Pub Date : 2021-06-10DOI: 10.2174/1874325002115010035
Kyriakos Kitsopoulos, B. Wiedenhoefer, S. Hemmer, C. Fleege, M. Arabmotlagh, M. Rauschmann, M. Rickert
Background: Compared with static cages, expandable cages for Transforaminal Lumbar Interbody Fusion (TLIF), are thought to require less posterior bony removal and nerve root retraction. They may allow the creation of a greater lordotic angle and lordosis restoration.
{"title":"Preliminary Results of Expandable Transforaminal Lumbar Interbody Fusion Cages","authors":"Kyriakos Kitsopoulos, B. Wiedenhoefer, S. Hemmer, C. Fleege, M. Arabmotlagh, M. Rauschmann, M. Rickert","doi":"10.2174/1874325002115010035","DOIUrl":"https://doi.org/10.2174/1874325002115010035","url":null,"abstract":"Background: Compared with static cages, expandable cages for Transforaminal Lumbar Interbody Fusion (TLIF), are thought to require less posterior bony removal and nerve root retraction. They may allow the creation of a greater lordotic angle and lordosis restoration.","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"49 1","pages":"35-40"},"PeriodicalIF":0.0,"publicationDate":"2021-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84892247","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}
Pub Date : 2021-05-03DOI: 10.2174/1874325002115010027
C. Rivière, J. Webb, P. Vendittoli
A severely degenerative knee joint with substantial bone attrition poses a significant challenge when performing Total Knee Arthroplasty (TKA) using the Kinematic Alignment (KA) technique. In order to restore the pre-arthritic knee anatomy, the surgeon has the task of estimating quantity and location of bone loss. We present three such cases and describe the key steps to safely perform KATKA in these complex situations.
{"title":"Kinematic Alignment Technique for TKA on Degenerative Knees with Severe Bone Loss: A Report of 3 Cases","authors":"C. Rivière, J. Webb, P. Vendittoli","doi":"10.2174/1874325002115010027","DOIUrl":"https://doi.org/10.2174/1874325002115010027","url":null,"abstract":"A severely degenerative knee joint with substantial bone attrition poses a significant challenge when performing Total Knee Arthroplasty (TKA) using the Kinematic Alignment (KA) technique. In order to restore the pre-arthritic knee anatomy, the surgeon has the task of estimating quantity and location of bone loss. We present three such cases and describe the key steps to safely perform KATKA in these complex situations.","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"22 1","pages":"27-34"},"PeriodicalIF":0.0,"publicationDate":"2021-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81288904","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}
Pub Date : 2021-04-12DOI: 10.2174/1874325002115010017
T. Sugita, Naohisa Miyatake, S. Miyamoto, A. Sasaki, Ikuo Maeda, M. Kamimura, T. Aizawa
The tibial resection depth during total knee arthroplasty for valgus knees has been variously described and not been standardized yet. Accordingly, it has been proposed in this article, that the sulcus between the medial and lateral intercondylar tibial tubercles can be used as a reference point for the tibial resection depth. The resection can be performed 8 to 9 mm distal to the sulcus.
{"title":"Proposal of a New Reference Point to Determine the Tibial Resection Depth during Total Knee Arthroplasty for Valgus Knees","authors":"T. Sugita, Naohisa Miyatake, S. Miyamoto, A. Sasaki, Ikuo Maeda, M. Kamimura, T. Aizawa","doi":"10.2174/1874325002115010017","DOIUrl":"https://doi.org/10.2174/1874325002115010017","url":null,"abstract":"The tibial resection depth during total knee arthroplasty for valgus knees has been variously described and not been standardized yet. Accordingly, it has been proposed in this article, that the sulcus between the medial and lateral intercondylar tibial tubercles can be used as a reference point for the tibial resection depth. The resection can be performed 8 to 9 mm distal to the sulcus.","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"64 1","pages":"17-21"},"PeriodicalIF":0.0,"publicationDate":"2021-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76040115","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}
Pub Date : 2021-04-12DOI: 10.2174/1874325002115010022
T. Tzatzairis, G. Firth, P. Bijlsma, D. Manoukian, C. Maizen, M. Ramachandran
* Address correspondence to this author at Department of Paediatric Orthopaedics, The Royal London Hospital, Barts Health NHS Trust, Whitechapel Road, London E1 1BB, UK; Tel: +447923301467; E-mail: ttzatzai@gmail.com or themistoklis.tzatzairis@nhs.net (patient size, thickness of body/body composition in the plane of beam and energy of beam) [3]. Calculating the surgeon’s exposure is also challenging as exposure time to radiation, distance from the beam, quality/thickness of the shield and direct versus scatter type of radiation all influence the dose received [4]. Children have greater radiosensitivity than adults, and the mortality risk from cancer after radiation has been estimated at 5% per Sievert for adults and up to 9% for a 10year old child, with the risk increasing for younger patients [5]. Minimizing radiation during paediatric orthopaedic procedures like supracondylar fixation is crucial.
*与作者的通信地址:英国伦敦Whitechapel Road E1 1BB, Barts Health NHS Trust，皇家伦敦医院儿科骨科;电话:+ 447923301467;E-mail: ttzatzai@gmail.com或themistoklis.tzatzairis@nhs.net(患者体型、体表厚度/体表在光束平面的组成及光束能量)[3]。计算外科医生的暴露量也很有挑战性，因为暴露于辐射的时间、与光束的距离、屏蔽的质量/厚度以及直接与散射类型的辐射都会影响接受的剂量。儿童的放射敏感性高于成人，据估计，成人辐射后癌症死亡风险为每西弗5%，10岁儿童高达9%，年龄较小的患者风险增加。在像髁上固定这样的儿科矫形手术中尽量减少辐射是至关重要的。
{"title":"Radiation Exposure in The Treatment of Pediatric Supracondylar Humerus Fractures: Comparison of Two Fixation Methods","authors":"T. Tzatzairis, G. Firth, P. Bijlsma, D. Manoukian, C. Maizen, M. Ramachandran","doi":"10.2174/1874325002115010022","DOIUrl":"https://doi.org/10.2174/1874325002115010022","url":null,"abstract":"* Address correspondence to this author at Department of Paediatric Orthopaedics, The Royal London Hospital, Barts Health NHS Trust, Whitechapel Road, London E1 1BB, UK; Tel: +447923301467; E-mail: ttzatzai@gmail.com or themistoklis.tzatzairis@nhs.net (patient size, thickness of body/body composition in the plane of beam and energy of beam) [3]. Calculating the surgeon’s exposure is also challenging as exposure time to radiation, distance from the beam, quality/thickness of the shield and direct versus scatter type of radiation all influence the dose received [4]. Children have greater radiosensitivity than adults, and the mortality risk from cancer after radiation has been estimated at 5% per Sievert for adults and up to 9% for a 10year old child, with the risk increasing for younger patients [5]. Minimizing radiation during paediatric orthopaedic procedures like supracondylar fixation is crucial.","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"1982 1","pages":"22-26"},"PeriodicalIF":0.0,"publicationDate":"2021-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82194238","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}
Pub Date : 2021-04-08DOI: 10.2174/1874325002115010013
S. Kuschner, Haben Berihun
Robert Wartenberg, a European-American neurologist, was born in 1887 and died in 1956. His description of radial sensory nerve compression at the forearm is memorialized as Wartenberg’s syndrome. He recognized that involuntary abduction of the little finger could be caused by ulnar nerve palsy - a finding often called Wartenberg’s sign Syndrome and signs are reviewed, and a brief biography is presented. To review Wartenberg’s sign and Wartenberg’s syndrome. Compression of the superficial branch of the radial nerve, often called Wartenberg’s syndrome, is characterized by pain, paresthesia, and dysesthesia along the dorsoradial distal forearm. Non-operative treatment can include activity restriction and anti-inflammatory medication. If symptoms persist, surgical decompression of the radial nerve is an option. The abducted posture of the little finger - Wartenberg’s sign - can result from a low ulnar nerve palsy. Tendon transfer can be performed to correct this deformity. Compression of the superficial branch of the radial nerve and abducted posture of the little finger were described by Robert Wartenberg and carry his name as eponymous syndrome and sign, respectively.
Robert Wartenberg，一位欧美神经学家，生于1887年，卒于1956年。他对前臂桡感觉神经受压的描述被称为Wartenberg综合征。他认识到小指的不自觉外展可能是由尺神经麻痹引起的——这一发现通常被称为Wartenberg症候群。复习一下Wartenberg氏征和Wartenberg氏综合征。桡神经浅支受压，常称为Wartenberg综合征，其特征是前臂远侧背桡侧疼痛、感觉异常和感觉不良。非手术治疗包括限制活动和抗炎药物。如果症状持续，手术减压桡神经是一种选择。小指外展的姿势——Wartenberg征——可能是由尺神经麻痹引起的。肌腱转移可以矫正这种畸形。Robert Wartenberg描述了桡神经浅支压迫和小指外展姿势，并分别以他的名字命名为同名综合征和体征。
{"title":"Robert Wartenberg Syndrome and Sign: A Review Article","authors":"S. Kuschner, Haben Berihun","doi":"10.2174/1874325002115010013","DOIUrl":"https://doi.org/10.2174/1874325002115010013","url":null,"abstract":"\u0000 \u0000 Robert Wartenberg, a European-American neurologist, was born in 1887 and died in 1956. His description of radial sensory nerve compression at the forearm is memorialized as Wartenberg’s syndrome. He recognized that involuntary abduction of the little finger could be caused by ulnar nerve palsy - a finding often called Wartenberg’s sign Syndrome and signs are reviewed, and a brief biography is presented.\u0000 \u0000 \u0000 \u0000 To review Wartenberg’s sign and Wartenberg’s syndrome.\u0000 \u0000 \u0000 \u0000 Compression of the superficial branch of the radial nerve, often called Wartenberg’s syndrome, is characterized by pain, paresthesia, and dysesthesia along the dorsoradial distal forearm. Non-operative treatment can include activity restriction and anti-inflammatory medication. If symptoms persist, surgical decompression of the radial nerve is an option. The abducted posture of the little finger - Wartenberg’s sign - can result from a low ulnar nerve palsy. Tendon transfer can be performed to correct this deformity.\u0000 \u0000 \u0000 \u0000 Compression of the superficial branch of the radial nerve and abducted posture of the little finger were described by Robert Wartenberg and carry his name as eponymous syndrome and sign, respectively.\u0000","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"399 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91464099","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}
Pub Date : 2021-03-22DOI: 10.2174/1874325002115010001
J. Kiuttu, P. Lehenkari, Hannu-Ville Leskelä, Olli Yrjämä, P. Ohtonen, M. Valkealahti
Division of Orthopedic and Trauma Surgery, Department of Surgery, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland Department of Anatomy and Cell Biology, Cancer Research and Translational Medicine Research Unit, Faculty of Medicine, University of Oulu, Oulu, Finland Division of Operative Care, Oulu University Hospital and Medical Research Center Oulu, University of Oulu, Oulu, Finland
{"title":"Intra-operative Clodronate Rinsing Improves the Integration of the Femoral Stem in a Prospective, Double-blinded, Randomized, Placebo-controlled Clinical RSA-study","authors":"J. Kiuttu, P. Lehenkari, Hannu-Ville Leskelä, Olli Yrjämä, P. Ohtonen, M. Valkealahti","doi":"10.2174/1874325002115010001","DOIUrl":"https://doi.org/10.2174/1874325002115010001","url":null,"abstract":"Division of Orthopedic and Trauma Surgery, Department of Surgery, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland Department of Anatomy and Cell Biology, Cancer Research and Translational Medicine Research Unit, Faculty of Medicine, University of Oulu, Oulu, Finland Division of Operative Care, Oulu University Hospital and Medical Research Center Oulu, University of Oulu, Oulu, Finland","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"92 1","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2021-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88180671","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}
Pub Date : 2021-01-01DOI: 10.2174/1874325002115010041
J. P. Kelly, B. Catoe, Mudassar Khan, D. Antekeier
Heel pad injuries can have devastating and debilitating consequences. All efforts to primarily reapproximate the heel pad should be undertaken. Reconstruction of the heel pad can often require multiple complex surgeries including microvascular flaps and tissue transfers. There is a paucity of successful techniques for primary repair in the literature. In this case report, we describe the successful use of polydioxanone suture with sterile buttons for the repair of the heel pad in a pediatric patient. An 8-year-old male was struck by a vehicle, sustaining a full-thickness heel pad avulsion injury measuring approximately 16-cm in length. The soft tissue was sharply debrided and repaired primarily to the calcaneal periosteum using #1 polydioxanone suture with external suture buttons, and an incisional wound VAC was applied. He was placed into a long-leg bent knee cast and kept non-weight bearing for a total of 6 weeks, at which time the suture and buttons were removed and he was progressed to weight bearing as tolerated in a walking boot. At the 6-month follow-up examination, the heel pad was viable and well-fixed; the patient reported no pain and was not limited in any chosen activities. This construct was shown to provide effective fixation while mitigating reported concerns of tissue necrosis caused by suture repair. At 1 year from injury, the patient’s mother noted a slight limp with running but not with walking. He reported no pain at any time, and his Oxford Ankle-Foot Questionnaire for Children score was 58, indicating excellent patient-reported outcome following his procedures.
{"title":"Traumatic Heel Pad Avulsion in a Pediatric Patient","authors":"J. P. Kelly, B. Catoe, Mudassar Khan, D. Antekeier","doi":"10.2174/1874325002115010041","DOIUrl":"https://doi.org/10.2174/1874325002115010041","url":null,"abstract":"Heel pad injuries can have devastating and debilitating consequences. All efforts to primarily reapproximate the heel pad should be undertaken. Reconstruction of the heel pad can often require multiple complex surgeries including microvascular flaps and tissue transfers. There is a paucity of successful techniques for primary repair in the literature. In this case report, we describe the successful use of polydioxanone suture with sterile buttons for the repair of the heel pad in a pediatric patient. An 8-year-old male was struck by a vehicle, sustaining a full-thickness heel pad avulsion injury measuring approximately 16-cm in length. The soft tissue was sharply debrided and repaired primarily to the calcaneal periosteum using #1 polydioxanone suture with external suture buttons, and an incisional wound VAC was applied. He was placed into a long-leg bent knee cast and kept non-weight bearing for a total of 6 weeks, at which time the suture and buttons were removed and he was progressed to weight bearing as tolerated in a walking boot. At the 6-month follow-up examination, the heel pad was viable and well-fixed; the patient reported no pain and was not limited in any chosen activities. This construct was shown to provide effective fixation while mitigating reported concerns of tissue necrosis caused by suture repair. At 1 year from injury, the patient’s mother noted a slight limp with running but not with walking. He reported no pain at any time, and his Oxford Ankle-Foot Questionnaire for Children score was 58, indicating excellent patient-reported outcome following his procedures.","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83465701","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}
Pub Date : 2020-12-31DOI: 10.2174/1874325002014010198
I. Mahmood, R. Burton, M. Choudhry, C. Coapes
Trapezio-Metacarpal Joint (TMJ) arthritis is a common cause of radial sided wrist pain. After conservative measures have been exhausted, the current mainstay of surgical treatment is trapeziectomy. Some surgeons combine this with additional ligament reconstruction and tendon or capsular interposition techniques to provide a more stable base for the thumb metacarpal. In modern Orthopaedic practice, arthroplasty is the procedure of choice for many end-stage arthritic joints. However, due to the reliable and reproducible outcomes of trapeziectomy, this has yet to be widely adopted by hand surgeons in the management of TMJ arthritis. Recent series of arthroplasty implants have consistently shown good outcomes and trapezio-metacarpal joint replacement has been observed to provide excellent long-term function in the fit and active patient. We have performed a total of 52 TMJ arthroplasties in 46 patients in our institution for over 5 years (2011 to 2016). After excluding 3 cases, 43 available patients (49 implants) were subsequently asked to submit QuickDASH scores and a patient satisfaction survey. Average QuickDASH score was 16.6, with high patient satisfaction postoperatively at 1 year. Complications included one intraoperative fracture, and five cases of post-operative instability/ dislocation. Dislocations were treated successfully with open reduction and revision. TMJ arthroplasty has shown good outcomes and patient satisfaction with a low revision rate and we recommend its use in active patients with well-preserved scapho-trapezio-trapezoid (STT) joints.
{"title":"Early to Mid-Term Results in Trapezio-metacarpal Joint Replacement using the ARPE Implant","authors":"I. Mahmood, R. Burton, M. Choudhry, C. Coapes","doi":"10.2174/1874325002014010198","DOIUrl":"https://doi.org/10.2174/1874325002014010198","url":null,"abstract":"\u0000 \u0000 Trapezio-Metacarpal Joint (TMJ) arthritis is a common cause of radial sided wrist pain. After conservative measures have been exhausted, the current mainstay of surgical treatment is trapeziectomy. Some surgeons combine this with additional ligament reconstruction and tendon or capsular interposition techniques to provide a more stable base for the thumb metacarpal.\u0000 \u0000 \u0000 \u0000 In modern Orthopaedic practice, arthroplasty is the procedure of choice for many end-stage arthritic joints. However, due to the reliable and reproducible outcomes of trapeziectomy, this has yet to be widely adopted by hand surgeons in the management of TMJ arthritis. Recent series of arthroplasty implants have consistently shown good outcomes and trapezio-metacarpal joint replacement has been observed to provide excellent long-term function in the fit and active patient.\u0000 \u0000 \u0000 \u0000 We have performed a total of 52 TMJ arthroplasties in 46 patients in our institution for over 5 years (2011 to 2016). After excluding 3 cases, 43 available patients (49 implants) were subsequently asked to submit QuickDASH scores and a patient satisfaction survey.\u0000 \u0000 \u0000 \u0000 Average QuickDASH score was 16.6, with high patient satisfaction postoperatively at 1 year. Complications included one intraoperative fracture, and five cases of post-operative instability/ dislocation. Dislocations were treated successfully with open reduction and revision.\u0000 \u0000 \u0000 \u0000 TMJ arthroplasty has shown good outcomes and patient satisfaction with a low revision rate and we recommend its use in active patients with well-preserved scapho-trapezio-trapezoid (STT) joints.\u0000","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78634527","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}
Pub Date : 2020-12-31DOI: 10.2174/1874325002014010204
Akira Ando, Kazuaki Suzuki, Masashi Koide, Y. Hagiwara
Greater Tuberosity (GT) malunion can lead to impingement against the acromion, resulting in pain, stiffness, and weakness of the rotator cuff. For patients with lesser degrees of displacement, partial removal of the GT with rotator cuff repair (tuberoplasty) under fluoroscopic guidance is considered. A sixty-five year old female fell from a standing height and suffered a minimally displaced isolated GT fracture. She was conservatively managed for four months and referred to our institution due to persisting pain and stiffness. The shoulder motion was severely restricted (anterior elevation: 90°, lateral elevation: 45°, external rotation with the arm at side: 25°, hand behind back: 4th lumber vertebrae) and pain aggravated especially when laterally elevated. Plain radiography and computed tomography showed small superiorly malunited GT and magnetic resonance imaging showed no rotator cuff pathology. Ultrasound images showed impingement of the GT against the acromion when laterally elevated. Arthroscopic excision of the malunited GT and rotator cuff repair along with capsular release and acromioplasty was performed under ultrasound guidance. The ultrasound images were simultaneously delineated to the arthroscopic monitor. Dynamic evaluation of the reshaped GT passing under the acromion was possible. Intraoperative use of ultrasound during arthroscopic tuberoplasty offers advantages over fluoroscopic guidance concerning control of the amount of bone resection and dynamic evaluation between the GT and the acromion in addition to the problems of radiation and space-occupying devices.
{"title":"Ultrasound-guided Arthroscopic Tuberoplasty for Greater Tuberosity Malunion: A Case Report","authors":"Akira Ando, Kazuaki Suzuki, Masashi Koide, Y. Hagiwara","doi":"10.2174/1874325002014010204","DOIUrl":"https://doi.org/10.2174/1874325002014010204","url":null,"abstract":"\u0000 \u0000 Greater Tuberosity (GT) malunion can lead to impingement against the acromion, resulting in pain, stiffness, and weakness of the rotator cuff. For patients with lesser degrees of displacement, partial removal of the GT with rotator cuff repair (tuberoplasty) under fluoroscopic guidance is considered.\u0000 \u0000 \u0000 \u0000 \u0000 A sixty-five year old female fell from a standing height and suffered a minimally displaced isolated GT fracture. She was conservatively managed for four months and referred to our institution due to persisting pain and stiffness. The shoulder motion was severely restricted (anterior elevation: 90°, lateral elevation: 45°, external rotation with the arm at side: 25°, hand behind back: 4th lumber vertebrae) and pain aggravated especially when laterally elevated. Plain radiography and computed tomography showed small superiorly malunited GT and magnetic resonance imaging showed no rotator cuff pathology. Ultrasound images showed impingement of the GT against the acromion when laterally elevated. Arthroscopic excision of the malunited GT and rotator cuff repair along with capsular release and acromioplasty was performed under ultrasound guidance. The ultrasound images were simultaneously delineated to the arthroscopic monitor. Dynamic evaluation of the reshaped GT passing under the acromion was possible.\u0000 \u0000 \u0000 \u0000 Intraoperative use of ultrasound during arthroscopic tuberoplasty offers advantages over fluoroscopic guidance concerning control of the amount of bone resection and dynamic evaluation between the GT and the acromion in addition to the problems of radiation and space-occupying devices.\u0000","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84919196","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}
Pub Date : 2020-12-31DOI: 10.2174/1874325002014010186
S. Ng, Ying Ling Ng, K. Cheng, W. Chan, T. Ho
Observation is the treatment of choice for idiopathic scoliosis with Cobb angles between 15 degrees - 20 degrees in growing children. This passive approach does not address the anxiety of the patient and the stress of the parents. In this paper, we attempt to identify skeletally immature patients with mild scoliosis curvatures that are more at risk of progression and propose possible intervention for this group of subjects. The literature was searched in Pubmed, and additional references were searched manually in the literature. Many studies have shown that low serum 25[OH]D level, bone mineral density (BMD), and body mass index (BMI) are related to the curve severity or progression of the curve. We suggest that skeletally immature patients (< Risser 2) with mild curves be divided into two groups, viz. Group O (observation) with a lower risk of progression, and Group I (intervention) with a higher risk of curvature progression. We propose early intervention for the latter group. It is suggested that pre-menarcheal, skeletally immature patients with mild idiopathic scoliosis, and low vitamin D, BMD, and BMI should be treated. Also, asymmetric foot biomechanics should be addressed, although nutrition and foot orthoses are regarded to have no role in the management of idiopathic scoliosis. The outcome of early intervention may be utterly different from late treatment when the curvature becomes more structural, and the patient more skeletally mature. Research is required to prove if the intervention is clinically indicated.
{"title":"Intervention versus Observation in Mild Idiopathic Scoliosis in Skeletally Immature Patients","authors":"S. Ng, Ying Ling Ng, K. Cheng, W. Chan, T. Ho","doi":"10.2174/1874325002014010186","DOIUrl":"https://doi.org/10.2174/1874325002014010186","url":null,"abstract":"\u0000 \u0000 Observation is the treatment of choice for idiopathic scoliosis with Cobb angles between 15 degrees - 20 degrees in growing children. This passive approach does not address the anxiety of the patient and the stress of the parents. In this paper, we attempt to identify skeletally immature patients with mild scoliosis curvatures that are more at risk of progression and propose possible intervention for this group of subjects.\u0000 \u0000 \u0000 \u0000 The literature was searched in Pubmed, and additional references were searched manually in the literature.\u0000 \u0000 \u0000 \u0000 Many studies have shown that low serum 25[OH]D level, bone mineral density (BMD), and body mass index (BMI) are related to the curve severity or progression of the curve.\u0000 We suggest that skeletally immature patients (< Risser 2) with mild curves be divided into two groups, viz. Group O (observation) with a lower risk of progression, and Group I (intervention) with a higher risk of curvature progression. We propose early intervention for the latter group.\u0000 It is suggested that pre-menarcheal, skeletally immature patients with mild idiopathic scoliosis, and low vitamin D, BMD, and BMI should be treated. Also, asymmetric foot biomechanics should be addressed, although nutrition and foot orthoses are regarded to have no role in the management of idiopathic scoliosis. The outcome of early intervention may be utterly different from late treatment when the curvature becomes more structural, and the patient more skeletally mature.\u0000 \u0000 \u0000 \u0000 Research is required to prove if the intervention is clinically indicated.\u0000","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85900313","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：