Pub Date : 2021-11-17DOI: 10.1007/978-1-4614-1596-1_32
Mark S. Cohen
{"title":"Lateral Epicondylitis","authors":"Mark S. Cohen","doi":"10.1007/978-1-4614-1596-1_32","DOIUrl":"https://doi.org/10.1007/978-1-4614-1596-1_32","url":null,"abstract":"","PeriodicalId":44224,"journal":{"name":"Techniques in Shoulder and Elbow Surgery","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78260614","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 : 2020-12-01DOI: 10.1097/BTE.0000000000000200
Alyssa D. Althoff, Hans Prakash, R. P. Gean, S. Yarboro
Periprosthetic humerus fractures remain problematic complications that are difficult to adequately reduce and maintain reduction. Patient-related risk factors, including poor bone quality, add an additional level of complexity to maintaining fixation in the setting of relatively narrow cortical margins adjacent to the shoulder prosthesis. Based on the challenges of obtaining adequate proximal fixation and the need to minimize dependence on cerclage fixation because of nerve injury risks and inadequate fracture reduction, the authors propose an alternative method intraoperative fixation. The technique described is a method of fixation utilizing a small fragment instrumentation set for periprosthetic humerus fractures as demonstrated in a Sawbones model and intraoperatively in a patient-specific case.
{"title":"Small Fragment Instrumentation for Periprosthetic Humerus Fracture Fixation Technique","authors":"Alyssa D. Althoff, Hans Prakash, R. P. Gean, S. Yarboro","doi":"10.1097/BTE.0000000000000200","DOIUrl":"https://doi.org/10.1097/BTE.0000000000000200","url":null,"abstract":"Periprosthetic humerus fractures remain problematic complications that are difficult to adequately reduce and maintain reduction. Patient-related risk factors, including poor bone quality, add an additional level of complexity to maintaining fixation in the setting of relatively narrow cortical margins adjacent to the shoulder prosthesis. Based on the challenges of obtaining adequate proximal fixation and the need to minimize dependence on cerclage fixation because of nerve injury risks and inadequate fracture reduction, the authors propose an alternative method intraoperative fixation. The technique described is a method of fixation utilizing a small fragment instrumentation set for periprosthetic humerus fractures as demonstrated in a Sawbones model and intraoperatively in a patient-specific case.","PeriodicalId":44224,"journal":{"name":"Techniques in Shoulder and Elbow Surgery","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88380927","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 : 2020-12-01DOI: 10.1097/BTE.0000000000000202
A. Atan, Zamri Abdul Rahman, Norhaslinda Bahaudin, K. R. Zayzan, A. Ahmad
Isolated acromion fractures, although unusual, are not uncommon. Traditionally treated conservatively, an improved understanding of shoulder biomechanics has extended the indications for surgical treatment. Surgical modalities described in the literature are plating, cortical lag screw, Kirschner wiring, and tension-band wiring. We describe a novel surgical technique for both fixation of an acute fracture or revision surgery of the base of acromion fracture. The technique involves the insertion of an intramedullary screw from the lateral tip of the acromion toward the tapered medial part of the scapular spine. This is supplemented by an anatomic locking reconstruction plating placed on the superior border of the acromion and scapular spine. We share an illustrated case of a 39-year-old woman, who successfully underwent a revision surgery with this technique and recovered well with excellent radiologic and functional outcomes. A long intramedullary screw provides good interfragmentary compression, 3-point fixation, and better bony purchases. A supplementary plate helps to resist rotational and muscular-pulling forces. In conclusion, intramedullary screw fixation, supplemented with plating, offers a viable surgical treatment for acromion fractures, and combined with a proper postoperative rehabilitation regime, it helps patients to achieve
{"title":"Intramedullary Screw Fixation Supplemented by Scapular Spine Plating: A Surgical Technique for the Base of Acromion Fracture","authors":"A. Atan, Zamri Abdul Rahman, Norhaslinda Bahaudin, K. R. Zayzan, A. Ahmad","doi":"10.1097/BTE.0000000000000202","DOIUrl":"https://doi.org/10.1097/BTE.0000000000000202","url":null,"abstract":"Isolated acromion fractures, although unusual, are not uncommon. Traditionally treated conservatively, an improved understanding of shoulder biomechanics has extended the indications for surgical treatment. Surgical modalities described in the literature are plating, cortical lag screw, Kirschner wiring, and tension-band wiring. We describe a novel surgical technique for both fixation of an acute fracture or revision surgery of the base of acromion fracture. The technique involves the insertion of an intramedullary screw from the lateral tip of the acromion toward the tapered medial part of the scapular spine. This is supplemented by an anatomic locking reconstruction plating placed on the superior border of the acromion and scapular spine. We share an illustrated case of a 39-year-old woman, who successfully underwent a revision surgery with this technique and recovered well with excellent radiologic and functional outcomes. A long intramedullary screw provides good interfragmentary compression, 3-point fixation, and better bony purchases. A supplementary plate helps to resist rotational and muscular-pulling forces. In conclusion, intramedullary screw fixation, supplemented with plating, offers a viable surgical treatment for acromion fractures, and combined with a proper postoperative rehabilitation regime, it helps patients to achieve","PeriodicalId":44224,"journal":{"name":"Techniques in Shoulder and Elbow Surgery","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80544492","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 : 2020-11-18DOI: 10.1097/BTE.0000000000000209
Andrew L. Schaver, J. Akeson, Robert A. Kinzinger, M. Ramirez
In displaced supracondylar humerus fractures, closed reduction percutaneous pinning is recommended and is most commonly performed in the supine position with the arm held in hyperflexion. The risk of iatrogenic ulnar nerve injury with medial pin placement is high in this position. We performed a retrospective case series of 149 patients with displaced supracondylar humerus fractures treated in the prone position. The aim of this study was to evaluate the incidence of iatrogenic ulnar nerve injury with medial pin placement, report our technique, and conduct a literature review to serve as historical control. The rate of iatrogenic ulnar nerve injury was evaluated and compared with a historical control cohort of 1029 patients treated supine. A total of 131 patients were included: 74 (56%) patients received a medial pin, and 57 (44%) patients received lateral pins only. Postoperative complications included 2 cases of pin migration (1.5%). No patients sustained iatrogenic ulnar nerve injury, compared with a historical control rate of 4.95%. Our technique is correlated with a lower incidence of ulnar nerve injuries than historical controls performed in the supine position. We believe this technique can facilitate safer pin placement in cases that require a medial pin. Level of Evidence: Level IV.
{"title":"Management of Supracondylar Fractures in the Prone Position: Case Series, Technique, and Literature Review","authors":"Andrew L. Schaver, J. Akeson, Robert A. Kinzinger, M. Ramirez","doi":"10.1097/BTE.0000000000000209","DOIUrl":"https://doi.org/10.1097/BTE.0000000000000209","url":null,"abstract":"In displaced supracondylar humerus fractures, closed reduction percutaneous pinning is recommended and is most commonly performed in the supine position with the arm held in hyperflexion. The risk of iatrogenic ulnar nerve injury with medial pin placement is high in this position. We performed a retrospective case series of 149 patients with displaced supracondylar humerus fractures treated in the prone position. The aim of this study was to evaluate the incidence of iatrogenic ulnar nerve injury with medial pin placement, report our technique, and conduct a literature review to serve as historical control. The rate of iatrogenic ulnar nerve injury was evaluated and compared with a historical control cohort of 1029 patients treated supine. A total of 131 patients were included: 74 (56%) patients received a medial pin, and 57 (44%) patients received lateral pins only. Postoperative complications included 2 cases of pin migration (1.5%). No patients sustained iatrogenic ulnar nerve injury, compared with a historical control rate of 4.95%. Our technique is correlated with a lower incidence of ulnar nerve injuries than historical controls performed in the supine position. We believe this technique can facilitate safer pin placement in cases that require a medial pin. Level of Evidence: Level IV.","PeriodicalId":44224,"journal":{"name":"Techniques in Shoulder and Elbow Surgery","volume":"21 1","pages":"112 - 115"},"PeriodicalIF":0.0,"publicationDate":"2020-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49404739","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 : 2020-11-18DOI: 10.1097/BTE.0000000000000207
S. Kamineni, Eric Abbenhaus, R. Snowden
Triceps-off approaches of the elbow detach not only the central tendinous insertion but also the medial and lateral peripheral muscular extensions, which are often replaced by scar tissue instead of functioning contractile muscular tissue when re-attached firmly with suture. These muscular extensions have been shown to be important for terminal elbow extension and may explain why triceps-off approaches have a higher rate of triceps insufficiency in terminal, antigravity elbow extension. Triceps-on approaches of the elbow lead to difficulty accessing the ulna for preparation and insertion of the ulna component of elbow replacements, with malpositioning of the ulna component a common concern. We present an elbow “triple window” surgical approach that preserves the contractile medial and lateral footprints of the triceps, while affording a better in-line access than a pure “triceps-on” approach. This approach only violates 50% of the central tendinous insertion, with the remainder of the central tendon and the medial and lateral muscular extensions preserved.
{"title":"“Triple Window” Surgical Approach to the Elbow: A Hybrid Exposure","authors":"S. Kamineni, Eric Abbenhaus, R. Snowden","doi":"10.1097/BTE.0000000000000207","DOIUrl":"https://doi.org/10.1097/BTE.0000000000000207","url":null,"abstract":"Triceps-off approaches of the elbow detach not only the central tendinous insertion but also the medial and lateral peripheral muscular extensions, which are often replaced by scar tissue instead of functioning contractile muscular tissue when re-attached firmly with suture. These muscular extensions have been shown to be important for terminal elbow extension and may explain why triceps-off approaches have a higher rate of triceps insufficiency in terminal, antigravity elbow extension. Triceps-on approaches of the elbow lead to difficulty accessing the ulna for preparation and insertion of the ulna component of elbow replacements, with malpositioning of the ulna component a common concern. We present an elbow “triple window” surgical approach that preserves the contractile medial and lateral footprints of the triceps, while affording a better in-line access than a pure “triceps-on” approach. This approach only violates 50% of the central tendinous insertion, with the remainder of the central tendon and the medial and lateral muscular extensions preserved.","PeriodicalId":44224,"journal":{"name":"Techniques in Shoulder and Elbow Surgery","volume":"21 1","pages":"116 - 123"},"PeriodicalIF":0.0,"publicationDate":"2020-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43194906","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 : 2020-11-18DOI: 10.1097/BTE.0000000000000199
Dennis A. DeBernardis, Kristin Sandrowski, E. Padegimas, Michael Rivlin
Olecranon fractures are common injuries of the upper extremity that frequently require operative fixation to restore elbow congruity and function. Surgery is often performed in the lateral or prone position, presenting challenges for anesthesia, nursing, and the surgical team to safely and appropriately position the patient. Supine positioning with the use of a hand table provides limited visualization of the olecranon and often requires an assistant for maintenance of limb position. We describe an easy and quick surgical setup requiring only 2 total knee arthroplasty foot positioners (commonly known as “paint rollers”) attached to a surgical table with the patient in a supine position. A retrospective review of 28 patients undergoing operative fixation of olecranon fractures utilizing this positioning method was performed. No patients were found to require repositioning (ie, supine to lateral) for any reason and no airway-related or positioning-related complications were noted. This setup provides excellent exposure to the operative site and stable positioning of the arm with minimal risk to the patient. In keeping the patient supine, monitored anesthesia care (intravenous general anesthesia) with regional blockade may be performed without the need for endotracheal or laryngeal mask anesthesia, thereby lowering anesthesia-related risks.
{"title":"A Simplified Technique for Patient Positioning During Olecranon Fracture Fixation","authors":"Dennis A. DeBernardis, Kristin Sandrowski, E. Padegimas, Michael Rivlin","doi":"10.1097/BTE.0000000000000199","DOIUrl":"https://doi.org/10.1097/BTE.0000000000000199","url":null,"abstract":"Olecranon fractures are common injuries of the upper extremity that frequently require operative fixation to restore elbow congruity and function. Surgery is often performed in the lateral or prone position, presenting challenges for anesthesia, nursing, and the surgical team to safely and appropriately position the patient. Supine positioning with the use of a hand table provides limited visualization of the olecranon and often requires an assistant for maintenance of limb position. We describe an easy and quick surgical setup requiring only 2 total knee arthroplasty foot positioners (commonly known as “paint rollers”) attached to a surgical table with the patient in a supine position. A retrospective review of 28 patients undergoing operative fixation of olecranon fractures utilizing this positioning method was performed. No patients were found to require repositioning (ie, supine to lateral) for any reason and no airway-related or positioning-related complications were noted. This setup provides excellent exposure to the operative site and stable positioning of the arm with minimal risk to the patient. In keeping the patient supine, monitored anesthesia care (intravenous general anesthesia) with regional blockade may be performed without the need for endotracheal or laryngeal mask anesthesia, thereby lowering anesthesia-related risks.","PeriodicalId":44224,"journal":{"name":"Techniques in Shoulder and Elbow Surgery","volume":"21 1","pages":"107 - 111"},"PeriodicalIF":0.0,"publicationDate":"2020-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41638542","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 : 2020-11-18DOI: 10.1097/BTE.0000000000000205
G. Hoy, M. Choudhry, Simon Hoy, S. Warby
The acromioclavicular joint (ACJ) ganglion (producing the “geyser sign”) produces poor quality skin and risk of infection with repeated aspirations and arthroscopic resection. The primary aim is to present our pedicled muscle flap procedure to prevent wound breakdown and recurrent infection over the ACJ. The secondary aim is to report our case series’ outcomes. By using a distally based rotation flap of the trapezius muscle to the ACJ defect after lateral clavicle excision the overlying skin can be supported by a well vascularized soft tissue bed. Included participants sustained recurrent ganglion cysts producing the geyser sign with poor quality skin and/or recurrent infection. Three patients underwent this technique. Favorable results were shown by excellent outcomes in all cases after surgery. There were no recurrent infections, and no other complications. This technique of using a local muscle flap resulted in a high patient satisfaction and a low rate of complications.
{"title":"Trapezius Rotation-plasty for Complicated Acromioclavicular Joint Ganglion Cysts","authors":"G. Hoy, M. Choudhry, Simon Hoy, S. Warby","doi":"10.1097/BTE.0000000000000205","DOIUrl":"https://doi.org/10.1097/BTE.0000000000000205","url":null,"abstract":"The acromioclavicular joint (ACJ) ganglion (producing the “geyser sign”) produces poor quality skin and risk of infection with repeated aspirations and arthroscopic resection. The primary aim is to present our pedicled muscle flap procedure to prevent wound breakdown and recurrent infection over the ACJ. The secondary aim is to report our case series’ outcomes. By using a distally based rotation flap of the trapezius muscle to the ACJ defect after lateral clavicle excision the overlying skin can be supported by a well vascularized soft tissue bed. Included participants sustained recurrent ganglion cysts producing the geyser sign with poor quality skin and/or recurrent infection. Three patients underwent this technique. Favorable results were shown by excellent outcomes in all cases after surgery. There were no recurrent infections, and no other complications. This technique of using a local muscle flap resulted in a high patient satisfaction and a low rate of complications.","PeriodicalId":44224,"journal":{"name":"Techniques in Shoulder and Elbow Surgery","volume":"21 1","pages":"150 - 154"},"PeriodicalIF":0.0,"publicationDate":"2020-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44428205","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 : 2020-11-18DOI: 10.1097/BTE.0000000000000206
Khang H. Dang, A. Lee, G. Prabhakar, Bao-Quynh Julian, Christina I. Brady, Anil K Dutta
The authors describe a novel split capsule technique for the open treatment of chronic locked anterior shoulder dislocation. The described technique is easily reproducible and focuses on preservation of the native joint with open reduction of the humeral head and soft tissue repair. The steps entail the creation of a neocapsule of the shoulder, elimination of the pseudoglenoid space with a medial capsular repair, and a combined medial and lateral capsular shift. In the present article, the procedure is outlined in detail with technical pearls, 3 case examples, and a review of treatment options.
{"title":"The Split Capsule Technique for Chronic Anterior Shoulder Dislocation: A Novel Surgical Technique and Case Series","authors":"Khang H. Dang, A. Lee, G. Prabhakar, Bao-Quynh Julian, Christina I. Brady, Anil K Dutta","doi":"10.1097/BTE.0000000000000206","DOIUrl":"https://doi.org/10.1097/BTE.0000000000000206","url":null,"abstract":"The authors describe a novel split capsule technique for the open treatment of chronic locked anterior shoulder dislocation. The described technique is easily reproducible and focuses on preservation of the native joint with open reduction of the humeral head and soft tissue repair. The steps entail the creation of a neocapsule of the shoulder, elimination of the pseudoglenoid space with a medial capsular repair, and a combined medial and lateral capsular shift. In the present article, the procedure is outlined in detail with technical pearls, 3 case examples, and a review of treatment options.","PeriodicalId":44224,"journal":{"name":"Techniques in Shoulder and Elbow Surgery","volume":"21 1","pages":"136 - 143"},"PeriodicalIF":0.0,"publicationDate":"2020-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45501327","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 : 2020-11-18DOI: 10.1097/BTE.0000000000000204
Y. Chua, P. Lam, G. Murrell
The aim of this study was to compare the early clinical and functional outcomes of patients who received the 2 major variations of reverse shoulder arthroplasty (RSA). The nonlateralized Aequalis Reversed Shoulder System (Tornier, Nice, France) was followed by the lateralized Encore Reverse Shoulder Prosthesis (DJO Surgical, Austin, Texas). Patient-determined pain and functional scores and examiner-determined range of motion and strength were assessed preoperatively and postoperatively at 1, 6, 12 weeks, and 6 months. Seventy RSAs performed in 66 consecutive patients: 35 shoulders in the lateralized group and 35 shoulders in the nonlateralized group met the inclusion criteria and formed the cohorts. Both groups experienced similar excellent clinical outcomes, with the exception that the lateralized group had better internal rotation range of motion (L3-4 vs. S1, P=0.03), lower frequency of pain during sleep (P=0.04), less severe pain at rest (P=0.03) and higher involvement in sporting activities (P=0.04) at 24 weeks. In conclusion, patients who underwent RSA with a lateralized glenosphere had better internal rotation range of motion, less pain, and better function than those who received a nonlateralized prosthesis. These differences were apparent within 6 months postsurgery. Level of Evidence: Level III.
本研究的目的是比较接受两种主要的反向肩关节置换术(RSA)的患者的早期临床和功能结果。非侧化的Aequalis反肩系统(Tornier, Nice, France)之后是侧化的Encore反肩假体(DJO Surgical, Austin, Texas)。术前和术后分别在1、6、12周和6个月评估患者确定的疼痛和功能评分以及检查者确定的活动范围和力量。在66例连续患者中进行了70例RSAs:侧化组35例肩部和非侧化组35例肩部符合纳入标准并形成队列。两组临床结果相似，除了侧化组在24周时有更好的内旋活动范围(L3-4 vs. S1, P=0.03)，睡眠时疼痛频率较低(P=0.04)，休息时疼痛程度较轻(P=0.03)和更多参与体育活动(P=0.04)。综上所述，与接受非侧化假体的患者相比，接受侧化假体的RSA患者具有更好的内旋活动范围，更少的疼痛和更好的功能。这些差异在术后6个月内明显。证据等级:三级。
{"title":"Lateralized Versus Nonlateralized Reverse Shoulder Arthroplasty: Impact on Clinical and Functional Outcomes","authors":"Y. Chua, P. Lam, G. Murrell","doi":"10.1097/BTE.0000000000000204","DOIUrl":"https://doi.org/10.1097/BTE.0000000000000204","url":null,"abstract":"The aim of this study was to compare the early clinical and functional outcomes of patients who received the 2 major variations of reverse shoulder arthroplasty (RSA). The nonlateralized Aequalis Reversed Shoulder System (Tornier, Nice, France) was followed by the lateralized Encore Reverse Shoulder Prosthesis (DJO Surgical, Austin, Texas). Patient-determined pain and functional scores and examiner-determined range of motion and strength were assessed preoperatively and postoperatively at 1, 6, 12 weeks, and 6 months. Seventy RSAs performed in 66 consecutive patients: 35 shoulders in the lateralized group and 35 shoulders in the nonlateralized group met the inclusion criteria and formed the cohorts. Both groups experienced similar excellent clinical outcomes, with the exception that the lateralized group had better internal rotation range of motion (L3-4 vs. S1, P=0.03), lower frequency of pain during sleep (P=0.04), less severe pain at rest (P=0.03) and higher involvement in sporting activities (P=0.04) at 24 weeks. In conclusion, patients who underwent RSA with a lateralized glenosphere had better internal rotation range of motion, less pain, and better function than those who received a nonlateralized prosthesis. These differences were apparent within 6 months postsurgery. Level of Evidence: Level III.","PeriodicalId":44224,"journal":{"name":"Techniques in Shoulder and Elbow Surgery","volume":"21 1","pages":"89 - 96"},"PeriodicalIF":0.0,"publicationDate":"2020-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/BTE.0000000000000204","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42147038","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 : 2020-11-18DOI: 10.1097/BTE.0000000000000203
W. Albishi, J. Lam, Aouod Agenor, A. Elmaraghy
Chronic disruption of the distal biceps tendon is a challenging problem and can lead to considerable disability. We conducted a group-matched retrospective study comparing clinical outcomes of chronic distal biceps reconstruction using our previously described “Anatomic Length Method” and those with an acute distal rupture and primary repair. Forty-six patients were included into the analysis; 23 underwent acute distal biceps repair, and 23 underwent chronic distal biceps reconstruction. Demographic and surgical data were reviewed retrospectively. Patients were evaluated and clinical outcome measures were obtained at least 1 year after surgical treatment. There were no significant differences in Patient-Rated Elbow Evaluation scores (6.0 vs. 4.4, respectively; P=0.53) and biceps shape contour satisfaction (19/19 vs. 6/7, respectively; P=0.093). No significant difference emerged in complication rates. This study suggests that chronic reconstruction of the distal biceps tendon using the “Anatomic Length Method” is a safe technique that produces similar clinical results to acute distal biceps primary repair.
{"title":"Distal Biceps Tendon Ruptures: Acute Repair Versus Chronic Reconstruction Using the “Anatomic Length Method” and Concomitant Bicipital Aponeurosis Repair: A Group-matched Comparative Retrospective Study","authors":"W. Albishi, J. Lam, Aouod Agenor, A. Elmaraghy","doi":"10.1097/BTE.0000000000000203","DOIUrl":"https://doi.org/10.1097/BTE.0000000000000203","url":null,"abstract":"Chronic disruption of the distal biceps tendon is a challenging problem and can lead to considerable disability. We conducted a group-matched retrospective study comparing clinical outcomes of chronic distal biceps reconstruction using our previously described “Anatomic Length Method” and those with an acute distal rupture and primary repair. Forty-six patients were included into the analysis; 23 underwent acute distal biceps repair, and 23 underwent chronic distal biceps reconstruction. Demographic and surgical data were reviewed retrospectively. Patients were evaluated and clinical outcome measures were obtained at least 1 year after surgical treatment. There were no significant differences in Patient-Rated Elbow Evaluation scores (6.0 vs. 4.4, respectively; P=0.53) and biceps shape contour satisfaction (19/19 vs. 6/7, respectively; P=0.093). No significant difference emerged in complication rates. This study suggests that chronic reconstruction of the distal biceps tendon using the “Anatomic Length Method” is a safe technique that produces similar clinical results to acute distal biceps primary repair.","PeriodicalId":44224,"journal":{"name":"Techniques in Shoulder and Elbow Surgery","volume":"21 1","pages":"97 - 100"},"PeriodicalIF":0.0,"publicationDate":"2020-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44522238","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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