Pub Date : 2024-07-24DOI: 10.1097/bto.0000000000000676
Gino Martínez Soto, Javier Richard Cajas, Alejandro Baar Zimend
To introduce an epiphysiodesis technique utilizing screws and nonabsorbable sutures, aimed at rectifying knee flexion contractures (KFCs) in arthrogryposis. Arthrogryposis, a congenital condition characterized by joint contractures, often presents with knee flexion involvement, impeding ambulation. Conservative methods such as casting and physiotherapy may be insufficient, necessitating surgical intervention. Anterior epiphysiodesis emerges as a viable option, with various techniques described in the literature. Eight knees in 4 patients with arthrogryposis and KFCs underwent anterior femoral epiphysiodesis using screws and nonabsorbable sutures. Pre and postoperative measurements of KFC and distal femoral diaphyseal-epiphyseal angle were analyzed using the Mann-Whitney U test. The procedure significantly improved KFCs, with a median final flexion angle of 0 degrees achieved postoperatively. The distal femoral diaphyseal-epiphyseal angle also increased significantly postoperatively. The average time for angular modification was 11.75 months. Long-term complications were minimal KFCs pose functional challenges, particularly in arthrogryposis. Traditional interventions may not suffice, necessitating surgical approaches like anterior epiphysiodesis. This technique offers early correction with minimal invasiveness, good tolerability, and reversibility; particularly beneficial for younger patients. Anterior epiphysiodesis with screws and non-absorbable sutures effectively corrects KFCs in arthrogryposis, offering a valuable alternative to more invasive procedures. It can achieve good results at a lower cost and with few complications, making it a valuable surgical option for younger patients.
{"title":"Guided Growth With Screws and Nonabsorbable Suture for Correcting Knee Flexion in Arthrogryposis for Preschool Population: Preliminary Report","authors":"Gino Martínez Soto, Javier Richard Cajas, Alejandro Baar Zimend","doi":"10.1097/bto.0000000000000676","DOIUrl":"https://doi.org/10.1097/bto.0000000000000676","url":null,"abstract":"\u0000 \u0000 To introduce an epiphysiodesis technique utilizing screws and nonabsorbable sutures, aimed at rectifying knee flexion contractures (KFCs) in arthrogryposis.\u0000 \u0000 \u0000 \u0000 Arthrogryposis, a congenital condition characterized by joint contractures, often presents with knee flexion involvement, impeding ambulation. Conservative methods such as casting and physiotherapy may be insufficient, necessitating surgical intervention. Anterior epiphysiodesis emerges as a viable option, with various techniques described in the literature.\u0000 \u0000 \u0000 \u0000 Eight knees in 4 patients with arthrogryposis and KFCs underwent anterior femoral epiphysiodesis using screws and nonabsorbable sutures. Pre and postoperative measurements of KFC and distal femoral diaphyseal-epiphyseal angle were analyzed using the Mann-Whitney U test.\u0000 \u0000 \u0000 \u0000 The procedure significantly improved KFCs, with a median final flexion angle of 0 degrees achieved postoperatively. The distal femoral diaphyseal-epiphyseal angle also increased significantly postoperatively. The average time for angular modification was 11.75 months. Long-term complications were minimal\u0000 \u0000 \u0000 \u0000 KFCs pose functional challenges, particularly in arthrogryposis. Traditional interventions may not suffice, necessitating surgical approaches like anterior epiphysiodesis. This technique offers early correction with minimal invasiveness, good tolerability, and reversibility; particularly beneficial for younger patients. Anterior epiphysiodesis with screws and non-absorbable sutures effectively corrects KFCs in arthrogryposis, offering a valuable alternative to more invasive procedures. It can achieve good results at a lower cost and with few complications, making it a valuable surgical option for younger patients.\u0000","PeriodicalId":507621,"journal":{"name":"Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141806477","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 : 2024-07-22DOI: 10.1097/bto.0000000000000675
Riley Swenson, Indraneel S. Brahme, David J. Weatherby, Peter A Cole
Reverse total shoulder arthroplasties have become common in orthopaedics to treat osteoarthritis in patients with rotator cuff deficiency. Complications of revision hemiarthroplasty from reverse total shoulder arthroplasty include anterosuperior escape, which is defined as a deficiency of the coracoacromial arch that allows the humeral head to migrate proximally. A 58-year-old woman, with superior escape and massive destruction of the shoulder suspensory complex after hemiarthroplasty conversion from a reverse total shoulder arthroplasty (rTSA), presented to our clinic with chronic, disabling shoulder pain. The patient underwent a novel salvage procedure with a calcaneo-achilles allograft fixed to the remaining glenoid through the proximal humeral shaft. The goal of this procedure was to preserve as much function in the patient’s arm as possible and reduce her chronic shoulder pain. The patient continued to follow up in our clinic for 1 year postoperatively. She noted complete relief of pain by 6 weeks postoperatively. She also denied any neurologic symptoms in her operative extremity. Her patient-reported outcomes indicated major improvement in her preoperative symptoms. A calcaneal-achilles bone tendon allograft interposition arthroplasty may be a viable solution for failed conversion of rTSA to hemiarthroplasty or problems of end-stage arthritis with superior escape and destruction of the shoulder girdle.
{"title":"Calcaneo-Achilles Allograft Shoulder Interposition Arthroplasty, Novel Technique for Superior Escape Post Hemiarthroplasty for Failed rTSA: A Case Report","authors":"Riley Swenson, Indraneel S. Brahme, David J. Weatherby, Peter A Cole","doi":"10.1097/bto.0000000000000675","DOIUrl":"https://doi.org/10.1097/bto.0000000000000675","url":null,"abstract":"\u0000 \u0000 Reverse total shoulder arthroplasties have become common in orthopaedics to treat osteoarthritis in patients with rotator cuff deficiency. Complications of revision hemiarthroplasty from reverse total shoulder arthroplasty include anterosuperior escape, which is defined as a deficiency of the coracoacromial arch that allows the humeral head to migrate proximally. A 58-year-old woman, with superior escape and massive destruction of the shoulder suspensory complex after hemiarthroplasty conversion from a reverse total shoulder arthroplasty (rTSA), presented to our clinic with chronic, disabling shoulder pain.\u0000 \u0000 \u0000 \u0000 The patient underwent a novel salvage procedure with a calcaneo-achilles allograft fixed to the remaining glenoid through the proximal humeral shaft. The goal of this procedure was to preserve as much function in the patient’s arm as possible and reduce her chronic shoulder pain.\u0000 \u0000 \u0000 \u0000 The patient continued to follow up in our clinic for 1 year postoperatively. She noted complete relief of pain by 6 weeks postoperatively. She also denied any neurologic symptoms in her operative extremity. Her patient-reported outcomes indicated major improvement in her preoperative symptoms.\u0000 \u0000 \u0000 \u0000 A calcaneal-achilles bone tendon allograft interposition arthroplasty may be a viable solution for failed conversion of rTSA to hemiarthroplasty or problems of end-stage arthritis with superior escape and destruction of the shoulder girdle.\u0000","PeriodicalId":507621,"journal":{"name":"Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141815692","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 : 2024-02-15DOI: 10.1097/bto.0000000000000659
Shelby R. Smith, Andre Sabet, Tyler Luthringer, Xavier C. Simcock, John J. Fernandez
Long oblique and spiral metacarpal shaft fractures are length-unstable fracture patterns susceptible to malrotation and shortening. We expand the use of intramedullary screw fixation for traditional length-unstable fracture patterns including long oblique and spiral with cerclage wire augmentation. Surgical technique of intramedullary screws for long oblique and spiral metacarpal shaft fractures, augmented with cerclage wires, is described. Case series of patients who underwent this technique over a 3-year period from 2 surgeons at a single institution were evaluated. The inclusion criteria included patients who underwent this technique with long oblique or spiral metacarpal shaft fractures. The exclusion criteria included open injuries, and base or neck fractures. A total of 8 patients were included with an average age at surgery 42 years old (range, 25 to 70). Six of the 8 patients achieved full range of motion at the time of final follow-up. One patient had ~5 to 10-degree deficit in both flexion and extension, and the other had 20-degree loss in both flexion and extension. The follow-up averaged 62 days (range, 25 to 144 days). There were no patients with nonunion, malunion, hardware failure, or postoperative fracture subsidence or malrotation. The average time to union was 6.1 weeks (range, 3.5 to 12.4 wks). This hybrid technique expands the use of intramedullary screws to traditional length-unstable fractures including long oblique and spiral patterns. Patients demonstrate return to full range of motion, union approximately in 6 weeks, with minimal complications following this minimally invasive technique.
{"title":"Fixation of Long Oblique and Spiral Metacarpal Shaft Fractures With Intramedullary Screw and Cerclage Wires","authors":"Shelby R. Smith, Andre Sabet, Tyler Luthringer, Xavier C. Simcock, John J. Fernandez","doi":"10.1097/bto.0000000000000659","DOIUrl":"https://doi.org/10.1097/bto.0000000000000659","url":null,"abstract":"\u0000 \u0000 Long oblique and spiral metacarpal shaft fractures are length-unstable fracture patterns susceptible to malrotation and shortening. We expand the use of intramedullary screw fixation for traditional length-unstable fracture patterns including long oblique and spiral with cerclage wire augmentation.\u0000 \u0000 \u0000 \u0000 Surgical technique of intramedullary screws for long oblique and spiral metacarpal shaft fractures, augmented with cerclage wires, is described. Case series of patients who underwent this technique over a 3-year period from 2 surgeons at a single institution were evaluated. The inclusion criteria included patients who underwent this technique with long oblique or spiral metacarpal shaft fractures. The exclusion criteria included open injuries, and base or neck fractures.\u0000 \u0000 \u0000 \u0000 A total of 8 patients were included with an average age at surgery 42 years old (range, 25 to 70). Six of the 8 patients achieved full range of motion at the time of final follow-up. One patient had ~5 to 10-degree deficit in both flexion and extension, and the other had 20-degree loss in both flexion and extension. The follow-up averaged 62 days (range, 25 to 144 days). There were no patients with nonunion, malunion, hardware failure, or postoperative fracture subsidence or malrotation. The average time to union was 6.1 weeks (range, 3.5 to 12.4 wks).\u0000 \u0000 \u0000 \u0000 This hybrid technique expands the use of intramedullary screws to traditional length-unstable fractures including long oblique and spiral patterns. Patients demonstrate return to full range of motion, union approximately in 6 weeks, with minimal complications following this minimally invasive technique.\u0000","PeriodicalId":507621,"journal":{"name":"Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139774868","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 : 2024-02-15DOI: 10.1097/bto.0000000000000659
Shelby R. Smith, Andre Sabet, Tyler Luthringer, Xavier C. Simcock, John J. Fernandez
Long oblique and spiral metacarpal shaft fractures are length-unstable fracture patterns susceptible to malrotation and shortening. We expand the use of intramedullary screw fixation for traditional length-unstable fracture patterns including long oblique and spiral with cerclage wire augmentation. Surgical technique of intramedullary screws for long oblique and spiral metacarpal shaft fractures, augmented with cerclage wires, is described. Case series of patients who underwent this technique over a 3-year period from 2 surgeons at a single institution were evaluated. The inclusion criteria included patients who underwent this technique with long oblique or spiral metacarpal shaft fractures. The exclusion criteria included open injuries, and base or neck fractures. A total of 8 patients were included with an average age at surgery 42 years old (range, 25 to 70). Six of the 8 patients achieved full range of motion at the time of final follow-up. One patient had ~5 to 10-degree deficit in both flexion and extension, and the other had 20-degree loss in both flexion and extension. The follow-up averaged 62 days (range, 25 to 144 days). There were no patients with nonunion, malunion, hardware failure, or postoperative fracture subsidence or malrotation. The average time to union was 6.1 weeks (range, 3.5 to 12.4 wks). This hybrid technique expands the use of intramedullary screws to traditional length-unstable fractures including long oblique and spiral patterns. Patients demonstrate return to full range of motion, union approximately in 6 weeks, with minimal complications following this minimally invasive technique.
{"title":"Fixation of Long Oblique and Spiral Metacarpal Shaft Fractures With Intramedullary Screw and Cerclage Wires","authors":"Shelby R. Smith, Andre Sabet, Tyler Luthringer, Xavier C. Simcock, John J. Fernandez","doi":"10.1097/bto.0000000000000659","DOIUrl":"https://doi.org/10.1097/bto.0000000000000659","url":null,"abstract":"\u0000 \u0000 Long oblique and spiral metacarpal shaft fractures are length-unstable fracture patterns susceptible to malrotation and shortening. We expand the use of intramedullary screw fixation for traditional length-unstable fracture patterns including long oblique and spiral with cerclage wire augmentation.\u0000 \u0000 \u0000 \u0000 Surgical technique of intramedullary screws for long oblique and spiral metacarpal shaft fractures, augmented with cerclage wires, is described. Case series of patients who underwent this technique over a 3-year period from 2 surgeons at a single institution were evaluated. The inclusion criteria included patients who underwent this technique with long oblique or spiral metacarpal shaft fractures. The exclusion criteria included open injuries, and base or neck fractures.\u0000 \u0000 \u0000 \u0000 A total of 8 patients were included with an average age at surgery 42 years old (range, 25 to 70). Six of the 8 patients achieved full range of motion at the time of final follow-up. One patient had ~5 to 10-degree deficit in both flexion and extension, and the other had 20-degree loss in both flexion and extension. The follow-up averaged 62 days (range, 25 to 144 days). There were no patients with nonunion, malunion, hardware failure, or postoperative fracture subsidence or malrotation. The average time to union was 6.1 weeks (range, 3.5 to 12.4 wks).\u0000 \u0000 \u0000 \u0000 This hybrid technique expands the use of intramedullary screws to traditional length-unstable fractures including long oblique and spiral patterns. Patients demonstrate return to full range of motion, union approximately in 6 weeks, with minimal complications following this minimally invasive technique.\u0000","PeriodicalId":507621,"journal":{"name":"Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139834486","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 : 2024-02-06DOI: 10.1097/bto.0000000000000658
Hayden P. Baker, Cody S. Lee, Jordan Serotte, Charles Poff, A. Athiviraham, Kelly K. Hynes, Jason A. Strelzow
The purpose of this study was to investigate the feasibility of performing a new minimally invasive technique for anterior closing–wedge high tibial osteotomy. Our hypothesis was that we would be able to successfully perform the minimally invasive osteotomy with consistent correction of the posterior tibial slope. Five lower limbs from cadaveric unidentified donors were obtained. Fluoroscopic imaging of the knee was obtained to determine the baseline tibial slope. A standard anterior closing–wedge osteotomy was planned to obtain the desired correction. The anterior bony segment was resected from the proximal tibia utilizing the Shannon burr under fluoroscopic guidance through a 2 cm medial incision. Fixation was completed with 2 staples positioned medial and lateral to the tibial tubercle. The average posterior tibial slope of the 5 specimens was 8 degrees (SD: 2.3, range: 6 to 12). The average final posterior tibial was 1.8 degrees (SD: 2.1, range: −1 to 5). The average slope correction was 6.2 degrees (SD: 0.7, range: 5 to 7). Posterior tibial cortical fracture did not occur in any of the cases. Our novel minimally invasive anterior closing–wedge high tibial osteotomy technique resulted in a reproducible correction of posterior tibial slope in a cadaveric model. This is the first study to describe a minimally invasive technique for anterior closing–wedge high tibial osteotomy. Larger cadaveric studies including multiple surgeons across institutions are warranted to validate the described technique between providers. Level IV—Controlled laboratory study
{"title":"Minimally Invasive Anterior Closing–wedge Osteotomy for Posterior Tibial Slope Correction: A Pilot Study","authors":"Hayden P. Baker, Cody S. Lee, Jordan Serotte, Charles Poff, A. Athiviraham, Kelly K. Hynes, Jason A. Strelzow","doi":"10.1097/bto.0000000000000658","DOIUrl":"https://doi.org/10.1097/bto.0000000000000658","url":null,"abstract":"\u0000 \u0000 The purpose of this study was to investigate the feasibility of performing a new minimally invasive technique for anterior closing–wedge high tibial osteotomy. Our hypothesis was that we would be able to successfully perform the minimally invasive osteotomy with consistent correction of the posterior tibial slope.\u0000 \u0000 \u0000 \u0000 Five lower limbs from cadaveric unidentified donors were obtained. Fluoroscopic imaging of the knee was obtained to determine the baseline tibial slope. A standard anterior closing–wedge osteotomy was planned to obtain the desired correction. The anterior bony segment was resected from the proximal tibia utilizing the Shannon burr under fluoroscopic guidance through a 2 cm medial incision. Fixation was completed with 2 staples positioned medial and lateral to the tibial tubercle.\u0000 \u0000 \u0000 \u0000 The average posterior tibial slope of the 5 specimens was 8 degrees (SD: 2.3, range: 6 to 12). The average final posterior tibial was 1.8 degrees (SD: 2.1, range: −1 to 5). The average slope correction was 6.2 degrees (SD: 0.7, range: 5 to 7). Posterior tibial cortical fracture did not occur in any of the cases.\u0000 \u0000 \u0000 \u0000 Our novel minimally invasive anterior closing–wedge high tibial osteotomy technique resulted in a reproducible correction of posterior tibial slope in a cadaveric model. This is the first study to describe a minimally invasive technique for anterior closing–wedge high tibial osteotomy. Larger cadaveric studies including multiple surgeons across institutions are warranted to validate the described technique between providers.\u0000 \u0000 \u0000 \u0000 Level IV—Controlled laboratory study\u0000","PeriodicalId":507621,"journal":{"name":"Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139800336","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 : 2024-02-06DOI: 10.1097/bto.0000000000000658
Hayden P. Baker, Cody S. Lee, Jordan Serotte, Charles Poff, A. Athiviraham, Kelly K. Hynes, Jason A. Strelzow
The purpose of this study was to investigate the feasibility of performing a new minimally invasive technique for anterior closing–wedge high tibial osteotomy. Our hypothesis was that we would be able to successfully perform the minimally invasive osteotomy with consistent correction of the posterior tibial slope. Five lower limbs from cadaveric unidentified donors were obtained. Fluoroscopic imaging of the knee was obtained to determine the baseline tibial slope. A standard anterior closing–wedge osteotomy was planned to obtain the desired correction. The anterior bony segment was resected from the proximal tibia utilizing the Shannon burr under fluoroscopic guidance through a 2 cm medial incision. Fixation was completed with 2 staples positioned medial and lateral to the tibial tubercle. The average posterior tibial slope of the 5 specimens was 8 degrees (SD: 2.3, range: 6 to 12). The average final posterior tibial was 1.8 degrees (SD: 2.1, range: −1 to 5). The average slope correction was 6.2 degrees (SD: 0.7, range: 5 to 7). Posterior tibial cortical fracture did not occur in any of the cases. Our novel minimally invasive anterior closing–wedge high tibial osteotomy technique resulted in a reproducible correction of posterior tibial slope in a cadaveric model. This is the first study to describe a minimally invasive technique for anterior closing–wedge high tibial osteotomy. Larger cadaveric studies including multiple surgeons across institutions are warranted to validate the described technique between providers. Level IV—Controlled laboratory study
{"title":"Minimally Invasive Anterior Closing–wedge Osteotomy for Posterior Tibial Slope Correction: A Pilot Study","authors":"Hayden P. Baker, Cody S. Lee, Jordan Serotte, Charles Poff, A. Athiviraham, Kelly K. Hynes, Jason A. Strelzow","doi":"10.1097/bto.0000000000000658","DOIUrl":"https://doi.org/10.1097/bto.0000000000000658","url":null,"abstract":"\u0000 \u0000 The purpose of this study was to investigate the feasibility of performing a new minimally invasive technique for anterior closing–wedge high tibial osteotomy. Our hypothesis was that we would be able to successfully perform the minimally invasive osteotomy with consistent correction of the posterior tibial slope.\u0000 \u0000 \u0000 \u0000 Five lower limbs from cadaveric unidentified donors were obtained. Fluoroscopic imaging of the knee was obtained to determine the baseline tibial slope. A standard anterior closing–wedge osteotomy was planned to obtain the desired correction. The anterior bony segment was resected from the proximal tibia utilizing the Shannon burr under fluoroscopic guidance through a 2 cm medial incision. Fixation was completed with 2 staples positioned medial and lateral to the tibial tubercle.\u0000 \u0000 \u0000 \u0000 The average posterior tibial slope of the 5 specimens was 8 degrees (SD: 2.3, range: 6 to 12). The average final posterior tibial was 1.8 degrees (SD: 2.1, range: −1 to 5). The average slope correction was 6.2 degrees (SD: 0.7, range: 5 to 7). Posterior tibial cortical fracture did not occur in any of the cases.\u0000 \u0000 \u0000 \u0000 Our novel minimally invasive anterior closing–wedge high tibial osteotomy technique resulted in a reproducible correction of posterior tibial slope in a cadaveric model. This is the first study to describe a minimally invasive technique for anterior closing–wedge high tibial osteotomy. Larger cadaveric studies including multiple surgeons across institutions are warranted to validate the described technique between providers.\u0000 \u0000 \u0000 \u0000 Level IV—Controlled laboratory study\u0000","PeriodicalId":507621,"journal":{"name":"Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139860110","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 : 2023-12-30DOI: 10.1097/bto.0000000000000656
Alexander H. Jinnah, Rebecca J. Schultz, Jessica A. McGraw-Heinrich
{"title":"A Novel Technique for Removal of a Dissociated Femoral Intramedullary Magnetic Lengthening Nail","authors":"Alexander H. Jinnah, Rebecca J. Schultz, Jessica A. McGraw-Heinrich","doi":"10.1097/bto.0000000000000656","DOIUrl":"https://doi.org/10.1097/bto.0000000000000656","url":null,"abstract":"","PeriodicalId":507621,"journal":{"name":"Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139140328","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 : 2023-12-30DOI: 10.1097/bto.0000000000000657
Cassie Yang, Youheng Ou Yang
The authors present a case report of spinal wound dehiscence successfully treated with a combination of incisional negative pressure wound therapy and skin adhesive tapes. This article discusses the technique, benefits and limitations, and finally provides a proposed mechanism of action.
{"title":"Combining Skin Adhesive Tape with Incisional Negative Pressure Wound Therapy for Gaping Spinal Wound Dehiscence: A Case Report","authors":"Cassie Yang, Youheng Ou Yang","doi":"10.1097/bto.0000000000000657","DOIUrl":"https://doi.org/10.1097/bto.0000000000000657","url":null,"abstract":"The authors present a case report of spinal wound dehiscence successfully treated with a combination of incisional negative pressure wound therapy and skin adhesive tapes. This article discusses the technique, benefits and limitations, and finally provides a proposed mechanism of action.","PeriodicalId":507621,"journal":{"name":"Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139137941","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 : 2023-09-08DOI: 10.1097/BTO.0000000000000642
A. Aldawoudy, Mahmoud Alajwani, Michael Hirschmann, Ahmad Badr, A. Waly, Eiman Soliman
Introduction: Many fixation methods are available for anterior cruciate ligament (ACL) grafts. Adjustable buttons (ABs) are characterized by their high fixation strength but have the disadvantage of potential stretching of their linking suture material. Press-fit bone plugs provide fixation at the joint line and enhance biological graft healing. Using both is thought to result in a higher fixation strength, enhancing graft biology and transferring the fixation point to the joint line. Materials and Methods: It is the aim of this technical note to describe a certain technique of ACL graft hybrid fixation for hamstrings or bone-tendon-bone grafts, using AB combined with bone grafting of the femoral and tibial tunnels with press-fit bone plugs or bone chips. Discussion: ABs are commonly used fixation devices for ACL grafts. AB also allows the surgeon to tighten the ACL graft in full or near full extension. The ultimate load to failure of AB has the potential disadvantage of rendering the ACL graft progressively slack. AB augmented with press-fitting bone plugs enhances biological potentials, adds to fixation strength, and transfers the fixation level of the graft from the outer femoral cortex to the joint line. Conclusion: Hybrid AB and bone plug fixation of ACL autografts, whether hamstrings or bone-tendon bone, optimizes ACL graft fixation by gaining advantages and omitting the disadvantages of both techniques.
导言：前交叉韧带（ACL）移植物有多种固定方法。可调节纽扣（AB）的特点是固定强度高，但缺点是其连接缝合材料可能会拉伸。压入式骨塞可在关节线处提供固定，并增强移植物的生物愈合。同时使用这两种方法被认为可以获得更高的固定强度，增强移植物的生物学特性，并将固定点转移到关节线。材料和方法：本技术说明旨在描述一种前交叉韧带移植物混合固定技术，用于腘绳肌或骨-肌腱-骨移植物，使用 AB 结合股骨和胫骨隧道的骨移植物，并使用压入式骨塞或骨片。讨论：AB是前交叉韧带移植常用的固定装置。AB 还允许外科医生在完全或接近完全伸展的状态下收紧前交叉韧带移植物。前交叉韧带移植物的终极失效载荷具有使其逐渐松弛的潜在缺点。使用压入式骨塞增强 AB 可提高生物潜力，增加固定强度，并将移植物的固定水平从股骨外皮质转移到关节线。结论混合 AB 和骨塞固定前交叉韧带自体移植物（无论是腘绳肌还是骨-肌腱骨）可优化前交叉韧带移植物的固定，既能获得两种技术的优点，又能避免其缺点。
{"title":"Hybrid Press-fit and Adjustable Button Femoral Fixation of Anterior Cruciate Ligament Semitendinosus and Bone-patellar Tendon-bone Autografts—A Technical Note","authors":"A. Aldawoudy, Mahmoud Alajwani, Michael Hirschmann, Ahmad Badr, A. Waly, Eiman Soliman","doi":"10.1097/BTO.0000000000000642","DOIUrl":"https://doi.org/10.1097/BTO.0000000000000642","url":null,"abstract":"Introduction: Many fixation methods are available for anterior cruciate ligament (ACL) grafts. Adjustable buttons (ABs) are characterized by their high fixation strength but have the disadvantage of potential stretching of their linking suture material. Press-fit bone plugs provide fixation at the joint line and enhance biological graft healing. Using both is thought to result in a higher fixation strength, enhancing graft biology and transferring the fixation point to the joint line. Materials and Methods: It is the aim of this technical note to describe a certain technique of ACL graft hybrid fixation for hamstrings or bone-tendon-bone grafts, using AB combined with bone grafting of the femoral and tibial tunnels with press-fit bone plugs or bone chips. Discussion: ABs are commonly used fixation devices for ACL grafts. AB also allows the surgeon to tighten the ACL graft in full or near full extension. The ultimate load to failure of AB has the potential disadvantage of rendering the ACL graft progressively slack. AB augmented with press-fitting bone plugs enhances biological potentials, adds to fixation strength, and transfers the fixation level of the graft from the outer femoral cortex to the joint line. Conclusion: Hybrid AB and bone plug fixation of ACL autografts, whether hamstrings or bone-tendon bone, optimizes ACL graft fixation by gaining advantages and omitting the disadvantages of both techniques.","PeriodicalId":507621,"journal":{"name":"Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139341607","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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