Pub Date : 2022-02-08DOI: 10.1097/BTO.0000000000000581
Joseph K. Kendal, M. Wong, S. Montgomery, Brent Benavides, M. Monument, S. Puloski
Three-dimensional printing technology has rapidly advanced as a promising technology for preoperative planning, education, and surgical execution in orthopedic surgery. Use of patient-specific instrumentation in orthopedic oncology sarcoma cases can streamline complex osteotomies while providing safe margins based on predetermined osteotomy levels. We describe use of an “in-house” protocol to create patient-specific bone tumor resection guides for use in orthopedic oncology cases. The described protocol bypasses expensive outsourcing options and facilitates use of preoperative surgical simulation and intimate involvement of the surgical team in the guide design. We report on the successful design and use of three-dimensional printed patient-specific bone tissue resection guides in a case of proximal tibial parosteal osteosarcoma resection and reconstruction with a size-matched allograft, and in a case of a secondary pelvic chondrosarcoma resection.
{"title":"“In-house” Design and Use of 3-dimensional Printed Patient-specific Bone Tumor Resection Guides for Geometric Osteotomies in Sarcoma Surgery","authors":"Joseph K. Kendal, M. Wong, S. Montgomery, Brent Benavides, M. Monument, S. Puloski","doi":"10.1097/BTO.0000000000000581","DOIUrl":"https://doi.org/10.1097/BTO.0000000000000581","url":null,"abstract":"Three-dimensional printing technology has rapidly advanced as a promising technology for preoperative planning, education, and surgical execution in orthopedic surgery. Use of patient-specific instrumentation in orthopedic oncology sarcoma cases can streamline complex osteotomies while providing safe margins based on predetermined osteotomy levels. We describe use of an “in-house” protocol to create patient-specific bone tumor resection guides for use in orthopedic oncology cases. The described protocol bypasses expensive outsourcing options and facilitates use of preoperative surgical simulation and intimate involvement of the surgical team in the guide design. We report on the successful design and use of three-dimensional printed patient-specific bone tissue resection guides in a case of proximal tibial parosteal osteosarcoma resection and reconstruction with a size-matched allograft, and in a case of a secondary pelvic chondrosarcoma resection.","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"131 1","pages":"238 - 244"},"PeriodicalIF":0.3,"publicationDate":"2022-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80984264","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 : 2022-02-08DOI: 10.1097/BTO.0000000000000574
John W. Robison, Emilio E Grau-Cruz, J. Bruggers, Stephen Becher
Introduction: The purpose of the study was to quantify the volume of graft that is obtained using sequential upsizing of reamers using the modularity of the second generation Reamer-Irrigator-Aspirator (RIA 2) system and determine any fracture or perforation risk with upsizing. We hypothesize that graft volume may be predicted using radiographic variables that can be measured before reaming. Materials and Methods: Eleven cadaveric specimens were used to evaluate the sequential amount of graft taken using the RIA 2 modular system. Each cadaveric specimen had bone graft harvested from the tibia and femur. Using a radiographic ruler, estimations of the canal size for both the femur and tibia were performed. Average graft volume with SD per incremental increase of reamer was calculated for both the femur and the tibia. Results: There were no perforations of the femur during any reaming. There were 5 perforations or fractures of the tibias during progressive reaming including 3 during the second pass and 2 during the third pass, with a significant increase in perforation in the tibial specimens (P=0.03). There was no significant difference in graft volume after 3 passes from either tibia or femoral harvesting. However, there was a significant decrease in graft volume on the second pass of the femur that was not seen in tibial harvesting (P=0.0013). Discussion: The RIA 2’s reamer head modularity allows multiple passes of the reamer, which gives surgeons the ability to upsize if more autograft is needed. Total autograft volume was similar between the femur and tibia; however, caution should be used in the tibia because of increased perforation risk. Level of Evidence: Level IV—therapeutic study.
{"title":"Bone Graft Volume by Reamer Head Size Using the RIA 2","authors":"John W. Robison, Emilio E Grau-Cruz, J. Bruggers, Stephen Becher","doi":"10.1097/BTO.0000000000000574","DOIUrl":"https://doi.org/10.1097/BTO.0000000000000574","url":null,"abstract":"Introduction: The purpose of the study was to quantify the volume of graft that is obtained using sequential upsizing of reamers using the modularity of the second generation Reamer-Irrigator-Aspirator (RIA 2) system and determine any fracture or perforation risk with upsizing. We hypothesize that graft volume may be predicted using radiographic variables that can be measured before reaming. Materials and Methods: Eleven cadaveric specimens were used to evaluate the sequential amount of graft taken using the RIA 2 modular system. Each cadaveric specimen had bone graft harvested from the tibia and femur. Using a radiographic ruler, estimations of the canal size for both the femur and tibia were performed. Average graft volume with SD per incremental increase of reamer was calculated for both the femur and the tibia. Results: There were no perforations of the femur during any reaming. There were 5 perforations or fractures of the tibias during progressive reaming including 3 during the second pass and 2 during the third pass, with a significant increase in perforation in the tibial specimens (P=0.03). There was no significant difference in graft volume after 3 passes from either tibia or femoral harvesting. However, there was a significant decrease in graft volume on the second pass of the femur that was not seen in tibial harvesting (P=0.0013). Discussion: The RIA 2’s reamer head modularity allows multiple passes of the reamer, which gives surgeons the ability to upsize if more autograft is needed. Total autograft volume was similar between the femur and tibia; however, caution should be used in the tibia because of increased perforation risk. Level of Evidence: Level IV—therapeutic study.","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"34 1","pages":"149 - 153"},"PeriodicalIF":0.3,"publicationDate":"2022-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74200782","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 : 2022-01-26DOI: 10.1097/bto.0000000000000580
A. Sabaghzadeh, F. Biglari, M. Jafari Kafiabadi, A. Ebrahimpour
{"title":"Fibular Strut Autograft as an Augmented Biological Plate","authors":"A. Sabaghzadeh, F. Biglari, M. Jafari Kafiabadi, A. Ebrahimpour","doi":"10.1097/bto.0000000000000580","DOIUrl":"https://doi.org/10.1097/bto.0000000000000580","url":null,"abstract":"","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"23 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72514258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-21DOI: 10.1097/BTO.0000000000000578
Roland Z. White, Anitha L Thalluri, J. Cabot, M. Sampson
I liopsoas impingement is a common cause of groin pain posttotal hip replacement (THR) and has a reported incidence as high as 8.3%.1 Iliopsoas impingement causes ill-defined groin pain which is worsened by active hip flexion. Pain exacerbated by activities such as walking up stairs and lifting the leg in and out of a motor vehicle can be helpful diagnostic clues. The most common site of impingement is at the acetabular cup where there is friction with the deep aspect of the iliopsoas tendon. The iliopsoas tendon is positioned immediately anterior to the hip, separated from the capsule only by the iliopsoas bursa. Causes of impingement include bony excrescence, cement extrusion, a Rouviere’s sulcus, inadequate implant anteversion, or projecting studs or screws, excessive size of reinforcement ring, or by an increase in hip offset or hip length ≥ 1 cm.1 We describe iliopsoas tendon impingement secondary to bony excrescence. Conservative management of iliopsoas tendon impingement includes ultrasound (US)-guided anesthetic/corticosteroid injections, activity modification and nonsteroidal anti-inflammatory medications are often initially trialed. After conservative management options fail, surgical alternatives such as open or arthroscopic psoas tenotomy and revision hip arthroplasty can reliably improve the patient’s symptoms. Open surgical procedures however carry a higher risk of infection, accrue longer hospital and recovery periods,2 and arthroscopic procedures have increased risk of neurovascular damage. The use of US is gaining traction in orthopedic procedures, with some utilizing its benefits for placement of portal placement in hip arthroscopies.3 We propose US-guided tenotomy and ostectomy for management of ilipsoas impingement post-THR as it provides a less invasive option with reduced hospital stay and recovery time. TECHNIQUE
{"title":"Ultrasound-guided Tenotomy and Osteectomy for the Treatment of Iliopsoas Impingement Post-total Hip Replacement","authors":"Roland Z. White, Anitha L Thalluri, J. Cabot, M. Sampson","doi":"10.1097/BTO.0000000000000578","DOIUrl":"https://doi.org/10.1097/BTO.0000000000000578","url":null,"abstract":"I liopsoas impingement is a common cause of groin pain posttotal hip replacement (THR) and has a reported incidence as high as 8.3%.1 Iliopsoas impingement causes ill-defined groin pain which is worsened by active hip flexion. Pain exacerbated by activities such as walking up stairs and lifting the leg in and out of a motor vehicle can be helpful diagnostic clues. The most common site of impingement is at the acetabular cup where there is friction with the deep aspect of the iliopsoas tendon. The iliopsoas tendon is positioned immediately anterior to the hip, separated from the capsule only by the iliopsoas bursa. Causes of impingement include bony excrescence, cement extrusion, a Rouviere’s sulcus, inadequate implant anteversion, or projecting studs or screws, excessive size of reinforcement ring, or by an increase in hip offset or hip length ≥ 1 cm.1 We describe iliopsoas tendon impingement secondary to bony excrescence. Conservative management of iliopsoas tendon impingement includes ultrasound (US)-guided anesthetic/corticosteroid injections, activity modification and nonsteroidal anti-inflammatory medications are often initially trialed. After conservative management options fail, surgical alternatives such as open or arthroscopic psoas tenotomy and revision hip arthroplasty can reliably improve the patient’s symptoms. Open surgical procedures however carry a higher risk of infection, accrue longer hospital and recovery periods,2 and arthroscopic procedures have increased risk of neurovascular damage. The use of US is gaining traction in orthopedic procedures, with some utilizing its benefits for placement of portal placement in hip arthroscopies.3 We propose US-guided tenotomy and ostectomy for management of ilipsoas impingement post-THR as it provides a less invasive option with reduced hospital stay and recovery time. TECHNIQUE","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"57 1","pages":"264 - 266"},"PeriodicalIF":0.3,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91305114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-25DOI: 10.1097/BTO.0000000000000567
G. Clark, C. Esposito, D. Wood
Introduction: The use of robotic technology is becoming a well-recognized alternative to conventional total knee arthroplasty (TKA). The quantitative soft tissue information generated in robotic surgery can be used to balance the knee and achieve functional alignment (FA) of the components. This paper describes a novel FA technique using an individualized preoperative plan that is then adjusted to achieve soft tissue balance. Materials and Methods: We report on surgical technique, indications, considerations, and complications after our experience of performing 650 functionally aligned TKAs. We collected 2-year patient reported outcomes on 165 TKAs in this series (165 of 193 TKAs have reached 2 years follow-up in the series of 650 TKAs; 85% follow-up rate). Results: We found significant postoperative improvements with few infections and no revisions for mechanical reasons 2 years after surgery with this technique. Patients had improved knee range-of-motion (105 degrees° flexion preoperatively vs. 125 degrees flexion postoperatively; P<0.001), higher Forgotten Joint Scores (17 preoperatively vs. 77 postoperatively; P<0.001), improved Oxford Knee Scores (22 preoperatively vs. 43 postoperatively; P<0.001), higher KOOS Jr scores (48 preoperatively vs. 88 postoperatively; P<0.001) and lower visual analogue score pain scores (70 preoperatively vs. 12 postoperatively; P<0.001) 2 years postoperatively. Discussion: The described surgical technique is a promising method for conducting a robotic TKA. Benefits of FA include improved efficiency with preresection balancing, reduced soft tissue releases compared with a mechanical alignment technique, and accurate bony cuts with robotic assistance. Further studies are required to compare this technique with established methods to determine any differences in outcomes.
机器人技术的使用正在成为传统全膝关节置换术(TKA)的公认替代方案。机器人手术中产生的定量软组织信息可用于平衡膝关节并实现部件的功能对齐(FA)。本文描述了一种新的FA技术，使用个性化的术前计划，然后调整以达到软组织平衡。材料和方法:我们报告650例功能对齐tka手术后的手术技术、适应证、注意事项和并发症。我们收集了该系列中165例tka的2年患者报告结果(193例tka中有165例在650例tka中随访2年;85%随访率)。结果:我们发现术后明显改善，感染少，术后2年无机械原因翻修。患者的膝关节活动度得到改善(术前105度，术后125度;P<0.001)，遗忘关节评分较高(术前17分，术后77分;P<0.001)，改善牛津膝关节评分(术前22分，术后43分;P<0.001)， KOOS Jr评分较高(术前48分，术后88分;P<0.001)和较低的视觉模拟评分疼痛评分(术前70分，术后12分;P<0.001)。讨论:所描述的外科技术是进行机器人TKA的一种很有前途的方法。FA的好处包括:与机械对齐技术相比，术前平衡提高了效率，减少了软组织的释放，以及在机器人辅助下精确的骨切割。需要进一步的研究将该技术与现有方法进行比较，以确定结果的差异。
{"title":"Individualized Functional Knee Alignment in Total Knee Arthroplasty: A Robotic-assisted Technique","authors":"G. Clark, C. Esposito, D. Wood","doi":"10.1097/BTO.0000000000000567","DOIUrl":"https://doi.org/10.1097/BTO.0000000000000567","url":null,"abstract":"Introduction: The use of robotic technology is becoming a well-recognized alternative to conventional total knee arthroplasty (TKA). The quantitative soft tissue information generated in robotic surgery can be used to balance the knee and achieve functional alignment (FA) of the components. This paper describes a novel FA technique using an individualized preoperative plan that is then adjusted to achieve soft tissue balance. Materials and Methods: We report on surgical technique, indications, considerations, and complications after our experience of performing 650 functionally aligned TKAs. We collected 2-year patient reported outcomes on 165 TKAs in this series (165 of 193 TKAs have reached 2 years follow-up in the series of 650 TKAs; 85% follow-up rate). Results: We found significant postoperative improvements with few infections and no revisions for mechanical reasons 2 years after surgery with this technique. Patients had improved knee range-of-motion (105 degrees° flexion preoperatively vs. 125 degrees flexion postoperatively; P<0.001), higher Forgotten Joint Scores (17 preoperatively vs. 77 postoperatively; P<0.001), improved Oxford Knee Scores (22 preoperatively vs. 43 postoperatively; P<0.001), higher KOOS Jr scores (48 preoperatively vs. 88 postoperatively; P<0.001) and lower visual analogue score pain scores (70 preoperatively vs. 12 postoperatively; P<0.001) 2 years postoperatively. Discussion: The described surgical technique is a promising method for conducting a robotic TKA. Benefits of FA include improved efficiency with preresection balancing, reduced soft tissue releases compared with a mechanical alignment technique, and accurate bony cuts with robotic assistance. Further studies are required to compare this technique with established methods to determine any differences in outcomes.","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"42 1","pages":"185 - 191"},"PeriodicalIF":0.3,"publicationDate":"2021-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88125227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-25DOI: 10.1097/bto.0000000000000568
S. Niedermeier, R. Gaston, B. Loeffler
{"title":"The Starfish Procedure","authors":"S. Niedermeier, R. Gaston, B. Loeffler","doi":"10.1097/bto.0000000000000568","DOIUrl":"https://doi.org/10.1097/bto.0000000000000568","url":null,"abstract":"","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"51 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86837022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-08DOI: 10.1097/bto.0000000000000577
N. Bor, E. Dujovny, N. Rozen, G. Rubin
{"title":"The Gigli Saw Osteotomy","authors":"N. Bor, E. Dujovny, N. Rozen, G. Rubin","doi":"10.1097/bto.0000000000000577","DOIUrl":"https://doi.org/10.1097/bto.0000000000000577","url":null,"abstract":"","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"11 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79695641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-08DOI: 10.1097/bto.0000000000000569
Breanna A. Polascik, Lily R. Mundy, L. Cendales
{"title":"Advanced Amputation Techniques in Orthopedic Surgery","authors":"Breanna A. Polascik, Lily R. Mundy, L. Cendales","doi":"10.1097/bto.0000000000000569","DOIUrl":"https://doi.org/10.1097/bto.0000000000000569","url":null,"abstract":"","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"67 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89153784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-02DOI: 10.1097/BTO.0000000000000489
S. Kane, S. Tanaka, Matt J. Smith
Introduction: The prevalence of proximal humerus fractures will continue to increase as the population ages. Although the use of fibular strut grafts to treat these fractures is well established and has been used for many years, the authors present an alternative technique that aligns the graft within the intermedullary canal, and proximal segment, allowing for greater fragment and reduction control throughout the procedure. Materials and Methods: The technique involves intramedullary reaming and the usage of a #5 suture through the strut graft proximally that allows for easy placement of the graft across the fracture and into the humeral head after reduction. Results: The representative case described in this paper demonstrates a simplified technique for placement of a fibular allograft and fracture reduction with locking plate fixation for the treatment of proximal humerus nonunions. Discussion: The technique is an effective and simple method for the placement of a fibular strut allograft within the intramedullary canal of the distal and proximal segments of a proximal humeral fracture. The use of an endosteal fibular allograft strut addresses the need to re-establish the medial column of the humerus, provides local bone stock, and helps avoid varus angulation, and allows for improved fixation of the plate in poor quality bone.
{"title":"Delivery Technique for Fibular Strut Bone Grafting to Proximal Humerus Nonunion Fractures","authors":"S. Kane, S. Tanaka, Matt J. Smith","doi":"10.1097/BTO.0000000000000489","DOIUrl":"https://doi.org/10.1097/BTO.0000000000000489","url":null,"abstract":"Introduction: The prevalence of proximal humerus fractures will continue to increase as the population ages. Although the use of fibular strut grafts to treat these fractures is well established and has been used for many years, the authors present an alternative technique that aligns the graft within the intermedullary canal, and proximal segment, allowing for greater fragment and reduction control throughout the procedure. Materials and Methods: The technique involves intramedullary reaming and the usage of a #5 suture through the strut graft proximally that allows for easy placement of the graft across the fracture and into the humeral head after reduction. Results: The representative case described in this paper demonstrates a simplified technique for placement of a fibular allograft and fracture reduction with locking plate fixation for the treatment of proximal humerus nonunions. Discussion: The technique is an effective and simple method for the placement of a fibular strut allograft within the intramedullary canal of the distal and proximal segments of a proximal humeral fracture. The use of an endosteal fibular allograft strut addresses the need to re-establish the medial column of the humerus, provides local bone stock, and helps avoid varus angulation, and allows for improved fixation of the plate in poor quality bone.","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"53 1","pages":"464 - 468"},"PeriodicalIF":0.3,"publicationDate":"2021-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85197095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-02DOI: 10.1097/BTO.0000000000000497
A. Moharram, Walid Reda, A. Farahat, M. Ibrahim, Mostafa Saladin
Introduction: Traumatic herniation of the leg muscle is not an uncommon condition. This may be a direct traumatic hernia caused by open injury to the leg, or an indirect traumatic hernia following blow to a contracted muscle causing rupture of the fascia and its consequent herniation. Tibialis anterior muscle herniation has been reported to be the most common form of muscle hernia of the lower extremities. Materials and Methods: We report on 3 cases of traumatic herniation of the tibialis anterior muscle who were treated using a periosteal rotation flap raised from the anteromedial aspect of the tibia and used to close the fascial defect. Conclusions: We have found this to be a safe surgical procedure in the adult and adolescent age group with satisfying results and reduced recurrence rate and postoperative complications.
{"title":"Periosteal Rotation Flap Technique in Management of Tibialis Anterior Muscle Hernia: A Case Series","authors":"A. Moharram, Walid Reda, A. Farahat, M. Ibrahim, Mostafa Saladin","doi":"10.1097/BTO.0000000000000497","DOIUrl":"https://doi.org/10.1097/BTO.0000000000000497","url":null,"abstract":"Introduction: Traumatic herniation of the leg muscle is not an uncommon condition. This may be a direct traumatic hernia caused by open injury to the leg, or an indirect traumatic hernia following blow to a contracted muscle causing rupture of the fascia and its consequent herniation. Tibialis anterior muscle herniation has been reported to be the most common form of muscle hernia of the lower extremities. Materials and Methods: We report on 3 cases of traumatic herniation of the tibialis anterior muscle who were treated using a periosteal rotation flap raised from the anteromedial aspect of the tibia and used to close the fascial defect. Conclusions: We have found this to be a safe surgical procedure in the adult and adolescent age group with satisfying results and reduced recurrence rate and postoperative complications.","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"137 1","pages":"486 - 489"},"PeriodicalIF":0.3,"publicationDate":"2021-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78193141","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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