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Discovery Elbow System arthroplasty polyethylene bearing exchange: outcomes and experience. Discovery 肘关节置换系统聚乙烯轴承交换:结果和经验。
Q2 ORTHOPEDICS Pub Date : 2024-03-01 Epub Date: 2024-01-26 DOI: 10.5397/cise.2023.00668
Daniel L J Morris, Katherine Walstow, Lisa Pitt, Marie Morgan, Amol A Tambe, D I Clark, Timothy Cresswell, Marius P Espag

Background: The Discovery Elbow System (DES) utilizes a polyethylene bearing within the ulnar component. An exchange bearing requires preoperative freezing and implantation within 2 minutes of freezer removal to allow insertion. We report our outcomes and experience using this technique.

Methods: This was an analysis of a two-surgeon consecutive series of DES bearing exchange. Inclusion criteria included patients in which exchange was attempted with a minimum 1-year follow-up. Clinical and radiographic review was performed 1, 2, 3, 5, 8 and 10 years postoperative. Outcome measures included range of movement, Oxford Elbow Score (OES), Mayo Elbow Performance Score (MEPS), complications and requirement for revision surgery.

Results: Eleven DESs in 10 patients were included. Indications were bearing wear encountered during humeral component revision (n=5); bearing failure (n=4); and infection treated with debridement, antibiotics and implant retention (DAIR; n=2). Bearing exchange was conducted on the first attempt in 10 cases. One case required a second attempt. One patient developed infection postoperatively managed with two-stage revision. Mean follow-up of the bearing exchange DES was 3 years. No further surgery was required, with no infection recurrence in DAIR cases. Mean elbow flexion-extension and pronosupination arcs were 107° (±22°) and 140° (±26°). Mean OES was 36/48 (±12) and MEPS was 83/100 (±19).

Conclusions: Our results support the use of DES bearing exchange in cases of bearing wear with well-fixed stems or acute infection. This series provides surgeons managing DES arthroplasty with management principles, successful and reproducible surgical techniques and expected clinical outcomes in performing DES polyethylene bearing exchange. Level of evidence: IV.

背景:发现者肘关节系统(DES)在尺侧组件内使用聚乙烯轴承。交换支座需要术前冷冻,并在取出冷冻装置后 2 分钟内植入,以便插入。我们报告了使用这种技术的结果和经验:这是一项由两名外科医生连续进行的DES轴承交换系列分析。纳入标准包括至少随访1年并尝试过置换的患者。术后1年、2年、3年、5年、8年和10年进行临床和放射学复查。结果指标包括活动范围、牛津肘评分(OES)、梅奥肘关节表现评分(MEPS)、并发症和翻修手术要求:结果:纳入了10名患者的11个DES。结果:纳入了10名患者的11个DES,适应症包括肱骨组件翻修过程中遇到的轴承磨损(5例);轴承故障(4例);以及通过清创、抗生素和植入物保留(DAIR;2例)治疗的感染。10例患者在第一次尝试时进行了轴承交换。1例需要第二次尝试。一名患者术后发生感染,经两期翻修处理。轴承交换 DES 的平均随访时间为 3 年。无需进一步手术,DAIR病例无感染复发。平均肘关节屈伸弧度为107°(±22°),前屈弧度为140°(±26°)。平均OES为36/48(±12),MEPS为83/100(±19):我们的研究结果支持在轴承磨损、柄固定良好或急性感染的病例中使用DES轴承交换。该系列研究为管理DES关节置换术的外科医生提供了管理原则、成功且可重复的手术技巧以及进行DES聚乙烯轴承交换时的预期临床结果。证据级别:IV级。
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引用次数: 0
Blood flow velocity in the anterior humeral circumflex artery and tear size can predict synovitis severity in patients with rotator cuff tears. 肱骨前环状动脉的血流速度和撕裂大小可预测肩袖撕裂患者滑膜炎的严重程度。
Q2 ORTHOPEDICS Pub Date : 2024-03-01 Epub Date: 2024-01-24 DOI: 10.5397/cise.2023.00752
Takahiro Machida, Takahiko Hirooka, Akihisa Watanabe, Hinako Katayama, Yuki Matsukubo

Background: Rotator cuff tears are often associated with synovitis, but the ability of noninvasive ultrasonography to predict the severity of synovitis remains unclear. We investigated whether ultrasound parameters, namely peak systolic velocity in the anterior humeral circumflex artery and Doppler activity in the glenohumeral joint and subacromial space, reflect synovitis severity.

Methods: A total of 54 patients undergoing arthroscopic rotator cuff repair were selected. Doppler ultrasound was used to measure peak systolic velocity in the anterior humeral circumflex artery and Doppler activity in the glenohumeral joint and subacromial space, and these values were compared with the intraoperative synovitis score in univariate and multivariate analyses.

Results: Univariate analyses revealed that tear size, peak systolic velocity in the anterior humeral circumflex artery, and Doppler activity in the glenohumeral joint were associated with synovitis in the glenohumeral joint (P=0.02, P<0.001, P=0.02, respectively). In the subacromial space, tear size, peak systolic velocity in the anterior humeral circumflex artery, and Doppler activity in the subacromial space were associated with synovitis severity (P=0.02, P<0.001, P=0.02, respectively). Multivariate analyses indicated that tear size and peak systolic velocity in the anterior humeral circumflex artery were independently associated with synovitis scores in both the glenohumeral joint and the subacromial space (all P<0.05).

Conclusions: These findings demonstrate that tear size and peak systolic velocity in the anterior humeral circumflex artery, which can both be measured noninvasively, are useful indicators of synovitis severity. Level of evidence: IV.

背景:肩袖撕裂常伴有滑膜炎,但无创超声波检查预测滑膜炎严重程度的能力仍不明确。我们研究了超声参数,即肱骨前环状动脉的收缩峰值速度和盂肱关节及肩峰下间隙的多普勒活动是否能反映滑膜炎的严重程度:方法:共选取了 54 名接受关节镜肩袖修复术的患者。使用多普勒超声测量肱骨前环状动脉的收缩速度峰值以及盂肱关节和肩峰下间隙的多普勒活动度,并将这些数值与术中滑膜炎评分进行单变量和多变量分析比较:单变量分析显示,撕裂大小、肱骨前环动脉收缩速度峰值和盂肱关节多普勒活动度与盂肱关节滑膜炎相关(P=0.02,PC结论:这些研究结果表明,肱骨前环动脉的撕裂大小和收缩速度峰值都可以无创测量,是滑膜炎严重程度的有用指标。
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引用次数: 0
Cubital tunnel syndrome associated with previous ganglion cyst excision in the elbow: a case report. 与肘部神经节囊肿切除术相关的眶管综合征:病例报告。
Q2 ORTHOPEDICS Pub Date : 2024-03-01 Epub Date: 2022-11-11 DOI: 10.5397/cise.2022.01102
Woojin Shin, Taebyeong Kang, Jeongwoon Han

Cubital tunnel syndrome refers to compression neuropathy caused by pressure on the ulnar nerve pathway around the elbow. A 63-year-old male patient visited the clinic complaining of decreased sensation and weakness in his left ring finger and little finger, stating that the symptoms first began 6 months prior. He had undergone surgery to remove a ganglion cyst from his left elbow joint about 5 years prior in Mongolia. Magnetic resonance imaging revealed a cystic mass located at the previous surgical site, which was compressing the ulnar nerve within the cubital tunnel. Ulnar nerve decompression and anterior transposition were performed, and the cystic mass was excised. Upon pathological examination, the mass was diagnosed as a ganglion cyst. The patient's symptoms including sensory dysfunction and weakness improved over the 1-year follow-up period. This report describes a rare case of ganglion cyst recurrence compressing the ulnar nerve in the cubital tunnel after previous ganglion cyst excision.

眶管综合征是指肘部周围尺神经通路受压引起的压迫性神经病。一名 63 岁的男性患者前来就诊,主诉其左手无名指和小指感觉减退和无力,并称症状最早出现在 6 个月前。大约 5 年前,他在蒙古接受了切除左肘关节神经节囊肿的手术。磁共振成像显示,之前的手术部位有一个囊性肿块,压迫了肘管内的尺神经。患者接受了尺神经减压术和前方转位术,并切除了囊性肿块。经病理检查,肿块被诊断为神经节囊肿。随访一年后,患者的感觉功能障碍和乏力等症状有所改善。本报告描述了一例罕见的神经节囊肿复发病例,该病例曾接受过神经节囊肿切除术,但复发后压迫了肘隧道内的尺神经。
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引用次数: 0
Arthroscopic remplissage: history, indications, and clinical outcomes 关节镜再植术:历史、适应症和临床结果
Q2 ORTHOPEDICS Pub Date : 2023-12-04 DOI: 10.5397/cise.2023.00325
M. Fares, Mohammad Daher, Peter Boufadel, Emil R. Haikal, Jonathan Koa, Jaspal Singh, Joseph A. Abboud
Several surgical procedures have been proposed to address anterior glenohumeral instability, which is one of the most common complaints in the general population. The remplissage, first described in early 2000s, is a procedure performed simultaneously with the arthroscopic Bankart repair to correct large, engaging Hill-Sachs lesions (HSLs). This procedure stabilizes the joint by tenodesing the infraspinatus tendon into the HSL to fill and disengage the defect. This procedure gained popularity because it has relatively low risk and is able to improve shoulder stability while being less invasive than other bone-blocking procedures. The remplissage has become a valuable add-on technique that can substantially improve outcomes in unstable patients undergoing arthroscopic Bankart repair. Nevertheless, several studies in the literature have raised concerns regarding its efficacy in critically unstable patients and the potential range of motion limitations that can arise postoperatively. Additional comparative studies and trials should be conducted to appropriately establish the role of remplissage in treating anterior instability, especially in patients with critical bone loss.
几种外科手术方法已被提出,以解决前盂肱骨不稳,这是在一般人群中最常见的投诉之一。该手术于21世纪初首次被描述,是一种与关节镜下Bankart修复术同时进行的手术,用于纠正大的、接合的Hill-Sachs病变(hsl)。该手术通过将冈下肌腱固定到HSL内以填补和脱离缺损来稳定关节。这种手术之所以受到欢迎,是因为它风险相对较低,能够改善肩部稳定性,同时比其他骨阻断手术的侵入性更小。这种复位术已经成为一种有价值的附加技术,可以大大改善不稳定患者接受关节镜Bankart修复的结果。然而,文献中的一些研究对其在严重不稳定患者中的疗效以及术后可能出现的活动范围限制提出了担忧。应该进行更多的比较研究和试验,以适当地确定复位在治疗前路不稳中的作用,特别是在严重骨质流失的患者中。
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引用次数: 0
Midterm outcomes of suture anchor fixation for displaced olecranon fractures 缝合锚固定治疗肩胛骨移位骨折的中期疗效
Q2 ORTHOPEDICS Pub Date : 2023-12-04 DOI: 10.5397/cise.2023.00528
Michael J. Gutman, Jacob M. Kirsch, Jonathan Koa, M. Fares, Joseph A. Abboud
Background: Displaced olecranon fractures constitute a challenging problem for elbow surgeons. The purpose of this study is to evaluate the role of suture anchor fixation for treating patients with displaced olecranon fractures.Methods: A retrospective review was performed for all consecutive patients with displaced olecranon fractures treated with suture anchor fixation with at least 2 years of clinical follow-up. Surgical repair was performed acutely in all cases with nonmetallic suture anchors in a double-row configuration utilizing suture augmentation via the triceps tendon. Osseous union and perioperative complications were uniformly assessed. Results: Suture anchor fixation was performed on 17 patients with displaced olecranon fractures. Functional outcome scores were collected from 12 patients (70.6%). The mean age at the time of surgery was 65.6 years, and the mean follow-up was 5.6 years. Sixteen of 17 patients (94%) achieved osseous union in an acceptable position. No hardware-related complications or fixation failure occurred. Mean postoperative shortened disabilities of the arm, shoulder, and hand (QuickDASH) score was 3.8±6.9, and mean Oxford Elbow Score was 47.5±1.0, with nine patients (75%) achieving a perfect score. Conclusions: Suture anchor fixation of displaced olecranon fractures resulted in excellent midterm functional outcomes. Additionally, this technique resulted in high rates of osseous union without any hardware-related complications or fixation failures.
背景:移位的鹰嘴骨折对肘部外科医生来说是一个具有挑战性的问题。本研究的目的是评估缝合锚定固定在治疗鹰嘴移位骨折患者中的作用。方法:回顾性分析所有连续接受缝合锚钉固定治疗的鹰嘴移位骨折患者,随访至少2年。所有病例均采用经肱三头肌肌腱加强缝合的双排非金属缝合锚钉进行急性手术修复。统一评估骨愈合和围手术期并发症。结果:17例鹰嘴移位骨折均行缝合锚钉固定。收集了12例(70.6%)患者的功能结局评分。手术时平均年龄为65.6岁,平均随访时间为5.6年。17例患者中有16例(94%)在可接受的位置实现骨愈合。无硬件相关并发症或固定失败发生。术后臂、肩、手缩短残疾(QuickDASH)评分平均为3.8±6.9分,牛津肘评分平均为47.5±1.0分,9例(75%)患者达到满分。结论:带缝线锚钉固定移位的鹰嘴骨折可获得良好的中期功能预后。此外,该技术导致骨愈合率高,没有任何与硬件相关的并发症或固定失败。
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引用次数: 0
Glenohumeral versus subacromial steroid injections for impingement syndrome with mild stiffness: a randomized controlled trial. 肩关节与肩峰下注射类固醇治疗轻度强直性撞击综合征:一项随机对照试验。
Q2 ORTHOPEDICS Pub Date : 2023-12-01 Epub Date: 2023-10-05 DOI: 10.5397/cise.2023.00346
Yong-Tae Kim, Tae-Yeong Kim, Jun-Beom Lee, Jung-Taek Hwang

Background: The subacromial (SA) space is a commonly used injection site for treatment of impingement syndrome. For shoulder stiffness, glenohumeral (GH) injections are commonly performed. However, in cases of impingement syndrome with mild shoulder stiffness, the optimal site of steroid injection has yet to be identified.

Methods: This prospective, randomized study compared the short-term outcomes of ultrasound-guided GH and SA steroid injections in patients who were diagnosed with impingement syndrome and mild stiffness. Each group comprised 24 patients who received either a GH or SA injection of 40 mg of triamcinolone. Range of motion and clinical scores were assessed before and 3, 7, and 13 weeks after the injection.

Results: GH and SA injections significantly improved the range of motion and clinical scores after 13 weeks of follow-up. Notably, targeting the GH joint resulted in an earlier gain of forward elevation, external rotation, and internal rotation in 3 weeks (P<0.001, P=0.012, and P=0.002, respectively) and of internal rotation and a Constant-Murley score in 7 weeks (P<0.001 and P=0.046). Subsequent measurements were similar between the groups and showed a steady improvement in all ranges of motion and clinical scores.

Conclusions: GH injections may be more favorable than SA injections for treatment of impingement syndrome with mild stiffness, especially in improving the range of motion in the early period. However, the procedures showed similar outcomes after 3 months. Level of evidence: I.

背景:肩峰下间隙是治疗撞击综合征常用的注射部位。对于肩部僵硬,通常进行肩关节(GH)注射。然而,在轻度肩部僵硬的撞击综合征病例中,类固醇注射的最佳部位尚未确定。方法:这项前瞻性随机研究比较了超声引导下GH和SA类固醇注射治疗被诊断为撞击综合征和轻度僵硬患者的短期疗效。每组包括24名接受生长激素或SA注射40mg曲安奈德的患者。在注射前和注射后3、7和13周评估运动范围和临床评分。结果:经过13周的随访,GH和SA注射显著改善了运动范围和临床评分。值得注意的是,靶向GH关节导致了早期的前向抬高、外旋、,3周内旋转(P结论:GH注射可能比SA注射更有利于治疗轻度僵硬的撞击综合征,尤其是在改善早期活动范围方面。然而,3个月后,手术显示出类似的结果。证据水平:I。
{"title":"Glenohumeral versus subacromial steroid injections for impingement syndrome with mild stiffness: a randomized controlled trial.","authors":"Yong-Tae Kim, Tae-Yeong Kim, Jun-Beom Lee, Jung-Taek Hwang","doi":"10.5397/cise.2023.00346","DOIUrl":"10.5397/cise.2023.00346","url":null,"abstract":"<p><strong>Background: </strong>The subacromial (SA) space is a commonly used injection site for treatment of impingement syndrome. For shoulder stiffness, glenohumeral (GH) injections are commonly performed. However, in cases of impingement syndrome with mild shoulder stiffness, the optimal site of steroid injection has yet to be identified.</p><p><strong>Methods: </strong>This prospective, randomized study compared the short-term outcomes of ultrasound-guided GH and SA steroid injections in patients who were diagnosed with impingement syndrome and mild stiffness. Each group comprised 24 patients who received either a GH or SA injection of 40 mg of triamcinolone. Range of motion and clinical scores were assessed before and 3, 7, and 13 weeks after the injection.</p><p><strong>Results: </strong>GH and SA injections significantly improved the range of motion and clinical scores after 13 weeks of follow-up. Notably, targeting the GH joint resulted in an earlier gain of forward elevation, external rotation, and internal rotation in 3 weeks (P<0.001, P=0.012, and P=0.002, respectively) and of internal rotation and a Constant-Murley score in 7 weeks (P<0.001 and P=0.046). Subsequent measurements were similar between the groups and showed a steady improvement in all ranges of motion and clinical scores.</p><p><strong>Conclusions: </strong>GH injections may be more favorable than SA injections for treatment of impingement syndrome with mild stiffness, especially in improving the range of motion in the early period. However, the procedures showed similar outcomes after 3 months. Level of evidence: I.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"390-396"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10698124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41118128","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}
引用次数: 0
Concomitant open distal clavicle excision is associated with greater improvement in range of motion without increased risk of acromial stress fracture after reverse total shoulder arthroplasty: a retrospective cohort study. 一项回顾性队列研究表明,同时行锁骨远端切开切除与肩关节逆行全肩关节置换术后肩胛应力性骨折的风险增加有关。
Q2 ORTHOPEDICS Pub Date : 2023-12-01 Epub Date: 2023-11-08 DOI: 10.5397/cise.2023.00465
Ajay C Kanakamedala, Dhruv S Shankar, Neil Gambhir, Matthew R Boylan, Michael Boin, Matthew G Alben, Mandeep S Virk, Young W Kwon

Background: The purpose of this study was to evaluate the effect of concomitant open distal clavicle excision (DCE) on postoperative clinical outcomes and incidence of acromial and scapular stress fractures (ASFs) in patients with symptomatic acromioclavicular joint osteoarthritis (ACJ OA) undergoing reverse total shoulder arthroplasty (RTSA).

Methods: A single-surgeon retrospective cohort study was conducted including patients who underwent primary elective RTSA with or without DCE from 2015 to 2019 with a minimum 6-month follow-up period. Shoulder active range of motion (AROM) and visual analog scale (VAS) pain were recorded preoperatively and postoperatively. ASFs and other adverse events were identified using postoperative notes and/or radiographs. Characteristics and outcomes were compared between the RTSA and RTSA-DCE groups.

Results: Forty-six RTSA patients (mean age, 67.9±8.7 years; 60.9% male; mean follow-up, 24.9±16.6 months) and 70 RTSA-DCE patients (mean age, 70.2±8.9 years; 20.0% male; mean follow-up, 22.7±12.9 months) were included. There were no significant intergroup differences in rates of ASF (RTSA, 0.0% vs. RTSA-DCE, 1.4%; P=1.00), stress reactions (RTSA, 8.7% vs. RTSA-DCE, 11.4%; P=0.76), reoperation, revision, or infection (all P>0.05), or in pre-to-postoperative reduction in VAS pain (P=0.17) at latest follow-up. However, the RTSA-DCE group had greater pre-to-postoperative improvement in flexion AROM (RTSA, 43.7°±38.5° vs. RTSA-DCE, 59.5°±33.4°; P=0.03) and internal rotation (IR) AROM (P=0.02) at latest follow-up.

Conclusions: Concomitant DCE in RTSA improves shoulder flexion and IR AROM, alleviates shoulder pain, and does not increase the risk of ASFs. Level of evidence: III.

背景:本研究的目的是评估同时开放性远端锁骨切除术(DCE)对有症状的肩锁关节骨性关节炎(acjoa)患者行逆行全肩关节置换术(RTSA)后临床结果和肩峰应力性骨折(asf)发生率的影响。方法:采用单外科医生回顾性队列研究,纳入2015年至2019年接受原发性选择性RTSA伴或不伴DCE的患者,随访期至少6个月。术前、术后分别记录肩关节活动度(AROM)和视觉模拟疼痛评分(VAS)。通过术后记录和/或x光片确定asf和其他不良事件。采用学生t检验、Mann-Whitney U检验或Fisher精确检验比较RTSA组和RTSA- dce组的特征和结果。p值结果:RTSA患者46例(平均年龄67.9±8.7岁;男性60.9%;平均随访24.9±16.6个月)和70例RTSA-DCE患者(平均年龄70.2±8.9岁;男性20.0%;平均随访22.7±12.9个月)。ASF发生率组间无显著差异(RTSA, 0.0% vs RTSA- dce, 1.4%;P=1.00),应激反应(RTSA, 8.7% vs RTSA- dce, 11.4%;P=0.76)、再手术、翻修或感染(均P < 0.05),或最新随访时术前至术后VAS疼痛减轻(P=0.17)。然而,RTSA- dce组在屈曲AROM方面有更大的术后改善(RTSA, 43.7°±38.5°vs RTSA- dce, 59.5°±33.4°;P=0.03)和内旋(IR) AROM (P=0.02)。结论:RTSA患者合并DCE可改善肩部屈曲和IR AROM,减轻肩部疼痛,且不增加asf的风险。证据水平:III。
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引用次数: 0
Classification system for partial distal biceps tendon tears: a descriptive 3-Tesla magnetic resonance imaging study of tear morphology. 部分远端二头肌腱撕裂的分类系统:撕裂形态的描述性3-T磁共振成像研究。
Q2 ORTHOPEDICS Pub Date : 2023-12-01 Epub Date: 2023-11-14 DOI: 10.5397/cise.2023.00458
Alex B Boyle, Simon Bm MacLean

Background: There is minimal literature on the morphology of partial distal biceps tendon (DBT) tears. We sought to investigate tear morphology by retrospectively reviewing 3-Tesla magnetic resonance imaging (3T MRI) scans of elbows with partial DBT tears and to propose a basic classification system.

Methods: 3T MRI scans of elbows with partial DBT tears were retrospectively reviewed by two experienced observers. Basic demographic data were collected. Tear morphology was recorded including type, presence of retraction (>5 mm), and presence of discrete long-head and short-head tendons at the DBT insertion.

Results: For analysis, 44 3T MRI scans of 44 elbows with partial DBT tears were included. There were 9 isolated long-head tears (20%), 13 isolated short-head tears (30%), 2 complete long-head tears with a partial short-head tear (5%), 5 complete short-head tears with a partial long-head tear (11%), and 15 peel-off tears (34%). Retraction was seen in 5 or 44 partial tears (11%), and 13 of the 44 DBTs were bifid tendons at the insertion (30%).

Conclusions: Partial DBT tears can be classified into five sub-types: long-head isolated tears, short-head isolated tears, complete long-head tears with partial short-head involvement, complete short-head tears with partial long-head involvement, and peel-off tears. Classification of tears may have implications for operative and non-operative management. Level of evidence: III.

背景:关于部分远端肱二头肌肌腱(DBT)撕裂的形态学文献很少。我们试图通过回顾性回顾3-特斯拉磁共振成像(3T MRI)扫描肘部部分DBT撕裂的撕裂形态,并提出一个基本的分类系统。方法:由两名经验丰富的观察者回顾性回顾3T MRI扫描肘部部分DBT撕裂。收集基本人口统计数据。记录撕裂形态,包括类型、是否存在回缩(bbb50 mm),以及在DBT插入处是否存在离散的长头和短头肌腱。结果:为了进行分析,纳入了44例肘部部分DBT撕裂的44例3T MRI扫描。分离的长头撕裂9例(20%),分离的短头撕裂13例(30%),完整的长头撕裂2例(5%),完整的短头撕裂5例(11%),部分长头撕裂15例(34%)。5或44例部分撕裂(11%)出现牵回,44例dbt中有13例为止点处的双裂肌腱(30%)。结论:部分DBT撕裂可分为5个亚型:长头孤立撕裂、短头孤立撕裂、部分短头受累的完全长头撕裂、部分长头受累的完全短头撕裂和剥脱撕裂。泪的分类可能对手术和非手术治疗有影响。证据水平:III。
{"title":"Classification system for partial distal biceps tendon tears: a descriptive 3-Tesla magnetic resonance imaging study of tear morphology.","authors":"Alex B Boyle, Simon Bm MacLean","doi":"10.5397/cise.2023.00458","DOIUrl":"10.5397/cise.2023.00458","url":null,"abstract":"<p><strong>Background: </strong>There is minimal literature on the morphology of partial distal biceps tendon (DBT) tears. We sought to investigate tear morphology by retrospectively reviewing 3-Tesla magnetic resonance imaging (3T MRI) scans of elbows with partial DBT tears and to propose a basic classification system.</p><p><strong>Methods: </strong>3T MRI scans of elbows with partial DBT tears were retrospectively reviewed by two experienced observers. Basic demographic data were collected. Tear morphology was recorded including type, presence of retraction (>5 mm), and presence of discrete long-head and short-head tendons at the DBT insertion.</p><p><strong>Results: </strong>For analysis, 44 3T MRI scans of 44 elbows with partial DBT tears were included. There were 9 isolated long-head tears (20%), 13 isolated short-head tears (30%), 2 complete long-head tears with a partial short-head tear (5%), 5 complete short-head tears with a partial long-head tear (11%), and 15 peel-off tears (34%). Retraction was seen in 5 or 44 partial tears (11%), and 13 of the 44 DBTs were bifid tendons at the insertion (30%).</p><p><strong>Conclusions: </strong>Partial DBT tears can be classified into five sub-types: long-head isolated tears, short-head isolated tears, complete long-head tears with partial short-head involvement, complete short-head tears with partial long-head involvement, and peel-off tears. Classification of tears may have implications for operative and non-operative management. Level of evidence: III.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"366-372"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10698130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92156866","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}
引用次数: 0
Anterior interosseous nerve palsy in the early postoperative period after open capsular release for elbow stiffness: a case report. 肘关节僵硬开放囊松解术后早期骨间神经麻痹1例。
Q2 ORTHOPEDICS Pub Date : 2023-12-01 Epub Date: 2022-11-21 DOI: 10.5397/cise.2022.00899
Christopher A Colasanti, Michael Boin, Jacques Hacquebord, Mandeep Virk

Surgical release of elbow contracture is associated with injury to structures traversing the elbow. To date, only one other case report has been published describing anterior interosseous nerve (AIN) palsy that developed immediately after open elbow contracture release and debridement. Here we describe the unique case of a patient that developed AIN palsy 1 week after operation, including magnetic resonance imaging and electrodiagnostic studies, to shed some light on the etiology of this rare complication.

肘关节挛缩的手术解除与穿过肘关节的结构损伤有关。迄今为止,仅有一例报道了在肘关节开放性挛缩解除和清创后立即发生骨间神经(AIN)麻痹的病例。在这里,我们描述了一例术后1周发生AIN性麻痹的患者,包括磁共振成像和电诊断研究,以阐明这种罕见并发症的病因。
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引用次数: 3
The impact of modern airport security protocols on patients with total shoulder replacements. 现代机场安全规程对全肩关节置换术患者的影响
Q2 ORTHOPEDICS Pub Date : 2023-12-01 Epub Date: 2023-08-08 DOI: 10.5397/cise.2022.01403
Michael D Scheidt, Neal Sethi, Matthew Ballard, Michael Wesolowski, Dane Salazar, Nickolas Garbis

Background: Advancements in airport screening measures in response to 9/11 have resulted in increased false alarm rates for patients with orthopedic and metal implants. With the implementation of millimeter-wave scanning technology, it is important to assess the changes in airport screening experiences of patients who underwent total shoulder arthroplasty (TSA).

Methods: Here, 197 patients with prior anatomic and reverse TSA completed between 2013 and 2020 responded to a questionnaire regarding their experiences with airport travel screening after their operation. Of these patients, 86 (44%) stated that they had traveled by plane, while 111 (56%) had not. The questionnaire addressed several measures including the number of domestic and international flights following the operation, number of false alarm screenings by the millimeter-wave scanner, patient body habitus, and presence of additional metal implants.

Results: A total of 53 patients (62%) responded "yes" to false screening alarms due to shoulder arthroplasty. The odds of a false screening alarm for patients with other metal implants was 5.87 times that of a false screening alarm for patients with no other metal implants (P<0.1). Of a reported 662 flights, 303 (45.8%) resulted in false screening alarms. Greater body mass index was not significantly lower in patients who experienced false screening alarms (P=0.30).

Conclusions: Patients with anatomic and reverse TSA trigger false alarms with millimeter-wave scanners during airport screening at rates consistent with prior reports following 9/11. Patient education on the possibility of false alarms during airport screening is important until improvements in implant identification are made. Level of evidence: IV.

背景:为应对911事件,机场安检措施的进步导致骨科和金属植入物患者误报率增加。随着毫米波扫描技术的实施,评估全肩关节置换术(TSA)患者机场安检体验的变化具有重要意义。方法:在此,2013年至2020年期间完成的197例术前解剖和反向TSA患者回答了一份关于他们手术后机场旅行筛查经历的问卷。在这些患者中,86例(44%)表示他们乘坐过飞机,111例(56%)没有乘坐过飞机。调查问卷涉及了几项措施,包括手术后国内和国际航班的数量,毫米波扫描仪的假警报筛选次数,患者的身体习惯以及是否存在额外的金属植入物。结果:53例患者(62%)对肩关节置换术引起的假筛查报警回答“是”。有其他金属植入物的患者假警报的几率是没有其他金属植入物的患者假警报的5.87倍(p结论:解剖和反向TSA患者在机场安检时使用毫米波扫描仪触发假警报的比率与9/11事件后的先前报告一致。在植入物识别技术得到改进之前,对患者进行机场检查时假警报可能性的教育是很重要的。证据等级:四级。
{"title":"The impact of modern airport security protocols on patients with total shoulder replacements.","authors":"Michael D Scheidt, Neal Sethi, Matthew Ballard, Michael Wesolowski, Dane Salazar, Nickolas Garbis","doi":"10.5397/cise.2022.01403","DOIUrl":"10.5397/cise.2022.01403","url":null,"abstract":"<p><strong>Background: </strong>Advancements in airport screening measures in response to 9/11 have resulted in increased false alarm rates for patients with orthopedic and metal implants. With the implementation of millimeter-wave scanning technology, it is important to assess the changes in airport screening experiences of patients who underwent total shoulder arthroplasty (TSA).</p><p><strong>Methods: </strong>Here, 197 patients with prior anatomic and reverse TSA completed between 2013 and 2020 responded to a questionnaire regarding their experiences with airport travel screening after their operation. Of these patients, 86 (44%) stated that they had traveled by plane, while 111 (56%) had not. The questionnaire addressed several measures including the number of domestic and international flights following the operation, number of false alarm screenings by the millimeter-wave scanner, patient body habitus, and presence of additional metal implants.</p><p><strong>Results: </strong>A total of 53 patients (62%) responded \"yes\" to false screening alarms due to shoulder arthroplasty. The odds of a false screening alarm for patients with other metal implants was 5.87 times that of a false screening alarm for patients with no other metal implants (P<0.1). Of a reported 662 flights, 303 (45.8%) resulted in false screening alarms. Greater body mass index was not significantly lower in patients who experienced false screening alarms (P=0.30).</p><p><strong>Conclusions: </strong>Patients with anatomic and reverse TSA trigger false alarms with millimeter-wave scanners during airport screening at rates consistent with prior reports following 9/11. Patient education on the possibility of false alarms during airport screening is important until improvements in implant identification are made. Level of evidence: IV.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"416-422"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10698132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9969801","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}
引用次数: 0
期刊
Clinics in Shoulder and Elbow
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