal fibula locked plate to nonlocked plate for treatment of Danis Weber type B fracture regarding union rate, union time, operation time, failure rate, and other complications.\u0000 \u0000 \u0000 \u0000 This study was conducted on 100 patients classified as a Weber B traumatic fracture. Fifty patients were undergoing open reduction internal fixation (ORIF) using locking plates (group A) and patients underwent ORIF using nonlocking plates (group B). The following parameters were assessed in both groups range of motion, union rate, union time, complications, operation time, American orthopedic foot and ankle society and failure rate.\u0000 \u0000 \u0000 \u0000 There was no statistically significant difference between both groups in operation time and blood loss. Length of hospital stays (days) and Time to full weight bearing, union time was lower in group A than group B. American orthopedic foot and ankle society was higher in group A than in group B. There was no statistically significant difference in range of motion (extension, flexion) between both groups. The rate of loosening of the distal screw and implant removal was higher in group B than in group A.\u0000 \u0000 \u0000 \u0000 No statistically significant difference was found between both groups regarding functional, radiological outcomes, and complications in patients less than or equal to 60 years old. Therefore, one-third plate is preferred in a young age in terms of cost-effectiveness. In patients over 60 years old, using the locking plates yields better stability, and functional and radiological outcome than non-locking plates.\u0000","PeriodicalId":171084,"journal":{"name":"The Egyptian Orthopaedic Journal","volume":"84 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139842497","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}
Ankle fractures were associated with syndesmosis injuries, so it is very important to gain accurate anatomical reduction of the ankle mortise and good fixation of the disrupted syndesmosis. Aim of this study was to assess lateral malleolus Weber C fractures’ outcomes in patients undergoing syndesmosis-only fixation versus syndesmosis and fibular fixation. The present study was designed as a randomized controlled clinical trial study that included all patients presenting to the emergency room at Suez Canal University hospital after an ankle twisting injury causing lateral malleolus Weber C fracture. Patients who had performed syndesmosis-only were found to have significantly higher tibiofibular clear space (AP and mortise views) at 6 months only compared to those who had syndesmosis and fixation. Also, There was no statistically significant difference between syndesmosis-only and syndesmosis with fixation groups in regard to medial clear space, incidence of soft tissue infection, delayed union, Complex regional pain syndrome or all items of OMAS scale. There was a significantly stability and nearby functional outcomes with a minimally invasive technique in the group managed by syndesmosis-only fixation and the group managed by syndesmosis and fibular fixation. The results are optimistic regarding the benefits of syndesmosis-only fixtion in patients with lateral malleolus Weber C fractures. However, more confirmatory studies need to be done.
踝关节骨折与腓骨联合损伤有关，因此，准确地解剖缩小踝关节臼，并对破坏的腓骨联合进行良好的固定非常重要。 本研究旨在评估单纯巩膜固定与巩膜和腓骨固定对外侧踝骨 Weber C 型骨折患者的疗效。 本研究是一项随机对照临床试验研究，包括所有因踝关节扭转损伤导致外侧踝关节韦伯 C 型骨折而到苏伊士运河大学医院急诊就诊的患者。 研究发现，与接受联合巩膜固定术的患者相比，仅接受联合巩膜固定术的患者在 6 个月时的胫腓骨间隙（AP 和臼切面）明显更高。此外，在内侧间隙、软组织感染发生率、延迟愈合、复杂区域疼痛综合征或OMAS量表的所有项目上，仅使用联合巩膜组和联合巩膜加固定组之间没有统计学意义上的差异。 仅使用腓骨联合固定的组别和使用腓骨联合固定的组别在使用微创技术后，稳定性和功能性都有明显改善。对于Weber C外侧踝骨骨折患者来说，仅使用腓骨联合固定的益处是乐观的。不过，还需要进行更多的确证研究。
{"title":"Assessment of lateral malleolus weber C fractures’ outcomes in patients undergoing syndesmosis-only fixation versus syndesmosis and fibular fixation","authors":"Ayman T. Henawy","doi":"10.4103/eoj.eoj_128_23","DOIUrl":"https://doi.org/10.4103/eoj.eoj_128_23","url":null,"abstract":"\u0000 \u0000 \u0000 Ankle fractures were associated with syndesmosis injuries, so it is very important to gain accurate anatomical reduction of the ankle mortise and good fixation of the disrupted syndesmosis.\u0000 \u0000 \u0000 \u0000 Aim of this study was to assess lateral malleolus Weber C fractures’ outcomes in patients undergoing syndesmosis-only fixation versus syndesmosis and fibular fixation.\u0000 \u0000 \u0000 \u0000 The present study was designed as a randomized controlled clinical trial study that included all patients presenting to the emergency room at Suez Canal University hospital after an ankle twisting injury causing lateral malleolus Weber C fracture.\u0000 \u0000 \u0000 \u0000 Patients who had performed syndesmosis-only were found to have significantly higher tibiofibular clear space (AP and mortise views) at 6 months only compared to those who had syndesmosis and fixation. Also, There was no statistically significant difference between syndesmosis-only and syndesmosis with fixation groups in regard to medial clear space, incidence of soft tissue infection, delayed union, Complex regional pain syndrome or all items of OMAS scale.\u0000 \u0000 \u0000 \u0000 There was a significantly stability and nearby functional outcomes with a minimally invasive technique in the group managed by syndesmosis-only fixation and the group managed by syndesmosis and fibular fixation. The results are optimistic regarding the benefits of syndesmosis-only fixtion in patients with lateral malleolus Weber C fractures. However, more confirmatory studies need to be done.\u0000","PeriodicalId":171084,"journal":{"name":"The Egyptian Orthopaedic Journal","volume":"33 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139783285","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}
Acromioclavicular joint (ACJ) dislocation is a common injury, which accounts for ~9% of all shoulder injuries. Surgical techniques for reconstructing or repairing ACJ dislocation have evolved over the last decades. Recent surgical techniques focus on reconstruction of the coracoclavicular ligament to recover the stability of ACJ. This was a prospective case series study that included 23 patients with acute ACJ dislocation, admitted to the Department of Orthopaedic Surgery and Traumatology, Faculty of Medicine, Kafr El Sheikh and Benha University. All cases were treated by coracoclavicular repair using Double Endobutton technique and Ethibond suture. The follow-up period ranged from 18 to 24 months postoperatively. Outcomes were assessed using Constant score and DASH score at of 6 weeks, 3, 6, 12 months, and final follow up. Radiological assessment was done using Zanca view and stress anteroposterior radiographs of both shoulders to compare acromiohumeral interval at the end of follow up. This study included 23 patients that were admitted to our department. Their mean age were 34.2 ± 2.3 years. The average time between injury and surgery was 5.2 ± 1.4 days. There were 20 men and three females. Regarding DASH score it improved from preoperative value of 88.3 ± 11.2 points to 14.3 ± 2.4 points. Regarding Constant score, it improved significantly from preoperative value of 45.3 ± 2.2 points to a postoperative value of 92.3 ± 3.6 points. Regarding acromiohumeral interval, the mean distance was 9.3 mm immediate postoperative period, and it was 10.1 at the end of follow up (P>0.05). ACJ reconstruction using Double Endobutton technique is safe, easy, and effective technique in cases with acute ACJ dislocation with little postoperative complications and excellent clinical and radiological outcomes.
{"title":"Evaluation of the results of acute acromioclavicular joint reconstruction using Double Endobutton technique","authors":"Hossam M. Gad, H. Gawish, El Sayed Bayomy","doi":"10.4103/eoj.eoj_122_21","DOIUrl":"https://doi.org/10.4103/eoj.eoj_122_21","url":null,"abstract":"\u0000 \u0000 \u0000 Acromioclavicular joint (ACJ) dislocation is a common injury, which accounts for ~9% of all shoulder injuries. Surgical techniques for reconstructing or repairing ACJ dislocation have evolved over the last decades. Recent surgical techniques focus on reconstruction of the coracoclavicular ligament to recover the stability of ACJ.\u0000 \u0000 \u0000 \u0000 This was a prospective case series study that included 23 patients with acute ACJ dislocation, admitted to the Department of Orthopaedic Surgery and Traumatology, Faculty of Medicine, Kafr El Sheikh and Benha University. All cases were treated by coracoclavicular repair using Double Endobutton technique and Ethibond suture. The follow-up period ranged from 18 to 24 months postoperatively. Outcomes were assessed using Constant score and DASH score at of 6 weeks, 3, 6, 12 months, and final follow up. Radiological assessment was done using Zanca view and stress anteroposterior radiographs of both shoulders to compare acromiohumeral interval at the end of follow up.\u0000 \u0000 \u0000 \u0000 This study included 23 patients that were admitted to our department. Their mean age were 34.2 ± 2.3 years. The average time between injury and surgery was 5.2 ± 1.4 days. There were 20 men and three females. Regarding DASH score it improved from preoperative value of 88.3 ± 11.2 points to 14.3 ± 2.4 points. Regarding Constant score, it improved significantly from preoperative value of 45.3 ± 2.2 points to a postoperative value of 92.3 ± 3.6 points. Regarding acromiohumeral interval, the mean distance was 9.3 mm immediate postoperative period, and it was 10.1 at the end of follow up (P>0.05).\u0000 \u0000 \u0000 \u0000 ACJ reconstruction using Double Endobutton technique is safe, easy, and effective technique in cases with acute ACJ dislocation with little postoperative complications and excellent clinical and radiological outcomes.\u0000","PeriodicalId":171084,"journal":{"name":"The Egyptian Orthopaedic Journal","volume":"122 48","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139784885","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}
Ankle fractures were associated with syndesmosis injuries, so it is very important to gain accurate anatomical reduction of the ankle mortise and good fixation of the disrupted syndesmosis. Aim of this study was to assess lateral malleolus Weber C fractures’ outcomes in patients undergoing syndesmosis-only fixation versus syndesmosis and fibular fixation. The present study was designed as a randomized controlled clinical trial study that included all patients presenting to the emergency room at Suez Canal University hospital after an ankle twisting injury causing lateral malleolus Weber C fracture. Patients who had performed syndesmosis-only were found to have significantly higher tibiofibular clear space (AP and mortise views) at 6 months only compared to those who had syndesmosis and fixation. Also, There was no statistically significant difference between syndesmosis-only and syndesmosis with fixation groups in regard to medial clear space, incidence of soft tissue infection, delayed union, Complex regional pain syndrome or all items of OMAS scale. There was a significantly stability and nearby functional outcomes with a minimally invasive technique in the group managed by syndesmosis-only fixation and the group managed by syndesmosis and fibular fixation. The results are optimistic regarding the benefits of syndesmosis-only fixtion in patients with lateral malleolus Weber C fractures. However, more confirmatory studies need to be done.
踝关节骨折与腓骨联合损伤有关，因此，准确地解剖缩小踝关节臼，并对破坏的腓骨联合进行良好的固定非常重要。 本研究旨在评估单纯巩膜固定与巩膜和腓骨固定对外侧踝骨 Weber C 型骨折患者的疗效。 本研究是一项随机对照临床试验研究，包括所有因踝关节扭转损伤导致外侧踝关节韦伯 C 型骨折而到苏伊士运河大学医院急诊就诊的患者。 研究发现，与接受联合巩膜固定术的患者相比，仅接受联合巩膜固定术的患者在 6 个月时的胫腓骨间隙（AP 和臼切面）明显更高。此外，在内侧间隙、软组织感染发生率、延迟愈合、复杂区域疼痛综合征或OMAS量表的所有项目上，仅使用联合巩膜组和联合巩膜加固定组之间没有统计学意义上的差异。 仅使用腓骨联合固定的组别和使用腓骨联合固定的组别在使用微创技术后，稳定性和功能性都有明显改善。对于Weber C外侧踝骨骨折患者来说，仅使用腓骨联合固定的益处是乐观的。不过，还需要进行更多的确证研究。
{"title":"Assessment of lateral malleolus weber C fractures’ outcomes in patients undergoing syndesmosis-only fixation versus syndesmosis and fibular fixation","authors":"Ayman T. Henawy","doi":"10.4103/eoj.eoj_128_23","DOIUrl":"https://doi.org/10.4103/eoj.eoj_128_23","url":null,"abstract":"\u0000 \u0000 \u0000 Ankle fractures were associated with syndesmosis injuries, so it is very important to gain accurate anatomical reduction of the ankle mortise and good fixation of the disrupted syndesmosis.\u0000 \u0000 \u0000 \u0000 Aim of this study was to assess lateral malleolus Weber C fractures’ outcomes in patients undergoing syndesmosis-only fixation versus syndesmosis and fibular fixation.\u0000 \u0000 \u0000 \u0000 The present study was designed as a randomized controlled clinical trial study that included all patients presenting to the emergency room at Suez Canal University hospital after an ankle twisting injury causing lateral malleolus Weber C fracture.\u0000 \u0000 \u0000 \u0000 Patients who had performed syndesmosis-only were found to have significantly higher tibiofibular clear space (AP and mortise views) at 6 months only compared to those who had syndesmosis and fixation. Also, There was no statistically significant difference between syndesmosis-only and syndesmosis with fixation groups in regard to medial clear space, incidence of soft tissue infection, delayed union, Complex regional pain syndrome or all items of OMAS scale.\u0000 \u0000 \u0000 \u0000 There was a significantly stability and nearby functional outcomes with a minimally invasive technique in the group managed by syndesmosis-only fixation and the group managed by syndesmosis and fibular fixation. The results are optimistic regarding the benefits of syndesmosis-only fixtion in patients with lateral malleolus Weber C fractures. However, more confirmatory studies need to be done.\u0000","PeriodicalId":171084,"journal":{"name":"The Egyptian Orthopaedic Journal","volume":"56 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139843087","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}
Elevated body mass index (BMI) was associated with increased complication rates including failures in arthroscopic anterior cruciate ligament (ACL) reconstruction surgery. We present our short-term results of our technique used for ACL reconstruction in obese patients with the aim to reduce chances for graft failure and improve outcomes. We present our case series of obese patients (BMI > 30) operated for ACL reconstruction during the period from January 2017 to January 2022 using a dedicated technique for ACL reconstruction. We are using hamstring tendons prepared in a single construct to reconstruct both the intra-articular ACL and the anterolateral ligament. All patients received the same surgical technique and associated injuries were operated on according to their indications and guidelines. All patients completed the subjective knee evaluation form of the International Knee Documentation Committee at the time of the procedure and at the last follow-up visit and assessment of knee laxity was performed using a KT-1000 arthrometer before the surgery and at the last follow-up. Twenty patients underwent anterior cruciate ligament reconstruction (ACLR) using this technique during the study period, with average follow-up period of 1 year. All cases were males, mean BMI was 32.2 (30.4–36.2), 18 cases were operated on using ipsilateral Semitendinosus and Gracilis grafts, 2 cases were operated on using contralateral knee hamstrings. All cases were instructed nonweight bearing for 6 weeks after surgery and received the same standard accelerated rehabilitation protocol. Two cases developed postoperative superficial wound infection at the graft harvest site that resolved with conservative treatment of oral antibiotics and wound care. The mean postoperative International Knee Documentation Committee score improved from 45.195 to 79.245 (P<0.001), and the mean KT-1000 arthrometer differential improved from 11.8 to 2.77 (P<0.001) and pivot shift tests were negative in the postoperative exam for all the cases. ACLR in obese patients should be approached with care, our technique can offer a feasible solution to obtain an acceptable outcome, Further work is required to provide insight on the long-term outcome of ACLR in obese patients.
{"title":"Short-term results of combined anterior cruciate ligament and anterolateral ligament reconstruction using a novel hamstrings graft construct in obese patients: A pilot study","authors":"Ahmed M F ElGuindy, Ibrahim Mohsen","doi":"10.4103/eoj.eoj_116_23","DOIUrl":"https://doi.org/10.4103/eoj.eoj_116_23","url":null,"abstract":"\u0000 \u0000 \u0000 Elevated body mass index (BMI) was associated with increased complication rates including failures in arthroscopic anterior cruciate ligament (ACL) reconstruction surgery.\u0000 We present our short-term results of our technique used for ACL reconstruction in obese patients with the aim to reduce chances for graft failure and improve outcomes.\u0000 \u0000 \u0000 \u0000 We present our case series of obese patients (BMI > 30) operated for ACL reconstruction during the period from January 2017 to January 2022 using a dedicated technique for ACL reconstruction. We are using hamstring tendons prepared in a single construct to reconstruct both the intra-articular ACL and the anterolateral ligament. All patients received the same surgical technique and associated injuries were operated on according to their indications and guidelines. All patients completed the subjective knee evaluation form of the International Knee Documentation Committee at the time of the procedure and at the last follow-up visit and assessment of knee laxity was performed using a KT-1000 arthrometer before the surgery and at the last follow-up.\u0000 \u0000 \u0000 \u0000 Twenty patients underwent anterior cruciate ligament reconstruction (ACLR) using this technique during the study period, with average follow-up period of 1 year. All cases were males, mean BMI was 32.2 (30.4–36.2), 18 cases were operated on using ipsilateral Semitendinosus and Gracilis grafts, 2 cases were operated on using contralateral knee hamstrings. All cases were instructed nonweight bearing for 6 weeks after surgery and received the same standard accelerated rehabilitation protocol. Two cases developed postoperative superficial wound infection at the graft harvest site that resolved with conservative treatment of oral antibiotics and wound care. The mean postoperative International Knee Documentation Committee score improved from 45.195 to 79.245 (P<0.001), and the mean KT-1000 arthrometer differential improved from 11.8 to 2.77 (P<0.001) and pivot shift tests were negative in the postoperative exam for all the cases.\u0000 \u0000 \u0000 \u0000 ACLR in obese patients should be approached with care, our technique can offer a feasible solution to obtain an acceptable outcome, Further work is required to provide insight on the long-term outcome of ACLR in obese patients.\u0000","PeriodicalId":171084,"journal":{"name":"The Egyptian Orthopaedic Journal","volume":"60 40","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139844328","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}
Elevated body mass index (BMI) was associated with increased complication rates including failures in arthroscopic anterior cruciate ligament (ACL) reconstruction surgery. We present our short-term results of our technique used for ACL reconstruction in obese patients with the aim to reduce chances for graft failure and improve outcomes. We present our case series of obese patients (BMI > 30) operated for ACL reconstruction during the period from January 2017 to January 2022 using a dedicated technique for ACL reconstruction. We are using hamstring tendons prepared in a single construct to reconstruct both the intra-articular ACL and the anterolateral ligament. All patients received the same surgical technique and associated injuries were operated on according to their indications and guidelines. All patients completed the subjective knee evaluation form of the International Knee Documentation Committee at the time of the procedure and at the last follow-up visit and assessment of knee laxity was performed using a KT-1000 arthrometer before the surgery and at the last follow-up. Twenty patients underwent anterior cruciate ligament reconstruction (ACLR) using this technique during the study period, with average follow-up period of 1 year. All cases were males, mean BMI was 32.2 (30.4–36.2), 18 cases were operated on using ipsilateral Semitendinosus and Gracilis grafts, 2 cases were operated on using contralateral knee hamstrings. All cases were instructed nonweight bearing for 6 weeks after surgery and received the same standard accelerated rehabilitation protocol. Two cases developed postoperative superficial wound infection at the graft harvest site that resolved with conservative treatment of oral antibiotics and wound care. The mean postoperative International Knee Documentation Committee score improved from 45.195 to 79.245 (P<0.001), and the mean KT-1000 arthrometer differential improved from 11.8 to 2.77 (P<0.001) and pivot shift tests were negative in the postoperative exam for all the cases. ACLR in obese patients should be approached with care, our technique can offer a feasible solution to obtain an acceptable outcome, Further work is required to provide insight on the long-term outcome of ACLR in obese patients.
{"title":"Short-term results of combined anterior cruciate ligament and anterolateral ligament reconstruction using a novel hamstrings graft construct in obese patients: A pilot study","authors":"Ahmed M F ElGuindy, Ibrahim Mohsen","doi":"10.4103/eoj.eoj_116_23","DOIUrl":"https://doi.org/10.4103/eoj.eoj_116_23","url":null,"abstract":"\u0000 \u0000 \u0000 Elevated body mass index (BMI) was associated with increased complication rates including failures in arthroscopic anterior cruciate ligament (ACL) reconstruction surgery.\u0000 We present our short-term results of our technique used for ACL reconstruction in obese patients with the aim to reduce chances for graft failure and improve outcomes.\u0000 \u0000 \u0000 \u0000 We present our case series of obese patients (BMI > 30) operated for ACL reconstruction during the period from January 2017 to January 2022 using a dedicated technique for ACL reconstruction. We are using hamstring tendons prepared in a single construct to reconstruct both the intra-articular ACL and the anterolateral ligament. All patients received the same surgical technique and associated injuries were operated on according to their indications and guidelines. All patients completed the subjective knee evaluation form of the International Knee Documentation Committee at the time of the procedure and at the last follow-up visit and assessment of knee laxity was performed using a KT-1000 arthrometer before the surgery and at the last follow-up.\u0000 \u0000 \u0000 \u0000 Twenty patients underwent anterior cruciate ligament reconstruction (ACLR) using this technique during the study period, with average follow-up period of 1 year. All cases were males, mean BMI was 32.2 (30.4–36.2), 18 cases were operated on using ipsilateral Semitendinosus and Gracilis grafts, 2 cases were operated on using contralateral knee hamstrings. All cases were instructed nonweight bearing for 6 weeks after surgery and received the same standard accelerated rehabilitation protocol. Two cases developed postoperative superficial wound infection at the graft harvest site that resolved with conservative treatment of oral antibiotics and wound care. The mean postoperative International Knee Documentation Committee score improved from 45.195 to 79.245 (P<0.001), and the mean KT-1000 arthrometer differential improved from 11.8 to 2.77 (P<0.001) and pivot shift tests were negative in the postoperative exam for all the cases.\u0000 \u0000 \u0000 \u0000 ACLR in obese patients should be approached with care, our technique can offer a feasible solution to obtain an acceptable outcome, Further work is required to provide insight on the long-term outcome of ACLR in obese patients.\u0000","PeriodicalId":171084,"journal":{"name":"The Egyptian Orthopaedic Journal","volume":"83 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139784595","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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