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fracture arthroscope

Phillip M Mitchell, Benjamin M Weisenthal, Cory A Collinge
OBJECTIVE: To evaluate the incidence of knee sepsis following suprapatellar nailing of open tibia fractures. DESIGN: Retrospective SETTING:: ACS Level 1 trauma centerPatients/Participants: We reviewed 139 open tibia fractures that underwent suprapatellar nailing as definitive treatment over a five-year period (January 1, 2011 to January 1, 2016). The majority of patients (90%, n=126) underwent intramedullary nailing at the time of their initial surgery. We defined knee sepsis as intra-articular infection requiring operative debridement, either open or arthroscopically, within one month's time...
October 1, 2016: Journal of Orthopaedic Trauma
Ryoko Uesato, Satoshi Toh, Yoshimitsu Hayashi, Keiichiro Maniwa, Yasuyuki Ishibashi
In scaphoid fractures, delayed diagnosis and nonunion are fairly common as a result of several factors, including the difficulty of radiographic diagnosis of non-displaced fractures and underestimation of the injury by the patient. Main factors to consider when deciding treatment are the type of fracture and fracture stability. In the stable nonunion (Type D1 according to the Filan and Herbert classification, or linear type of Ikeda's classification), percutaneous screw fixation without bone graft is recommended...
October 19, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Andrew R Palisch, Ronald R Winters, Marc H Willis, Collin D Bray, Theodore B Shybut
The menisci play an important biomechanical role in axial load distribution of the knees by means of hoop strength, which is contingent on intact circumferentially oriented collagen fibers and meniscal root attachments. Disruption of the meniscal root attachments leads to altered biomechanics, resulting in progressive cartilage loss, osteoarthritis, and subchondral edema, with the potential for development of a subchondral insufficiency fracture. Identification of meniscal root tears at magnetic resonance (MR) imaging is crucial because new arthroscopic surgical techniques (transtibial pullout repair) have been developed to repair meniscal root tears and preserve the tibiofemoral cartilage of the knee...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Megan K Mills, Colin D Strickland, Mary K Jesse, Peter A Lowry, Omer Mei-Dan, Jonathan A Flug
Osteoarthritis of the hip remains a prevalent disease condition that influences ever-changing treatment options. Procedures performed to correct anatomic variations, and, in turn, prevent or slow the progression of osteoarthritis, are aptly referred to as types of hip preservation surgery (HPS). Conditions that predispose individuals to femoroacetabular impingement (FAI), including pincer- and cam-type morphology, and hip dysplasia are specifically targeted in HPS. Common surgical interventions include acetabuloplasty, osteochondroplasty, periacetabular osteotomy (PAO), and derotational femoral osteotomy (DFO)...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Deepak N Bhatia
Displaced radial head fractures are treated with open reduction and internal fixation using implants. Failure of fixation may occur in the presence of comminution and in multifragmentary fractures; open surgical approaches are necessary for removal of the implants and radial head resection. Arthroscopic radial head resection has been described as a minimally invasive and effective treatment for failed radial head fracture fixation; however, periarticular adhesions and prominent implants add to the complexity and technical difficulty of the procedure...
August 2016: Arthroscopy Techniques
Won-Taek Oh, Yun-Rak Choi, Ho-Jung Kang, Il-Hyun Koh, Kyung-Han Lim
PURPOSE: To compare union rates and clinical and radiological outcomes of arthroscopic-assisted reduction and fixation with those of open reduction and fixation in patients with trans-scaphoid perilunate fracture dislocations. METHODS: This retrospective study included consecutive patients with trans-scaphoid PLFDs who underwent arthroscopic-assisted reduction and fixation (group A) or open reduction and fixation (group O), and who were followed up for a minimum of 2 years between May 2005 and March 2013...
October 1, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Varun Chouhan
INTRODUCTION: Arthroscopic fixation of tibial spine fracture in patients with open physis without damaging the growth plate is very important. We have described a very simple and effective technique for the first time in this article. CASE REPORT: A 16-year-old boy sustained avulsion fractures of tibial spine while playing. He was treated arthroscopically with excellent results. CONCLUSION: Arthroscopic fixation of tibial spine fracture in patients with open physis with two cannulated screws perpendicular to each other is a very simple technique providing strong construct, and allowing early mobilization without risk of damage to the growth plate...
April 2016: Journal of Orthopaedic Case Reports
Nihat Demirhan Demirkiran, Olcay Akdeniz, Onur Hapa, Hasan Havıtçıoğlu
INTRODUCTION: Arthroscopic fixation of tibial spine fracture without damage to the growth plate is very important in patients with open physis. The present article describes a simple and effective technique being used for the first time to treat this condition. CASE REPORT: A 16-year-old boy sustained avulsion fractures of tibial spine while playing. He was treated arthroscopically with excellent result. CONCLUSION: Arthroscopic fixation of tibial spine fracture in patients with open physis with two cannulated screws perpendicular to each other is a very simple technique which provides strong construct, and allows early mobilization without risk of damage to the growth plate...
April 2016: Journal of Orthopaedic Case Reports
C D Smith, S J Booker, H S Uppal, J Kitson, T D Bunker
AIMS: Despite the expansion of arthroscopic surgery of the shoulder, the open deltopectoral approach is increasingly used for the fixation of fractures and arthroplasty of the shoulder. The anatomy of the terminal branches of the posterior circumflex humeral artery (PCHA) has not been described before. We undertook an investigation to correct this omission. PATIENTS AND METHODS: The vascular anatomy encountered during 100 consecutive elective deltopectoral approaches was recorded, and the common variants of the terminal branches of the PCHA are described...
October 2016: Bone & Joint Journal
Jung-Ro Yoon, Chan-Deok Park, Dae-Hee Lee
PURPOSE: This study examined the clinical outcomes of a newly developed technique, arthroscopic suture bridge fixation with crossover ties of PCL tibial avulsion fracture using two tibial tunnels and a posterior trans-septal portal. METHODS: Records were reviewed of 18 patients (median age 33.5 years, range 13-55 years) with PCL tibial avulsion fractures treated with an arthroscopic suture bridge technique. Knee function before surgery and at last follow-up was evaluated by Lysholm and Tegner scores...
September 28, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Matthew Archer, Tom Parkin, Mark David Latimer
We report the case of an 11-year-old boy presenting with a type III tibial eminence fracture. The fracture fragment was reduced arthroscopically. Two 1.6 mm retrograde K-wires were inserted from the tibial metaphysis across the physis and into the fracture fragment using a standard anterior cruciate ligament tibial tunnel guide. Once the wires were clearly visible within the joint the tips were bent over by ∼120°. The wires were then tensioned around a single small fragment screw inserted into the tibial metaphysis...
2016: BMJ Case Reports
Kyle T Leggott, Matthew Martin, David Sklar, Deborah Helitzer, Randy Rosett, Cameron Crandall, Firoz Vagh, Deana Mercer
INTRODUCTION: To provide insight into how an innovation in healthcare is implemented and diffused, we studied the transition from routine use of general anesthesia to peripheral nerve blocks (PNBs) for ambulatory orthopedic extremity surgery. Rogers' diffusion of innovations (DOI) theory was used as our theoretical framework. We identified themes that would be helpful for others attempting to diffuse innovations into healthcare settings. MATERIAL AND METHODS: A mixed quantitative and qualitative methodology was used...
September 2016: Healthcare
Michael S Guss, David Kaye, Michael Rettig
A Bennett fracture is a common injury that involves an intra-articular fracture at the base of the first metacarpal. This fracture typically results in a dorsally and radially displaced metacarpal shaft relative to the well-anchored volar ulnar fragment. Most Bennett fractures are treated with operative fixation, including closed reduction and percutaneous fixation, open reduction and internal fixation, or arthroscopically assisted fixation. However, the optimal surgical approach is controversial. There is a paucity of literature comparing the outcomes of the various treatments, leaving the surgeon without a clear treatment algorithm...
September 2016: Bulletin of the Hospital for Joint Diseases
Blandine Marion, Shahnaz Klouche, Julien Deranlot, Thomas Bauer, Geoffroy Nourissat, Philippe Hardy
PURPOSE: To compare postoperative pain during the first postoperative week and the position of the coracoid bone block at the anterior aspect of the glenoid after the arthroscopic and the mini-open Latarjet procedure. The secondary purpose was to assess functional results and recurrence after at least 2 years of follow-up. METHODS: This comparative prospective study included patients who underwent a Latarjet-Bristow procedure for anterior shoulder instability in 2012...
September 8, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Michael P Gaspar, Patrick M Kane, Sidney M Jacoby, Randall W Culp
BACKGROUND: Nonunion of scaphoid proximal pole fractures presents a challenging management dilemma to hand surgeons. This problem is further complicated in the uncommon concurrence of scapholunate (SL) ligament disruption. CASE DESCRIPTION: A 39-year-old male patient presented with new-onset wrist pain following a remote history of a proximal pole scaphoid fracture sustained as a teenager, which was treated nonoperatively. Six months before presentation, the patient sustained a fall while snowboarding...
April 2016: Journal of Hand and Microsurgery
Douglas E Lucas, B Collier Watson, G Alex Simpson, Gregory C Berlet, Christopher F Hyer
: Ankle fractures are a common injury treated by orthopaedic surgeons. The distal tibiofibular syndesmosis can be injured during these fractures as well as in isolation. They pose a significant challenge with regard to the diagnosis of instability as well as evaluating reduction after fixation. Multiple studies have demonstrated that traditional radiographic analysis fails to accurately identify syndesmotic diastasis, instability, or malreduction. Ankle arthroscopy has been proposed as an alternative way to evaluate the syndesmosis...
September 9, 2016: Foot & Ankle Specialist
Sean T Grambart
Osteochondral fractures of the ankle are typically caused by traumatic injuries of the ankle. Repetitive trauma can lead to further cartilage damage with subsequent increasing size of the lesion, ultimately leading to severe cartilage disorder and degenerative arthritis of the ankle. Arthroscopic bone marrow stimulation has been shown to be a highly successful option for patients with small osteochondral lesions. Studies show a higher failure rate for larger lesions and cystic changes that disrupt the subchondral plate...
October 2016: Clinics in Podiatric Medicine and Surgery
Yougun Won, Gi Soo Lee, Sang Bum Kim, Sun Joong Kim, Kyu Hyun Yang
As anatomical reduction of the articular surface of femoral head fractures and restoration of damaged cartilage are essential for good long-term results, many treatment options have been suggested, including fixation of the fracture using various surgical exposures and implants, as well as arthroscopic irrigation and debridement, bone marrow stimulating techniques, osteochondral allograft, autograft, and autogenous chondrocyte implantation. We report a case of osteochondral autograft harvested from its own femoral articular surface through surgical hip dislocation...
November 2016: Yonsei Medical Journal
Eric Hohn, Nirav K Pandya
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction is one of several surgical procedures used to treat patellofemoral instability. Use of allograft tissue can preserve autogenous tissue and may be preferable in patients with connective tissue disorders or ligamentous laxity. Although there are successful reports in adults, it is unclear if the use of allograft tissue in MPFL reconstruction can restore patellofemoral stability in children and adolescents. QUESTIONS/PURPOSES: (1) Does allograft tissue in MPFL reconstruction in pediatric and adolescent patients restore patellar stability? (2) What complications were associated with allograft MPFL reconstructions in children and adolescents? METHODS: Between June 2012 and August 2015, one surgeon (NKP) performed 26 MPFL reconstructions in 23 patients with gracilis allograft for traumatic patellar instability...
September 2, 2016: Clinical Orthopaedics and related Research
Joideep Phadnis, Gregory I Bain
BACKGROUND: Failure of total elbow arthroplasty is more common than after other major joint arthroplasties and is often a result of aseptic loosening, peri-prosthetic infection, fracture and instability. Infection can be a devastating complication, yet there are no established guidelines for the pre-operative diagnosis of total elbow peri-prosthetic infection. This is because pre-operative clinical, radiographic and biochemical tests are often unreliable. METHODS: Using three case examples, a standardized protocol for the clinical and arthroscopic assessment of the painful total elbow arthroplasty is described...
January 2016: Shoulder & Elbow
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