Pub Date : 2025-03-01DOI: 10.1053/S1048-6666(25)00026-6
{"title":"Editorial Board (pick up from previous issue w/updates)","authors":"","doi":"10.1053/S1048-6666(25)00026-6","DOIUrl":"10.1053/S1048-6666(25)00026-6","url":null,"abstract":"","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":"35 1","pages":"Article 101192"},"PeriodicalIF":0.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069972","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 : 2025-03-01DOI: 10.1016/j.oto.2025.101171
Samantha Maasarani , Corinne Wee
Due to its role in hand function, median nerve injuries can have a significant impact on patients’ lives. Nerve transfers can be performed alone or in conjunction with tendon transfers to restore critical functions supplied by the median nerve, with a particular emphasis on restoring grasp, pinch, and sensation. Continued study into possible nerve transfers for median nerve injury has led to multiple options that can be tailored to the patient's demands, deficits, and injury pattern.
{"title":"Nerve Transfers for Median Nerve Injury","authors":"Samantha Maasarani , Corinne Wee","doi":"10.1016/j.oto.2025.101171","DOIUrl":"10.1016/j.oto.2025.101171","url":null,"abstract":"<div><div>Due to its role in hand function, median nerve injuries can have a significant impact on patients’ lives. Nerve transfers can be performed alone or in conjunction with tendon transfers to restore critical functions supplied by the median nerve, with a particular emphasis on restoring grasp, pinch, and sensation. Continued study into possible nerve transfers for median nerve injury has led to multiple options that can be tailored to the patient's demands, deficits, and injury pattern.</div></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":"35 1","pages":"Article 101171"},"PeriodicalIF":0.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069402","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 : 2025-03-01DOI: 10.1016/j.oto.2025.101172
Nicholas I. Pilla, Rafael J. Diaz-Garcia
Ulnar nerve injuries, whether traumatic or iatrogenic, lead to profound motor and sensory impairments, including reduced grip strength, fine motor dysfunction, and deformities like claw hand. The ulnar nerve, originating predominantly from the C8-T1 roots, traverses anatomically significant regions like the cubital tunnel and Guyon's canal, where it innervates muscles critical for hand function and provides sensory input to the ulnar hand and fingers. Functional recovery is constrained by the slow axonal regeneration rate (1 mm/day) and delayed presentation, necessitating alternative treatments such as nerve and tendon transfers. Diagnostic evaluation, including electrodiagnostic testing, imaging, along with clinical assessment is essential for treatment planning. Commonly performed transfers include the anterior interosseous nerve (AIN)-to-ulnar nerve transfers for proximal injuries and the opponens pollicis to deep ulnar motor branch for distal injuries. The development of novel nerve transfer and improved surgical techniques have demonstrated promising success for improving motor reinnervation and sensory restoration. These techniques have transformed the prognosis for ulnar nerve injuries, offering functional recovery and improved quality of life.
{"title":"Operative Techniques in Orthopedics: Ulnar Nerve Transfers","authors":"Nicholas I. Pilla, Rafael J. Diaz-Garcia","doi":"10.1016/j.oto.2025.101172","DOIUrl":"10.1016/j.oto.2025.101172","url":null,"abstract":"<div><div>Ulnar nerve injuries, whether traumatic or iatrogenic, lead to profound motor and sensory impairments, including reduced grip strength, fine motor dysfunction, and deformities like claw hand. The ulnar nerve, originating predominantly from the C8-T1 roots, traverses anatomically significant regions like the cubital tunnel and Guyon's canal, where it innervates muscles critical for hand function and provides sensory input to the ulnar hand and fingers. Functional recovery is constrained by the slow axonal regeneration rate (1 mm/day) and delayed presentation, necessitating alternative treatments such as nerve and tendon transfers. Diagnostic evaluation, including electrodiagnostic testing, imaging, along with clinical assessment is essential for treatment planning. Commonly performed transfers include the anterior interosseous nerve (AIN)-to-ulnar nerve transfers for proximal injuries and the opponens pollicis to deep ulnar motor branch for distal injuries. The development of novel nerve transfer and improved surgical techniques have demonstrated promising success for improving motor reinnervation and sensory restoration. These techniques have transformed the prognosis for ulnar nerve injuries, offering functional recovery and improved quality of life.</div></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":"35 1","pages":"Article 101172"},"PeriodicalIF":0.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069403","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 : 2025-03-01DOI: 10.1016/j.oto.2025.101173
Andrew L. O'Brien , Hannah Smith , Kanu Goyal
Radial nerve palsy is a devastating condition that may present with a combination of loss of elbow extension, wrist extension, or finger extension depending on the level of injury. These palsies may arise from myriad etiologies, ranging from spinal cord and brachial plexus injuries to idiopathic and inflammatory conditions. The purpose of this chapter is to present nerve transfers as an emerging approach to radial nerve deficits. We also present principles and evidence for alternative treatment strategies, including primary repair, nerve grafting, and tendon transfers.
{"title":"Nerve Transfers for Radial Nerve Palsy: History, Outcomes, Alternatives, and Surgical Techniques","authors":"Andrew L. O'Brien , Hannah Smith , Kanu Goyal","doi":"10.1016/j.oto.2025.101173","DOIUrl":"10.1016/j.oto.2025.101173","url":null,"abstract":"<div><div>Radial nerve palsy is a devastating condition that may present with a combination of loss of elbow extension, wrist extension, or finger extension depending on the level of injury. These palsies may arise from myriad etiologies, ranging from spinal cord and brachial plexus injuries to idiopathic and inflammatory conditions. The purpose of this chapter is to present nerve transfers as an emerging approach to radial nerve deficits. We also present principles and evidence for alternative treatment strategies, including primary repair, nerve grafting, and tendon transfers.</div></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":"35 1","pages":"Article 101173"},"PeriodicalIF":0.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069404","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 : 2025-03-01DOI: 10.1016/j.oto.2025.101176
Syeda Hoorulain Ahmed , Ramin Shekouhi , Mohammed S. Rais , Harvey Chim
Complete brachial plexus injuries (BPI) are among the most severe and debilitating nerve injuries, often leading to extensive motor and sensory loss in the upper extremity. This paper reviews the surgical management of complete BPI, focusing on nerve transfers, functional muscle transfers, and pain management techniques, such as dorsal root entry zone (DREZ) lesioning. Common nerve transfer options in complete BPI include the spinal accessory nerve SAN to the suprascapular nerve (SSN) transfer for shoulder reanimation, (SAN) to musculocutaneous nerve (MCN), intercostal nerves to MCN, phrenic to MCN for reconstruction of elbow flexion, and contralateral C7 transfer for reanimation of finger and elbow flexion. Functional free muscle transfers, most often utilizing the gracilis, are particularly effective in chronic BPI where nerve grafting or nerve transfers are not possible. DREZ lesioning provides pain relief in chronic neuropathic cases. Early intervention and structured rehabilitation are crucial for optimal outcomes. Effective management of complete BPI requires a multidisciplinary approach. Techniques like nerve grafting, muscle transfer, and DREZ lesioning offer significant potential for recovery, while timing and rehabilitation are crucial to improving outcomes. Continued advancements in surgical methods are promising for improving patient recovery and quality of life.
{"title":"Complete Brachial Plexus Injuries: Review of Surgical Techniques and Functional Outcomes","authors":"Syeda Hoorulain Ahmed , Ramin Shekouhi , Mohammed S. Rais , Harvey Chim","doi":"10.1016/j.oto.2025.101176","DOIUrl":"10.1016/j.oto.2025.101176","url":null,"abstract":"<div><div>Complete brachial plexus injuries (BPI) are among the most severe and debilitating nerve injuries, often leading to extensive motor and sensory loss in the upper extremity. This paper reviews the surgical management of complete BPI, focusing on nerve transfers, functional muscle transfers, and pain management techniques, such as dorsal root entry zone (DREZ) lesioning. Common nerve transfer options in complete BPI include the spinal accessory nerve SAN to the suprascapular nerve (SSN) transfer for shoulder reanimation, (SAN) to musculocutaneous nerve (MCN), intercostal nerves to MCN, phrenic to MCN for reconstruction of elbow flexion, and contralateral C7 transfer for reanimation of finger and elbow flexion. Functional free muscle transfers, most often utilizing the gracilis, are particularly effective in chronic BPI where nerve grafting or nerve transfers are not possible. DREZ lesioning provides pain relief in chronic neuropathic cases. Early intervention and structured rehabilitation are crucial for optimal outcomes. Effective management of complete BPI requires a multidisciplinary approach. Techniques like nerve grafting, muscle transfer, and DREZ lesioning offer significant potential for recovery, while timing and rehabilitation are crucial to improving outcomes. Continued advancements in surgical methods are promising for improving patient recovery and quality of life.</div></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":"35 1","pages":"Article 101176"},"PeriodicalIF":0.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069398","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 : 2024-12-01DOI: 10.1016/j.oto.2024.101150
Vaibhav R. Tadepalli MD , Vaya Chhabra , Pradip Ramamurti MD , Richard F. Nauert MD , Brian C. Werner MD
As the number of reverse total shoulder arthroplasties (rTSA) in the United States continues to increase, so will the number of revisions rTSAs conducted. Common indications for revision rTSA include instability, infection, humeral or glenoid component loosening or periprosthetic humeral fracture, and each indication for revision warrants specific preoperative management and intraoperative strategies. Accurate diagnosis and management of the patient is key, as failure to recognize the correct indication for revision may result in failure of the revision surgery. Revision rTSA is a technically challenging procedure. However, with diligent preoperative planning including serologic evaluation for infection, evaluation of bone loss and implant stability with computed tomography, anticipating need for bone grafting, and detailed identification of implanted components to plan for explantation, surgeons can avoid common pitfalls in the operating room. This review article will discuss the major indications for revision rTSA and provide insight and technical tips to assist with the surgical management of these challenging cases.
{"title":"Revision Reverse Total Shoulder Arthroplasty: Current Concepts and Operative Strategies","authors":"Vaibhav R. Tadepalli MD , Vaya Chhabra , Pradip Ramamurti MD , Richard F. Nauert MD , Brian C. Werner MD","doi":"10.1016/j.oto.2024.101150","DOIUrl":"10.1016/j.oto.2024.101150","url":null,"abstract":"<div><div>As the number of reverse total shoulder arthroplasties (rTSA) in the United States continues to increase, so will the number of revisions rTSAs conducted. Common indications for revision rTSA include instability, infection, humeral or glenoid component loosening or periprosthetic humeral fracture, and each indication for revision warrants specific preoperative management and intraoperative strategies. Accurate diagnosis and management of the patient is key, as failure to recognize the correct indication for revision may result in failure of the revision surgery. Revision rTSA is a technically challenging procedure. However, with diligent preoperative planning including serologic evaluation for infection, evaluation of bone loss and implant stability with computed tomography, anticipating need for bone grafting, and detailed identification of implanted components to plan for explantation, surgeons can avoid common pitfalls in the operating room. This review article will discuss the major indications for revision rTSA and provide insight and technical tips to assist with the surgical management of these challenging cases.</div></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":"34 4","pages":"Article 101150"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743185","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 : 2024-12-01DOI: 10.1016/j.oto.2024.101147
Mikalyn T. DeFoor MD , Robert U. Hartzler MD , Andrew J. Sheean MD
Anatomic total shoulder arthroplasty (aTSA) is best performed in the setting of glenohumeral joint osteoarthritis with an intact rotator cuff tear in patients with symptoms refractory to appropriate nonoperative treatment. Mid- to long-term follow-up supports overall high patient satisfaction with low complications rates. As reverse total shoulder arthroplasty (rTSA) allows the surgeon to manage a broader range of shoulder problems with greater technical ease and fewer complications, it has become the more commonly used option over aTSA. Specifically, glenoid deformity, joint incongruity, and rotator cuff deficiency pose challenging technical considerations for aTSA. The purpose of this article is to review the appropriate patient selection, preoperative planning, perioperative and intraoperative technical considerations required to achieve a successful outcome if aTSA is chosen.
{"title":"A Review of Preoperative Planning and Technical Considerations for Anatomic Total Shoulder Arthroplasty","authors":"Mikalyn T. DeFoor MD , Robert U. Hartzler MD , Andrew J. Sheean MD","doi":"10.1016/j.oto.2024.101147","DOIUrl":"10.1016/j.oto.2024.101147","url":null,"abstract":"<div><div>Anatomic total shoulder arthroplasty (aTSA) is best performed in the setting of glenohumeral joint osteoarthritis with an intact rotator cuff tear in patients with symptoms refractory to appropriate nonoperative treatment. Mid- to long-term follow-up supports overall high patient satisfaction with low complications rates. As reverse total shoulder arthroplasty (rTSA) allows the surgeon to manage a broader range of shoulder problems with greater technical ease and fewer complications, it has become the more commonly used option over aTSA. Specifically, glenoid deformity, joint incongruity, and rotator cuff deficiency pose challenging technical considerations for aTSA. The purpose of this article is to review the appropriate patient selection, preoperative planning, perioperative and intraoperative technical considerations required to achieve a successful outcome if aTSA is chosen.</div></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":"34 4","pages":"Article 101147"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743187","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 : 2024-12-01DOI: 10.1016/j.oto.2024.101148
Benjamin E. Neubauer , Justin W. Griffin
In the United States, the use of total shoulder arthroplasty has grown significantly over the past decade, leading to an increased need for revision total shoulder arthroplasty. The most common causes for revision include instability, rotator cuff deficiency, infection, fractures, and component loosening. Although revisions are sometimes unavoidable, thoughtful preoperative planning and proper implant positioning, among other mitigation strategies, can help reduce this risk. A comprehensive evaluation is essential for determining the appropriate treatment modality, with computed tomography arthrography and metal suppression magnetic resonance imaging being particularly helpful depending on the etiology. Initial treatments may include conservative approaches, such as analgesic medications and physical therapy, but more commonly, surgical intervention is required. This typically involves revision total shoulder arthroplasty or conversion to reverse total shoulder arthroplasty, and in rare cases diagnostic arthroscopy or arthroscopic rotator cuff repair. Surgeons should be prepared for all potential treatments and complications, and a thorough work-up ensures that all possible scenarios are accounted for.
{"title":"Revision Anatomic Total Shoulder Arthroplasty Surgical Technique/Tips and Tricks","authors":"Benjamin E. Neubauer , Justin W. Griffin","doi":"10.1016/j.oto.2024.101148","DOIUrl":"10.1016/j.oto.2024.101148","url":null,"abstract":"<div><div>In the United States, the use of total shoulder arthroplasty has grown significantly over the past decade, leading to an increased need for revision total shoulder arthroplasty. The most common causes for revision include instability, rotator cuff deficiency, infection, fractures, and component loosening. Although revisions are sometimes unavoidable, thoughtful preoperative planning and proper implant positioning, among other mitigation strategies, can help reduce this risk. A comprehensive evaluation is essential for determining the appropriate treatment modality, with computed tomography arthrography and metal suppression magnetic resonance imaging being particularly helpful depending on the etiology. Initial treatments may include conservative approaches, such as analgesic medications and physical therapy, but more commonly, surgical intervention is required. This typically involves revision total shoulder arthroplasty or conversion to reverse total shoulder arthroplasty, and in rare cases diagnostic arthroscopy or arthroscopic rotator cuff repair. Surgeons should be prepared for all potential treatments and complications, and a thorough work-up ensures that all possible scenarios are accounted for.</div></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":"34 4","pages":"Article 101148"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743184","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 : 2024-12-01DOI: 10.1016/j.oto.2024.101151
Ehab M. Nazzal, Jaren LaGreca, Matthew F. Gong, Matthew Como, Jonathan D. Hughes
Proximal humerus fractures (PHFs) are relatively common fractures that are especially prevalent amongst the geriatric population. Various fracture patterns exist, ranging from minimally displaced fractures to fracture dislocations with multiple fragments. Traditionally, treatment strategies have included nonoperative management with a sling and gradual return to range of motion, as well as both open reduction internal fixation and hemiarthroplasty. Recently, there has been an increase in the frequency of utilization of reverse shoulder arthroplasty (RSA) as a treatment option for PHFs, to maximize mobility and function. The purpose of this article is to review current concepts for the treatment of PHFs, with a special focus on indications, technical pearls, clinical/functional outcomes, and complications for RSA as a definitive management strategy.
{"title":"Reverse Shoulder Arthroplasty for the Treatment of Proximal Humerus Fractures","authors":"Ehab M. Nazzal, Jaren LaGreca, Matthew F. Gong, Matthew Como, Jonathan D. Hughes","doi":"10.1016/j.oto.2024.101151","DOIUrl":"10.1016/j.oto.2024.101151","url":null,"abstract":"<div><div>Proximal humerus fractures (PHFs) are relatively common fractures that are especially prevalent amongst the geriatric population. Various fracture patterns exist, ranging from minimally displaced fractures to fracture dislocations with multiple fragments. Traditionally, treatment strategies have included nonoperative management with a sling and gradual return to range of motion, as well as both open reduction internal fixation and hemiarthroplasty. Recently, there has been an increase in the frequency of utilization of reverse shoulder arthroplasty (RSA) as a treatment option for PHFs, to maximize mobility and function. The purpose of this article is to review current concepts for the treatment of PHFs, with a special focus on indications, technical pearls, clinical/functional outcomes, and complications for RSA as a definitive management strategy.</div></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":"34 4","pages":"Article 101151"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743190","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号