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Kadir Buyukdogan, Michael S Laidlaw, Mark D Miller
The management of multiligament knee injury is a complex process starting with the adequate identification of the injury. A detailed physical and radiographic examination with a thorough understanding of knee anatomy is crucial to assess all damaged structures: anterior cruciate ligament, posterior cruciate ligament, posteromedial corner including the medial collateral ligament, and posterolateral corner including the lateral collateral ligament. Several surgical techniques have been developed throughout the years to adequately address these ligament insufficiencies...
February 2018: Arthroscopy Techniques
Michael S Laidlaw, Scott M Feeley, Jeffrey R Ruland, David R Diduch
There are multiple etiologies for recurrent patellar instability. While patella alta, an elevated tibial tubercle trochlear groove distance, and prior lateral patellar dislocations with medial patellofemoral ligament (MPFL) insufficiency have been shown to be risk factors for recurrent patellar instability, trochlear dysplasia can result in a significant impediment to normal patellar tracking. With the adequate identification of risk factors, appropriate surgical treatments can be individually tailored to the patient...
February 2018: Arthroscopy Techniques
Wilson Wai Shun Hau, Tun Hing Lui, Wai Kit Ngai
Post-traumatic peroneal tendon subluxation or dislocation is most commonly due to injury to the superior peroneal retinaculum. Acute repair of the retinaculum is an option for active athletes who desire quick return of sport activity. In general, conventional open surgeries require extensive exposure of the injured superficial peroneal retinaculum and have potential risks of scar formation, sural nerve injury, limited range of movement, peroneal tendon re-subluxation, and tendon irritation. The purpose of this Technical Note is to describe the details of endoscopic superior peroneal retinaculum reconstruction...
January 2018: Arthroscopy Techniques
Philippe Collin, Alexandre Lädermann
Anteroinferior glenohumeral instability can be treated by variants of the Bankart repair, remplissage , and the Latarjet procedure, although all options remain associated with complications, including recurrence, stiffness, persistent pain, apprehension, and dislocation arthropathy. The authors therefore thought of a concept of dynamic anterior stabilization to treat anteroinferior glenohumeral instability by transferring the long head of the biceps within a subscapularis split to the anterior glenoid margin, thereby creating a "sling effect" by using a conservative technique...
January 2018: Arthroscopy Techniques
Tennessee D Park, Joshua M Enyart, Terrence E Goyke, Marna Rayl Greenberg
A 23-year-old man was transported to a trauma center after injuring himself while snowboarding. He presented with bilateral shoulder pain and associated deformity to both shoulders. His exam was otherwise unremarkable, and his x-rays confirmed bilateral shoulder dislocations. Cunningham and external rotation without sedation and analgesia techniques were unsuccessful even with local anesthesia to the joint. Subsequent bilateral reduction was successful with moderate sedation using the Milch technique. Simultaneous anterior bilateral shoulder dislocations are rare and providers may need to adjust their techniques to accommodate this unusual presentation...
February 2018: Radiology Case Reports
A-G Hue, R Gauthé, A-C Tobenas-Dujardin, A Vallée, J Mouton, F Dujardin
INTRODUCTION: Among the various options for internal fixation of acetabular fractures, the enlarged iliofemoral approach is less often used, being more invasive, although providing greater exposure enabling control of all components in complex fractures. Even so, the impact of its invasiveness has not been confirmed, and long-term results are not known. We therefore performed a retrospective study, aiming 1) to assess long-term functional outcome, and 2) to assess associated morbidity...
March 15, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Christian Klemt, Joe A Prinold, Sharon Morgans, Samuel H L Smith, Daniel Nolte, Peter Reilly, Anthony M J Bull
BACKGROUND: Knowledge of forces acting through the glenohumeral joint during activities of daily living is a prerequisite for improving implant design and aiding rehabilitation planning. Existing data are limited by the number of activities performed and, in some cases, the lack of representation of the glenohumeral loading direction, although high shear force components may cause joint dislocation or implant loosening. This study aims to analyse shoulder compression and shear force components during essential functional activities of daily living...
March 14, 2018: Clinical Biomechanics
Michelle H Chua, Raksmey Hong, Tytim Rydeth, Iv Vycheth, Sam Nang, Din Vuthy, Kee B Park
INTRODUCTION: In recent years, delivery of cost-effective "essential neurosurgery" in resource-limited communities has been recognized as an indispensable part of health care and a global health priority. The purpose of this study was to review outcomes from operative management of spine trauma at a resource limited government hospital in Phnom Penh, Cambodia, and to provide an epidemiologic report to guide prevention programs. METHODS: A retrospective review of a prospective neurosurgical database was performed to identify risk factors for spine trauma and severe spinal cord injury (ASIA A or ASIA B) and to evaluate the cost-effectiveness of surgery for patients treated at Preah Kossamak Hospital for subaxial and thoracolumbar spine trauma from 2013 to 2016...
March 14, 2018: World Neurosurgery
Richard J Mackool, Richard J Mackool, Brian M Solinsky
We describe a technique to simplify the retrieval process of an intraocular lens (IOL) that has fallen into the posterior segment of the eye. A high-vacuum level setting is used to achieve fixation of the IOL to the vitrectomy tip, permitting the IOL to be elevated into the anterior segment. The clothesline technique is then used to secure the IOL partially within the anterior chamber for subsequent suture fixation or explantation. This technique simplifies the elevation, repositioning, and/or explantation of a posteriorly dislocated IOL and eliminates the need to perform more complex and potentially traumatic maneuvers...
March 14, 2018: Journal of Cataract and Refractive Surgery
Assem A Sultan, Anton Khlopas, Inyang Udo-Inyang, Morad Chughtai, Nipun Sodhi, Suela Lamaj, Roland Starr, Nicolas S Piuzzi, Anil Bhave, Michael A Mont
INTRODUCTION: Changes in pelvic position has been shown to affect acetabular coverage of the femoral head in total hip arthroplasty (THA) and may contribute to complications such as impingement, dislocation, or early wear. Understanding the kinematic changes of these positions during functional activities may help surgeons reach a consensus regarding stable hip mechanics and ideal implant positioning in THA. Therefore, in this study, we aimed to evaluate the following in patients who had unilateral hip OA: 1) dynamic changes; and 2) variability; in the following pelvic position parameters: A) tilt; B) obliquity; and C) rotation standing position to walking...
March 16, 2018: Surgical Technology International
Olga M Pavlova, Sergey O Ryabykh, Alexander V Burcev, Alexander V Gubin
STUDY DESIGN: Case series, level 4 of evidence. OBJECTIVES: To analyze clinical and radiological features of pathological atlantoaxial displacement (PAAD) in pediatric patients. To compose treatment algorithm for anomaly-related PAAD. SUMMARY OF BACKGROUND DATA: Criteria of different types of PAAD and treatment algorithms have been widely reported in the literature, but difficulty applicable in patients with odontoid abnormalities, C2-C3 block, spina bifida C1 and children...
March 13, 2018: World Neurosurgery
Karim Mahmoud, Mohamed Maged Mekhaimar, Abduljabbar Alhammoud
Peroneal tendon instability associated with an intraarticular calcaneal fracture is a common injury that still often passes undiscovered by both radiologists and orthopedic surgeons. Timely identification of this injury will guide the choice of surgical technique used and treatment of patients. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, several databases were searched through June 2017 for any observational or experimental studies that reported the prevalence/incidence of peroneal tendon subluxation/dislocation with a calcaneus fracture with regard to fracture classifications and the significance of the fleck sign...
March 14, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Katsuaki Kanbe
BACKGROUND: The purpose of this study was to investigate the long-term clinical outcome and its related factors regarding the severity of adhesion of CH ligament over long head of biceps (LHB) after shoulder arthroscopic capsular release for frozen shoulder with technical points in 255 patients. METHODS: We performed arthroscopic capsular release for frozen shoulder in 267 shoulders of 255 patients, 112 males and 143 females, with mean age of 56.39 years, mean disease duration periods of 0...
March 16, 2018: Journal of Orthopaedic Surgery and Research
Christian B Theodotou, George M Ghobrial, Andrew L Middleton, Michael Y Wang, Allan D Levi
BACKGROUND: Cervical facet dislocations are among the most common traumatic spinal injuries. Posterior, anterior, and combined surgical approaches have been described and are widely debated. OBJECTIVE: To demonstrate efficacy in anterior-only surgical management for subaxial cervical facet dislocations. METHODS: A consistent surgical algorithm for cervical facet dislocation was applied over a 19-yr period and analyzed retrospectively in adults with acute unilateral or bilateral facet dislocation of the subaxial cervical spine...
March 14, 2018: Neurosurgery
Min Liu, Qing-Xian Ma, Jian-Bin Luo
20Mn5 steel is widely used in the manufacture of heavy hydro-generator shaft forging due to its strength, toughness, and wear resistance. However, the hot deformation and recrystallization behaviors of 20Mn5 steel compressed under a high temperature were not studied. For this article, hot compression experiments under temperatures of 850-1200 °C and strain rates of 0.01 s-1 -1 s-1 were conducted using a Gleeble-1500D thermo-mechanical simulator. Flow stress-strain curves and microstructure after hot compression were obtained...
March 16, 2018: Materials
Manuela Gander, Diana Diamond, Anna Buchheim, Kathrin Sevecke
Forced displacements and their psychosocial consequences in adolescent refugees and their families have received increasing attention in recent years. Although supportive family relations play a key role in buffering the impact of traumatization in adolescents, parental ability to provide such is often subject to extreme pressure. Under conditions of forced dislocation and fear, maladaptive interpersonal strategies in the parent-child relationships may develop, contributing to the onset of psychopathology. We explore new aspects of attachment-related issues for the understanding and treatment of adolescent refugees who have experienced multiple traumas in their childhood...
March 16, 2018: Journal of Trauma & Dissociation
Jan Friso Nast, Christoph Berliner, Thomas Rösch, Daniel von Renteln, Tania Noder, Guido Schachschal, Stefan Groth, Harald Ittrich, Jan F Kersten, Gerhard Adam, Yuki B Werner
BACKGROUND: The newly developed technique of peroral endoscopic myotomy (POEM) has been shown to be effective in several short- and mid-term studies. Limited information is available about the adequacy of immediate post-POEM monitoring tests. METHODS: POEM was performed under general anesthesia in 228 patients (59.6% male, mean age 45.6 ± 15.5 years). Post-procedural checks comprised clinical and laboratory examination, and, during post-procedure days 1-5, endoscopy and-in the first 114 cases-radiologic examination using water-soluble contrast (1st group); the remaining patients underwent post-procedure controls without radiology (2nd group)...
March 15, 2018: Surgical Endoscopy
Olga Gutkowska, Jacek Martynkiewicz, Marek Stępniewski, Jerzy Gosk
Brachial plexus injuries (BPIs) caused by shoulder dislocation usually have a transient character and tend to resolve spontaneously. However, in some patients the symptoms can persist and require operative intervention. This work aims to determine the risk factors for persistent BPIs resulting from shoulder dislocation. The study comprised 73 patients (58 men, 15 women; mean age: 50 years) treated operatively between the years 2000 and 2016 for persistent BPIs resulting from shoulder dislocation. Patient age, gender, type of initial trauma, number of affected nerves, presence of accompanying injuries, and time interval from dislocation to its reduction were analysed...
2018: BioMed Research International
Seow Theng Ong, Madhavi Latha Somaraju Chalasani, M H U Turabe Fazil, Praseetha Prasannan, Atish Kizhakeyil, Graham D Wright, Dermot Kelleher, Navin Kumar Verma
Centrosome- and Golgi-localized protein kinase N-associated protein (CG-NAP), also known as AKAP450, is a cytosolic scaffolding protein involved in the targeted positioning of multiple signaling molecules, which are critical for cellular functioning. Here, we show that CG-NAP is predominantly expressed in human primary T-lymphocytes, localizes in close proximity (<0.2 μm) with centrosomal and Golgi structures and serves as a docking platform for Protein Kinase A (PKA). GapmeR-mediated knockdown of CG-NAP inhibits LFA-1-induced T-cell migration and impairs T-cell chemotaxis toward the chemokine SDF-1α...
2018: Frontiers in Immunology
Jiangwei Wang, Yanming Wang, Wei Cai, Jixue Li, Ze Zhang, Scott X Mao
Shear band in metallic crystals is localized deformation with high dislocation density, which is often observed in nanopillar deformation experiments. The shear band dynamics coupled with dislocation activities, however, remains unclear. Here, we investigate the dynamic processes of dislocation and shear band in body-centered cubic (BCC) tungsten nanowires via an integrated approach of in situ nanomechanical testing and atomistic simulation. We find a strong effect of surface orientation on dislocation nucleation in tungsten nanowires, in which {111} surfaces act as favorite sites under high strain...
March 15, 2018: Scientific Reports
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