Pub Date : 2022-05-17DOI: 10.1097/BTO.0000000000000591
Jonas Liebe, Aude Lehnen, A. Jandali, C. Meier, P. Wahl
Introduction: Up to 17% of patients with total hip arthroplasty (THA) suffer from greater trochanteric or lateral trochanteric pain. Subcutaneous soft tissue or trochanteric bone substance defects with protrusion of the underlying stem may be challenging causes. Surgical Technique: We present the surgical technique of a de-epithelialized cutaneous transposition inversion flap to cover subcutaneous implant protrusion, performed successfully in a patient with posttraumatic trochanteric defect following THA after failed internal fixation for a trochanteric fracture. Results and Conclusion: The patient had no more trochanteric pain, allowing her to walk, sit, and sleep without pain. The THA protrusion was no longer palpable under the uneventfully healed skin. The technique described is relatively simple and may help improve therapy in patients with symptomatic trochanteric bone or soft tissue defects. Level of Evidence: Level IV, Special technical article.
{"title":"A Cutaneous Transposition Inversion Flap to Treat Symptomatic Subcutaneous Trochanteric or Soft Tissue Defects After Hip Arthroplasty: A Technical Note","authors":"Jonas Liebe, Aude Lehnen, A. Jandali, C. Meier, P. Wahl","doi":"10.1097/BTO.0000000000000591","DOIUrl":"https://doi.org/10.1097/BTO.0000000000000591","url":null,"abstract":"Introduction: Up to 17% of patients with total hip arthroplasty (THA) suffer from greater trochanteric or lateral trochanteric pain. Subcutaneous soft tissue or trochanteric bone substance defects with protrusion of the underlying stem may be challenging causes. Surgical Technique: We present the surgical technique of a de-epithelialized cutaneous transposition inversion flap to cover subcutaneous implant protrusion, performed successfully in a patient with posttraumatic trochanteric defect following THA after failed internal fixation for a trochanteric fracture. Results and Conclusion: The patient had no more trochanteric pain, allowing her to walk, sit, and sleep without pain. The THA protrusion was no longer palpable under the uneventfully healed skin. The technique described is relatively simple and may help improve therapy in patients with symptomatic trochanteric bone or soft tissue defects. Level of Evidence: Level IV, Special technical article.","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"23 1","pages":"249 - 252"},"PeriodicalIF":0.3,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82276012","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 : 2022-05-16DOI: 10.1097/BTO.0000000000000590
A. Khalifa, A. Abdelaal, Mohamed M. A. Moustafa, M. Mahran
R evision total joint (hip and knee) arthroplasty is a complex procedure that usually necessitates implant removal, which, if done correctly, will ease the subsequent reconstruction.1 Preoperative planning is of paramount importance in the revision of total joint arthroplasty surgeries; the surgeon should make sure that he/she has both the skills and the equipment needed for the surgery, an integral part of this plan is how the surgeon is going to remove the implants with the minimal force (to avoid soft tissue disruption) and with the least bone loss possible.2,3 Various tools had been introduced to facilitate fixed knee or hip implants removal, such as drills, oscillating saws, Gigli saws, reciprocating saws, thin flexible osteotomes, high-speed metal cutting burrs, punches, impactors, and universal distraction devices for cement removal, hooks, curettes, flag splitter, and ultrasonic devices could be used.1–4 In this technical note, we described how a humble periodontal probe (from dental surgery tools) could be a helpful tool for removing fixed implants in revision total joint arthroplasty surgery. TECHNIQUE
{"title":"A Humble Periodontal Probe Can Help Implant Removal During Revision Total Joint Arthroplasty: A Technical Note","authors":"A. Khalifa, A. Abdelaal, Mohamed M. A. Moustafa, M. Mahran","doi":"10.1097/BTO.0000000000000590","DOIUrl":"https://doi.org/10.1097/BTO.0000000000000590","url":null,"abstract":"R evision total joint (hip and knee) arthroplasty is a complex procedure that usually necessitates implant removal, which, if done correctly, will ease the subsequent reconstruction.1 Preoperative planning is of paramount importance in the revision of total joint arthroplasty surgeries; the surgeon should make sure that he/she has both the skills and the equipment needed for the surgery, an integral part of this plan is how the surgeon is going to remove the implants with the minimal force (to avoid soft tissue disruption) and with the least bone loss possible.2,3 Various tools had been introduced to facilitate fixed knee or hip implants removal, such as drills, oscillating saws, Gigli saws, reciprocating saws, thin flexible osteotomes, high-speed metal cutting burrs, punches, impactors, and universal distraction devices for cement removal, hooks, curettes, flag splitter, and ultrasonic devices could be used.1–4 In this technical note, we described how a humble periodontal probe (from dental surgery tools) could be a helpful tool for removing fixed implants in revision total joint arthroplasty surgery. TECHNIQUE","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"14 1","pages":"283 - 284"},"PeriodicalIF":0.3,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79424638","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 : 2022-05-05DOI: 10.1097/bto.0000000000000589
Kevin D. Martin, Reid Palumbo, Jesse H. Morris
{"title":"The “Flying V”: A Novel Construct to Address Concurrent Lateral Ankle and Syndesmotic Instability","authors":"Kevin D. Martin, Reid Palumbo, Jesse H. Morris","doi":"10.1097/bto.0000000000000589","DOIUrl":"https://doi.org/10.1097/bto.0000000000000589","url":null,"abstract":"","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"41 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79900177","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 : 2022-05-04DOI: 10.1097/bto.0000000000000588
J. Schwarz, Yiyang Zhang, J. Dieterich, M. Hausman
{"title":"Percutaneous Removal of a Foreign Body From the Distal Phalanx Using a 14 Gauge Needle and Fluoroscopy","authors":"J. Schwarz, Yiyang Zhang, J. Dieterich, M. Hausman","doi":"10.1097/bto.0000000000000588","DOIUrl":"https://doi.org/10.1097/bto.0000000000000588","url":null,"abstract":"","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75682795","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 : 2022-04-08DOI: 10.1097/bto.0000000000000584
Joshua N. Speirs, M. Wilson, Joey P Johnson
{"title":"Intramedullary Delivery of Autologous Bone Graft to Long Bone Defects Using Reamer Irrigator Aspirator 2 System: Technical Trick","authors":"Joshua N. Speirs, M. Wilson, Joey P Johnson","doi":"10.1097/bto.0000000000000584","DOIUrl":"https://doi.org/10.1097/bto.0000000000000584","url":null,"abstract":"","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"10 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90935625","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 : 2022-04-05DOI: 10.1097/bto.0000000000000585
A. Dimitroulias, Ryhor Harbacheuski, N. Gougoulias, D. Murphy, M. Sen
{"title":"Technique Tip: Bicortical Fixation of Medial Malleolus Fractures With 2.7 mm Screws","authors":"A. Dimitroulias, Ryhor Harbacheuski, N. Gougoulias, D. Murphy, M. Sen","doi":"10.1097/bto.0000000000000585","DOIUrl":"https://doi.org/10.1097/bto.0000000000000585","url":null,"abstract":"","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"73 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88306784","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 : 2022-03-29DOI: 10.1097/BTO.0000000000000570
Y. Okazaki, T. Furumatsu, T. Hiranaka, Keisuke Kintaka, Ximing Zhang, Yuya Kodama, Yusuke Kamatsuki, Tadashi Yamawaki, Toshifumi Ozaki
Introduction: Transtibial pullout repair is the gold standard surgical treatment for medial meniscus (MM) posterior root tear. However, posteromedial extrusion of the MM during knee flexion may remain a problem postoperatively. Materials and Methods: We used a novel posterior anchoring technique to help reduce posteromedial extrusion, applying two cinch sutures (TCSs) to the MM posterior horn and creating a bone tunnel at the center of the posterior root attachment to pullout the suture. Another bone tunnel was created at the posterior corner of the medial tibial plateau in the externally rotated knee flexion. The first anchor of an all-inside meniscal repair device was inserted through the inferior surface of the MM posterior horn with tensioning TCS and the second anchor into the bone tunnel. Tibial fixation of pullout sutures was performed using a bioabsorbable screw in 30 degrees knee flexion. Conclusions: Our posterior anchoring method, combined with conventional pullout repair with TCS, helped reduce posteromedial extrusion in patients with a MM posterior root tear.
{"title":"Novel Posterior Anchoring Method Associated With Medial Meniscus Posterior Root Repair","authors":"Y. Okazaki, T. Furumatsu, T. Hiranaka, Keisuke Kintaka, Ximing Zhang, Yuya Kodama, Yusuke Kamatsuki, Tadashi Yamawaki, Toshifumi Ozaki","doi":"10.1097/BTO.0000000000000570","DOIUrl":"https://doi.org/10.1097/BTO.0000000000000570","url":null,"abstract":"Introduction: Transtibial pullout repair is the gold standard surgical treatment for medial meniscus (MM) posterior root tear. However, posteromedial extrusion of the MM during knee flexion may remain a problem postoperatively. Materials and Methods: We used a novel posterior anchoring technique to help reduce posteromedial extrusion, applying two cinch sutures (TCSs) to the MM posterior horn and creating a bone tunnel at the center of the posterior root attachment to pullout the suture. Another bone tunnel was created at the posterior corner of the medial tibial plateau in the externally rotated knee flexion. The first anchor of an all-inside meniscal repair device was inserted through the inferior surface of the MM posterior horn with tensioning TCS and the second anchor into the bone tunnel. Tibial fixation of pullout sutures was performed using a bioabsorbable screw in 30 degrees knee flexion. Conclusions: Our posterior anchoring method, combined with conventional pullout repair with TCS, helped reduce posteromedial extrusion in patients with a MM posterior root tear.","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"2015 1","pages":"175 - 180"},"PeriodicalIF":0.3,"publicationDate":"2022-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73316483","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 : 2022-03-23DOI: 10.1097/BTO.0000000000000583
Mohamad Qoreishy, A. Alamian, M. Movahedinia, S. Keyhani
Introduction: Percutaneous screw fixation have been introduced as a minimally invasive method in anterior pelvic ring fractures. The aim of the study is to present the outcomes of a new minimally invasive technique for fixation of anterior pelvic ring fractures medial to the pubic tubercle. Materials and Methods: Sixty-two patients were referred to our center during 5 years for the fixation of the anterior pelvic ring fracture under the new procedure. The fracture site was bridged using a 3-hole 3.5 mm reconstruction plate when 1 or 2 long retrograde screw was passed through the plate in the superior ramus. Results: A case of device failure was observed in the patient treated with the new method, which did not lead to loss of reduction and did not limit the patient’s activity. Apart from this, we did not have any abnormalities in the follow-up radiographs of the patients and no complications were reported. Conclusion: The results of this study showed the potential of our new method for fixation of various types of anterior pelvic ring injuries. Level of Evidence: Level IV.
{"title":"A New Technique for Anterior Pelvic Ring Fixation Using a Minimally Invasive Approach","authors":"Mohamad Qoreishy, A. Alamian, M. Movahedinia, S. Keyhani","doi":"10.1097/BTO.0000000000000583","DOIUrl":"https://doi.org/10.1097/BTO.0000000000000583","url":null,"abstract":"Introduction: Percutaneous screw fixation have been introduced as a minimally invasive method in anterior pelvic ring fractures. The aim of the study is to present the outcomes of a new minimally invasive technique for fixation of anterior pelvic ring fractures medial to the pubic tubercle. Materials and Methods: Sixty-two patients were referred to our center during 5 years for the fixation of the anterior pelvic ring fracture under the new procedure. The fracture site was bridged using a 3-hole 3.5 mm reconstruction plate when 1 or 2 long retrograde screw was passed through the plate in the superior ramus. Results: A case of device failure was observed in the patient treated with the new method, which did not lead to loss of reduction and did not limit the patient’s activity. Apart from this, we did not have any abnormalities in the follow-up radiographs of the patients and no complications were reported. Conclusion: The results of this study showed the potential of our new method for fixation of various types of anterior pelvic ring injuries. Level of Evidence: Level IV.","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"89 1","pages":"218 - 223"},"PeriodicalIF":0.3,"publicationDate":"2022-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88497796","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 : 2022-02-18DOI: 10.1097/bto.0000000000000582
B. Browner
{"title":"A Big Structural Change for Techniques in Orthopaedics","authors":"B. Browner","doi":"10.1097/bto.0000000000000582","DOIUrl":"https://doi.org/10.1097/bto.0000000000000582","url":null,"abstract":"","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"27 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89899537","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 : 2022-02-09DOI: 10.1097/BTO.0000000000000579
Ponrachai Wongthongsalee, Thanapon Chobpenthai
Background: Patellar fractures account for 0.5% to 1.5% of all bone fractures. Tension band wiring with heavy gauge steel wire and K-wires is traditionally procedure for treating patellar fractures. However, this method is associated with implant-related complications. Present study aimed to evaluate functional clinical outcomes of patellar fracture fixation with transosseous suture using an all-FiberWire technique. Methods: This was a retrospective study involving 16 patellar fractures patients were repaired by open reduction and internal fixation with FiberWire using a 3-transosseous tunnel technique. The functional outcomes were evaluated with Tegner-Lysholm and Bostman scoring. We also evaluated clinical and radiologic outcomes. Results: The mean time to bony union was 8.87±1.54 weeks (range, 7 to 12 wk). The mean Bostman score at final follow-up was 27.13±2.5 (range, 21 to 30), and mean Lysholm score at final follow-up was 90.69±5.75 (range, 83 to 100). Fractures healed in all patients, with no fixation failures. Minor loss of reduction (<2 mm) were observed in 3 patients (18.75%). No patient has reoperation. One patient developed knee stiffness, with an infected hematoma 10 weeks postoperatively. None of patients developed anterior knee pain postoperatively. Two patients (12.5%) developed mild localized pain from prominent suture knots. There were no significant implant-related complications and no repeat surgery was necessary. Conclusions: The use of nonmetallic sutures with an all-FiberWire technique in patellar fracture fixation avoids implant-associated complications and possibility of a second surgery to remove metal implants. Nonmetallic high-resistance FiberWire matches traditional metallic fixation, with a reduced risk of postoperative complications. Level of Evidence: Level IV (therapeutic).
{"title":"Transosseous Suture With an All-FiberWire Technique in Patellar Fracture Fixation","authors":"Ponrachai Wongthongsalee, Thanapon Chobpenthai","doi":"10.1097/BTO.0000000000000579","DOIUrl":"https://doi.org/10.1097/BTO.0000000000000579","url":null,"abstract":"Background: Patellar fractures account for 0.5% to 1.5% of all bone fractures. Tension band wiring with heavy gauge steel wire and K-wires is traditionally procedure for treating patellar fractures. However, this method is associated with implant-related complications. Present study aimed to evaluate functional clinical outcomes of patellar fracture fixation with transosseous suture using an all-FiberWire technique. Methods: This was a retrospective study involving 16 patellar fractures patients were repaired by open reduction and internal fixation with FiberWire using a 3-transosseous tunnel technique. The functional outcomes were evaluated with Tegner-Lysholm and Bostman scoring. We also evaluated clinical and radiologic outcomes. Results: The mean time to bony union was 8.87±1.54 weeks (range, 7 to 12 wk). The mean Bostman score at final follow-up was 27.13±2.5 (range, 21 to 30), and mean Lysholm score at final follow-up was 90.69±5.75 (range, 83 to 100). Fractures healed in all patients, with no fixation failures. Minor loss of reduction (<2 mm) were observed in 3 patients (18.75%). No patient has reoperation. One patient developed knee stiffness, with an infected hematoma 10 weeks postoperatively. None of patients developed anterior knee pain postoperatively. Two patients (12.5%) developed mild localized pain from prominent suture knots. There were no significant implant-related complications and no repeat surgery was necessary. Conclusions: The use of nonmetallic sutures with an all-FiberWire technique in patellar fracture fixation avoids implant-associated complications and possibility of a second surgery to remove metal implants. Nonmetallic high-resistance FiberWire matches traditional metallic fixation, with a reduced risk of postoperative complications. Level of Evidence: Level IV (therapeutic).","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"13 1","pages":"224 - 231"},"PeriodicalIF":0.3,"publicationDate":"2022-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78486814","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：