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Open Orthopaedics Journal

Iain Rankin, Haroon Rehman, George Patrick Ashcroft
Background: The fabella is a sesamoid bone situated within the lateral head of the gastrocnemius tendon, close to the lateral femoral condyle, and adjoined to the fabellofibular ligament. It is a normal variant, found in up to 87% of patients. Fabella Syndrome describes traditionally posterolateral knee pain, occurring due to biomechanical pressure of the fabella against the lateral femoral condyle. Given its rarity, its diagnosis is often overlooked. We present a case of Fabella Syndrome with a modified surgical excision technique and review of the literature...
2018: Open Orthopaedics Journal
Cecilie P Schrøder
SLAP lesions were first classified by Snyder in 1990. Results of treatment have been controversial without clear consensus. All have agreed that prospective studies would be useful. We conducted such a study between 2008 to 2114 that randomized treatment between sham surgery, biceps tenodesis and labral repair. No significant differences in results between the groups were found. Crossover between groups was only possible from the sham surgery group and this may introduce some degree of bias. However, the six month outcomes between all three groups before any crossover were statistically identical...
2018: Open Orthopaedics Journal
William A Hester, Michael J O'Brien, Wendell M R Heard, Felix H Savoie
Background: Superior labrum tears extending from anterior to posterior (SLAP lesion) are a cause of significant shoulder pain and disability. Management for these lesions is not standardized. There are no clear guidelines for surgical versus non-surgical treatment, and if surgery is pursued there are controversies regarding SLAP repair versus biceps tenotomy/tenodesis. Objective: This paper aims to briefly review the anatomy, classification, mechanisms of injury, and diagnosis of SLAP lesions...
2018: Open Orthopaedics Journal
Chadwick C Prodromos, Susan Finkle, Alexander Dawes, Ji Young Baik
Background: Poor results after repair of type 2 SLAP tears are relatively common and some have reported better results after biceps tenodesis or tenotomy than repair. In addition, some believe that the long head of the biceps is expendable. Therefore, many now favor biceps tenotomy or tenodesis over biceps anchor repair either in all patients or in older patients, reserving SLAP lesion repair only for young athletes. Hypothesis: We hypothesized that repair of the biceps anchor of the labrum would be effective in all patients regardless of age provided that care was taken not to overtighten the labrum and that rotator cuff pain as the primary pain generator had been ruled out...
2018: Open Orthopaedics Journal
Robert D Boutin, Richard A Marder
Background: SLAP lesions of the shoulder are challenging to diagnose by clinical means alone. Interpretation of MR images requires knowledge of the normal appearance of the labrum, its anatomical variants, and the characteristic patterns of SLAP lesions. In general, high signal extending anterior and posterior to the biceps anchor is the hallmark of SLAP lesions. Common diagnostic criteria for a SLAP lesion by MR or MR arthrography include the following: presence of a laterally curved, high signal intensity in the labrum on a coronal image, multiple or branching lines of high signal intensity in the superior labrum on a coronal image, full-thickness detachment with irregularly marginated high signal intensity and/or separation >2 mm on conventional MRI or 3 mm on MR arthrography between the labrum and glenoid on a coronal image, and a paralabral cyst extending from the superior labrum...
2018: Open Orthopaedics Journal
Cristin John Mathew, David Mark Lintner
Background: The diagnosis and treatment of Superior Labrum Anterior to Posterior (SLAP) tears have been evolving and controversial. The lack of clear diagnostic criteria on physical examination, Magnetic Resonance Imaging (MRI), and arthroscopic evaluation clouds the issue. The high rate of MRI diagnosed SLAP lesions in the asymptomatic population of athletes and non-athletes warrants consideration when planning treatment for those with shoulder pain. Objective: To provide information on the evaluation, diagnosis and management of SLAP tears in athletes...
2018: Open Orthopaedics Journal
Yung Han, Janet Lee, Sung Park, Eugene Suh
Introduction: Optimal treatment of type II superior labrum anterior and posterior (SLAP) tears is controversial. There has been a recent trend towards biceps tenodesis over SLAP repair in older patients. Few surgeons have performed combined biceps tenodesis and SLAP repair with inferior results. Case Report: This case describes a 46-year-old patient who had persistent pain and stiffness after combined biceps tenodesis and SLAP repair for a type II SLAP tear. His pain and motion improved after arthroscopic superior capsular release...
2018: Open Orthopaedics Journal
Apostolos Stathellis, Emmanouil Brilakis, Jim-Dimitris Georgoulis, Emmanouil Antonogiannakis, Anastasios Georgoulis
Background: The surgical treatment of a Superior Labrum Anterior and Posterior (SLAP) lesion becomes more and more frequent as the surgical techniques, the implants and the postoperative rehabilitation of the patient are improved and provide in most cases an excellent outcome. Objective: However, a standard therapy of SLAP lesions in the shoulder surgery has not been established yet. An algorithm on how to treat SLAP lesions according to their type and data on the factors that influence the surgical outcome is essential for the everyday clinical practice...
2018: Open Orthopaedics Journal
Adam M Johannsen, John G Costouros
Background: The management of Type-II superior labral tears (SLAP) of the shoulder remains a controversial topic. Treatment ranges from non-operative management to surgical management including SLAP repair, biceps tenotomy, and biceps tenodesis. An optimal treatment algorithm has yet to reach universal acceptance. Objective: The goal of this paper was to provide a treatment algorithm for the management of Type-II SLAP tears based on current literature and expert opinion...
2018: Open Orthopaedics Journal
Michael D Charles, David R Christian, Brian J Cole
Background: Type II SLAP tears predominantly occur in males between their third and fifth decades of life. The mechanism of injury is often repeated overheard activity but can also occur due to direct compression loads and traction injuries. The treatment options have changed over the years and include non-operative therapy, direct labral-biceps complex repair, and labral debridement with biceps tenodesis or tenotomy. Objective: To review the existing literature on the management of Type II SLAP tears and provide clinical recommendations based on patient age and activity level...
2018: Open Orthopaedics Journal
Chadwick C Prodromos
No abstract text is available yet for this article.
2018: Open Orthopaedics Journal
Aydın Arslan, Bilal Çuglan, Bülent Özkurt, Ali Utkan, Mehmet Fatih Korkmaz, Tuba Tülay Koca, Resit Sevimli
Background: Patients suffering from knee osteoarthritis lead a less active life than their healthy peers. It is well known that insufficient physical activity is the most common cause of chronic diseases. However, there is not enough research to enlighten the effect of increased functional capacity on cardiac functions after Total Knee Arthroplasty (TKA). This study aimed to investigate whether the orthopedic surgeons can predict that the patients will be healthier after TKA in terms of cardiac functions or not? Methods: 109 patients who underwent TKA were prospectively followed for one year...
2018: Open Orthopaedics Journal
Hans-Rudolf Weiss, Sarah Seibel
Background: We regularly use Angle of Trunk Rotation (ATR) measurements for scoliosis screening and also for clinical follow-up of our scoliosis patients under treatment. In some patients, when ATR measurements exceed the screening threshold but without a significant degree of curvature on the X-ray (Cobb angle), a Hemidystrophic Thorax (HDT) is diagnosed. The purpose of this paper was to present a case series of patients with this kind of thoracic deformity because this may be mimicking scoliosis to a significant degree...
2018: Open Orthopaedics Journal
Peter Moriarty, Heather Moriarty, Michael Maher, James Harty
Background: As imaging technology improves small Pulmonary Emboli (PE) of debatable clinical relevance are increasingly detected leading to higher numbers of patients receiving anticoagulation. Although PE are an important cause of morbidity and mortality in patients undergoing repair of proximal femur fractures, this cohort of patients are at increased falls risk and are therefore largely unsuitable for long term anticoagulant therapy. Objective: 1. To review sequential Computed Tomography Pulmonary Angiograms (CTPA) performed in patients who underwent repair of proximal femur fractures at our institution...
2018: Open Orthopaedics Journal
Hari Prasad Sapkota, Poojan K Rokaya, Mangal Rawal, Dhan Bahadur Karki, Deoman Limbu
Introduction: Lateral condyle fracture of the distal humerus is the second most common paediatric elbow fracture. Unstable, rotated and displaced (>2 mm) fractures are managed with open reduction and internal fixation with Kirschner's wires or screws. Debate persists as for how long the Kirschner's wires should be placed in situ after internal fixation. We aimed to compare the functional and radiological outcome after early versus late removal of internally fixated Kirschner's wires for displaced lateral condyle fracture of distal humerus...
2018: Open Orthopaedics Journal
Aristotelis Kaisidis, Panagiotis G Pantos, Dimitrios Bochlos, Horst Lindner
Background: The incidence of isolated greater tuberosity fractures has been estimated to be 20% of all proximal humeral fractures. It is generally accepted that displaced (>5 mm) fractures should be treated surgically but the optimal surgical fixation of greater tuberosity fractures remains unclear. Objective: The goal of this study was to simulate the environment of application of a new plate system (Kaisidis plate, Fa Königsee) for fractures of greater tuberosity, and to demonstrate the stability of the plate...
2018: Open Orthopaedics Journal
Motoki Sonohata, Masaru Kitajima, Shunsuke Kawano, Masaaki Mawatari
Background: Differences in clinical and radiographic results following total hip arthroplasty between failed wedge and curved varus osteotomy are unclear. Objective: To investigate differences in clinical and radiographic results following total hip arthroplasty in patients who exhibited failed wedge or curved varus osteotomy. Method: We performed 18 total hip arthroplasties after failed femoral varus osteotomy. Hips were divided into two groups: 14 had failed wedge varus osteotomy and four had failed curved varus osteotomy...
2018: Open Orthopaedics Journal
Frank Liaw, Odhrán Murray, Yan Yu Tan, Timothy Hems
Background: Diabetic peripheral neuropathy puts patients at increased risk of acute injury by foreign bodies and also contributes to delayed presentation and diagnosis. Case report: We describe a 57-year-old patient with poorly controlled type 1 diabetes who presented with a three-week history of worsening swelling and erythema in the metacarpophalangeal joint of his left thumb. He denied any previous trauma or injury and was initially treated with intravenous antibiotics...
2018: Open Orthopaedics Journal
Radosław Stempin, Kacper Stempin, Wiesław Kaczmarek, Julian Dutka
Background: There is an ongoing debate about whether to use cementless or cemented fixation for Total Knee Arthroplasty (TKA). Objective: The study aimed to assess midterm survivorship of the Vanguard cementless system, and to demonstrate the utility of the Bone Hardness Test (BHT) for the selection of cementless fixation TKA. Methods: From September 2009 through November 2014, 123 total knee arthroplasties were completed, with cementless Vanguard Cruciate Retaining TKA in 110 knees (102 patients) and cemented Vanguard in 13 cases (12 patients)...
2018: Open Orthopaedics Journal
Jagdeep Singh, Anoop Kalia, Anshul Dahuja
Introduction: Dislocation of the radial head in adults is quite uncommon. A simultaneous dislocation of the radial head with a fracture of ipsilateral shaft radius without any other associated injury is even rare. Case Presentation: We are reporting a case of a young adult male who was operated for proximal one-third radial shaft fracture at some peripheral centre by Open Reduction and Internal Fixation (ORIF), but came to our centre on the fourth post-operative day with complaints of painful restricted movements of the elbow joint...
2018: Open Orthopaedics Journal
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