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https://www.readbyqxmd.com/read/28214461/wide-awake-hand-surgery
#1
Matthew Cantlon, Steven Yang
Wide awake hand surgery employs local-only anesthesia with low-dose epinephrine to create a bloodless field without the use of an arm tourniquet. Despite traditional teaching, evidence-based medicine suggests epinephrine is safe for use in hand and digital anesthesia. Eliminating an arm tourniquet reduces the requirement for sedation and general anesthetic. This confers particular advantage in surgeries such as tendon repairs, tendon transfers, and soft tissue releases in which intraoperative active motion can used to optimize outcomes...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28195983/management-of-the-relapsed-clubfoot-following-treatment-using-the-ponseti-method
#2
Pooya Hosseinzadeh, Derek M Kelly, Lewis E Zionts
The Ponseti method to treat idiopathic clubfoot deformity has proven to be reliable, and several centers have reported excellent outcomes. Although the method has been dependable in obtaining initial correction of the foot, relapse rates ranging from 26% to 48% have been reported. When a relapsed deformity is detected early, treatment with a short series of manipulations and cast applications followed by resumption of postcorrective bracing may be all that is required to regain and maintain correction. In patients aged >2...
March 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28195745/anatomic-and-biomechanical-comparison-of-the-classic-and-congruent-arc-techniques-of-the-latarjet-procedure
#3
Scott R Montgomery, J Christoph Katthagen, Jacob D Mikula, Daniel Cole Marchetti, Dimitri S Tahal, Grant J Dornan, Kimi D Dahl, Alex W Brady, Travis Lee Turnbull, Peter J Millett
BACKGROUND: The Latarjet procedure is commonly performed using either the classic or the congruent-arc technique. Each technique has potential clinical advantages and disadvantages. However, data on the anatomic and biomechanical effects, benefits, and limitations of each technique are limited. Hypothesis/Purpose: To compare the anatomy and biomechanical fixation strength (failure load) between the 2 techniques. It was hypothesized that the classic technique would have superior initial fixation when compared with the congruent-arc technique and that this would be affected by sex and coracoid size...
February 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28194290/latissimus-dorsi-tendon-transfer-with-graftjacket%C3%A2-augmentation-to-increase-tendon-length-for-an-irreparable-rotator-cuff-tear
#4
John G Skedros, Tanner R Henrie
Massive irreparable rotator cuff tears can be reconstructed with latissimus dorsi tendon transfers (LDTT). Although uncommon, the natural length of the latissimus dorsi tendon (LDT) could be insufficient for transfer even after adequate soft tissue releases. Descriptions of cases where grafts were needed to lengthen the LDT are therefore rare. We located only two reports of the use of an acellular dermal matrix to increase effective tendon length in tendon transfers about the shoulder: (1) GraftJacket patch for a pectoralis major tendon reconstruction and (2) ArthroFlex® patch for LDTT...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28185265/teres-major-muscle-insertion-footprint
#5
Malte Dancker, Simon Lambert, Erich Brenner
Teres major muscle (TM) and latissimus dorsi muscle (LD) are frequently used in muscle transfers around the shoulder girdle. Some authors have suggested harvesting techniques in which the muscle is detached in continuity with a bone segment. Information on the bony attachment footprint of these muscles is lacking. The purpose of this study was to investigate the region of attachment of the TM to facilitate safe and complete harvesting with a bone segment where it is indicated, and to determine the relationship of the TM footprint with that of the LD...
February 9, 2017: Journal of Anatomy
https://www.readbyqxmd.com/read/28178093/management-of-clubfoot-relapses-with-the-ponseti-method-results-of-a-survey-of-the-posna-members
#6
Pooya Hosseinzadeh, Gary M Kiebzak, Lori Dolan, Lewis E Zionts, Jose Morcuende
BACKGROUND: Despite the high rate of initial success using the Ponseti method to manage idiopathic clubfoot deformity, relapse continues to be a problem. We surveyed the Pediatric Orthopedic Society of North America (POSNA) members about their experience with relapsed deformity following the initial correction of clubfeet. METHODS: We created a survey to focus on the management of clubfeet after initial correction of deformity. The survey included questions on postcorrective bracing, clinical findings used to identify relapse, the observed frequency of relapsed deformity, and how relapses are managed...
February 7, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28170430/efficient-decellularization-for-tissue-engineering-of-the-tendon-bone-interface-with-preservation-of-biomechanics
#7
Kai Xu, Lara A Kuntz, Peter Foehr, Katharina Kuempel, Alexandra Wagner, Jutta Tuebel, Constantin V Deimling, Rainer H Burgkart
Interfaces between tendon/ligament and bone ("entheses") are highly specialized tissues that allow for stress transfer between mechanically dissimilar materials. Entheses show very low regenerative capacity resulting in high incidences of failure after surgical repair. Tissue engineering is a promising approach to recover functionality of entheses. Here, we established a protocol to decellularize porcine entheses as scaffolds for enthesis tissue engineering. Chemical detergents as well as physical treatments were investigated with regard to their efficiency to decellularize 2 mm thick porcine Achilles tendon entheses...
2017: PloS One
https://www.readbyqxmd.com/read/28166968/interspecies-somatic-cell-nuclear-transfer-in-asiatic-cheetah-using-nuclei-derived-from-post-mortem-frozen-tissue-in-absence-of-cryo-protectant-and-in%C3%A2-vitro-matured-domestic-cat-oocytes
#8
F Moulavi, S M Hosseini, N Tanhaie-Vash, S Ostadhosseini, S H Hosseini, M Hajinasrollah, M H Asghari, H Gourabi, A Shahverdi, A D Vosough, M H Nasr-Esfahani
Recent accomplishments in the field of somatic cell nuclear transfer (SCNT) hold tremendous promise to prevent rapid loss of animal genetic resources using ex situ conservation technology. Most of SCNT studies use viable cells for nuclear transfer into recipient oocytes. However, preparation of live cells in extreme circumstances, in which post-mortem material of endangered/rare animals is improperly retained frozen, is difficult, if not impossible. This study investigated the possibility of interspecies-SCNT (iSCNT) in Asiatic cheetah (Acinonyx jubatus venaticus), a critically endangered subspecies, using nuclei derived from frozen tissue in absence of cryo-protectant at -20 °C and in vitro matured domestic cat oocytes...
March 1, 2017: Theriogenology
https://www.readbyqxmd.com/read/28163203/the-high-variability-of-the-chiasma-plantare-and-the-long-flexor-tendons-anatomical-aspects-of-tendon-transfer-in-foot-surgery
#9
Bettina Pretterklieber
As tendon transfer of the flexor hallucis longus (FHL) and the flexor digitorum longus (FDL) is an established procedure, exact knowledge of the formation of the chiasma plantare is of great interest. Although the quadratus plantae (QP) appears to play a major role, it has been rarely addressed in previous studies. The aim of the present study was to reinvestigate the formation of the chiasma plantare and the composition of the long flexor tendons in order to clarify the inexact and partly contradictory descriptions published from 1865 onward...
February 3, 2017: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
https://www.readbyqxmd.com/read/28160906/thumb-reconstruction-with-thin-proximal-ulnar-perforator-free-flap
#10
REVIEW
Mario Cherubino, Martina Corno, Luigi Valdatta, Roberto Adani
Soft tissue defects of the thumb with exposure of tendons, periosteum, or neurovascular bundles require a complex reconstruction aimed at restoring both skin coverage and the essential function of pinching and manipulation. When large defects are involved, a free tissue transfer is indicated. The proximal ulnar perforator flap represents an interesting solution without the drawbacks of other more widespread free flaps. This report describes the case of a patient with a squamous cell carcinoma of the thumb that required circumferential resection of the soft tissue of the distal phalanx and the interphalangeal joint...
February 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28159718/mechanical-function-near-defects-in-an-aligned-nanofiber-composite-is-preserved-by-inclusion-of-disorganized-layers-insight-into-meniscus-structure-and-function
#11
Sonia Bansal, Sai Mandalapu, Céline Aeppli, Feini Qu, Spencer E Szczesny, Robert L Mauck, Miltiadis H Zgonis
: The meniscus is comprised of circumferentially aligned fibers that resist the tensile forces within the meniscus (i.e., hoop stress) that develop during loading of the knee. Although these circumferential fibers are severed by radial meniscal tears, tibial contact stresses do not increase until the tear reaches ∼90% of the meniscus width, suggesting that the severed circumferential fibers still bear load and maintain the mechanical functionality of the meniscus. Recent data demonstrates that the interfibrillar matrix can transfer strain energy to disconnected fibrils in tendon fascicles...
January 31, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28159046/modified-double-plantar-plate-tenodesis
#12
T H Lui, L L LiYeung
BACKGROUND: Metatarsophalangeal joint instability of the lesser toe can cause acquired toe deformity. Plantar plate deficiency is the major pathology. Plantar plate repair can stabilize the joint but may result in iatrogenic transverse plane toe deformity in correction of claw toe deformity. Limited toe extension can be resulted after correction of crossover toe deformity by plantar plate tenodesis and extensor digitorum brevis transfer. A modification of the technique is proposed. MATERIALS AND METHODS: The clinical outcomes of 10 patients with the modified procedure performed were assessed...
March 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28149732/arthroscopic-reduction-and-balloon-humeroplasty-in-the-treatment-of-acute-hill-sachs-lesions
#13
Drew Ratner, Jeffrey Backes, John M Tokish
Shoulder instability is often associated with an impaction fracture of the humeral head, commonly referred to as a "Hill-Sachs lesion." This lesion is present in both anterior and posterior instability. Forty percent to 90% of anterior shoulder dislocations have associated Hill-Sachs lesions, whereas 29% to 86% of posterior shoulder dislocations have reverse Hill-Sachs lesions. Both of these lesions can contribute to recurrent instability of the shoulder and require surgery to be treated. Currently, the most common procedures to address Hill-Sachs lesions are the remplissage procedure (transfer of the infraspinatus into the posterior humeral head defect), capsular shift, disimpaction technique, humeral head resurfacing, bone block transfer, or shoulder arthroplasty...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28145955/long-term-outcome-after-pectoralis-major-transfer-for-irreparable-anterosuperior-rotator-cuff-tears
#14
Philipp Moroder, Eva Schulz, Marian Mitterer, Fabian Plachel, Herbert Resch, Stefan Lederer
BACKGROUND: Promising short-term outcomes after pectoralis major tendon transfer for the treatment of an irreparable anterosuperior rotator cuff tear have been reported. The purpose of this study was to evaluate the long-term outcome. METHODS: Twenty-seven consecutive patients with irreparable anterosuperior rotator cuff tears without advanced cuff arthropathy or advanced humeral head migration were treated with a partial subcoracoid pectoralis major tendon transfer between 2004 and 2005...
February 1, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28141953/interposition-dermal-matrix-xenografts
#15
Julie A Neumann, Miltiadis H Zgonis, Kathleen D Rickert, Kendall E Bradley, Thomas J Kremen, Blake R Boggess, Alison P Toth
BACKGROUND: Management of massive rotator cuff tears in shoulders without glenohumeral arthritis remains problematic for surgeons. Repairs of massive rotator cuff tears have failure rates of 20% to 94% at 1 to 2 years postoperatively as demonstrated with arthrography, ultrasound, and magnetic resonance imaging. Additionally, inconsistent outcomes have been reported with debridement alone of massive rotator cuff tears, and limitations have been seen with other current methods of operative intervention, including arthroplasty and tendon transfers...
January 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28137440/active-extensor-indicis-proprius-extension-strength-after-its-use-as-a-tendon-transfer-19%C3%A2-cases
#16
V Matter-Parrat, G Prunières, S Collon, S Facca, P Liverneaux, J J Hidalgo Diaz
: Complications following extensor indicis proprius (EIP) tendon transfer are loss of strength, independence and mobility in the index finger in extension. The main goal of this study was to measure the index finger's independent and dependent extension strength after a tendon transfer. Secondary goals were to determine if the index finger retained the ability to extend independently after the transfer and to evaluate second metacarpophalangeal (MCP) joint mobility. Our study consisted of 19 patients in whom the EIP tendon had been divided proximally to the extensor hood...
February 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28116261/palmaris-longus-tendon-grafting-for-extensor-pollicis-longus-tendon-rupture-bscrew-tip-after-20-years
#17
Jitendra Nath Pal, Amiya Kumar Bera, Amarendra Nath Roy, Wasim Bari
INTRODUCTION: Spontaneous ruptures of extension pollicis longus tendon predominantly occur after undisplaced or minimally displaced distal radial fracture near Lister tubercle. Systemic inflammatory diseases and systemic or local steroid, mechanical causes like bony ridges, presence of bone plate or external fixator pin may precipitate this. Repetitive uses in certain occupation like cooking, cow milking, tailoring and direct trauma in kick boxer are also identified as cause. In this study it is caused by screw tip that also after 20 years...
July 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28109624/metatarsalgia
#18
REVIEW
J-L Besse
The causes of metatarsalgia are classified as primary, secondary, and iatrogenic. Anatomical and biomechanical considerations separate "static" from "propulsive" forms of metatarsalgia. The physical examination should be combined with an assessment of weight-bearing radiographs and, if needed, of ultrasound or magnetic resonance imaging scans. The first-line treatment is conservative (stretching exercises, footwear modification, insoles, and lesion debridement). Soft-tissue surgical procedures (gastrocnemius muscle recession, tendon transfer, and plantar plate repair) should also be considered...
January 18, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28072735/localized-type-volkmann-s-contracture-treated-with-tendon-transfer-and-tension-reduced-early-mobilization-a-case-report
#19
Yoshio Kaji, Osamu Nakamura, Konosuke Yamaguchi, Sachiko Tobiume, Tetsuji Yamamoto
RATIONALE: For localized type Volkmann's contracture, in which degeneration of the flexor digitorum profundus (FDP) muscle to one or two fingers and restriction of finger extension occur, dissection or excision of the affected muscle is usually recommended. However, these surgical procedures need relatively wide exposure of the muscle, because the FDP muscle is in the deep portion of the forearm. PATIENT CONCERNS: In this report, the case of a 35-year-old woman with localized type Volkmann's contracture is presented...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28071819/evidence-that-interfibrillar-load-transfer-in-tendon-is-supported-by-small-diameter-fibrils-and-not-extrafibrillar-tissue-components
#20
Spencer E Szczesny, Kristen L Fetchko, George R Dodge, Dawn M Elliott
Collagen fibrils in tendon are believed to be discontinuous and transfer tensile loads through shear forces generated during interfibrillar sliding. However, the structures that transmit these interfibrillar forces are unknown. Various extrafibrillar tissue components (e.g., glycosaminoglycans, collagens XII and XIV) have been suggested to transmit interfibrillar loads by bridging collagen fibrils. Alternatively, collagen fibrils may interact directly through physical fusions and interfibrillar branching. The objective of this study was to test whether extrafibrillar proteins are necessary to transmit load between collagen fibrils or if interfibrillar load transfer is accomplished directly by the fibrils themselves...
January 10, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
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