- Does preoperative deformity diminish radiographic outcome after hallux valgus correction with scarf osteotomy?: A retrospective study of 102 cases. [Journal Article]
- FAFoot Ankle Surg 2019 May 27
- CONCLUSIONS: Preoperative deformity does not correlate with postoperative loss of correction after scarf osteotomy, except DMAA.Our results may be helpful in counseling patients regarding recurrence of hallux valgus deformity after scarf osteotomy.
- Bone resection for mechanically aligned total knee arthroplasty creates frequent gap modifications and imbalances. [Journal Article]
- KSKnee Surg Sports Traumatol Arthrosc 2019 Jun 14
- CONCLUSIONS: A systematic use of the simulated measured resection MA technique for TKA leads to many cases with imbalance. Some imbalances may not be correctable surgically and may result in TKA instability. Modified versions of the MA technique or other alignment methods that better reproduce knee anatomies should be explored.
- Effect of Akin Osteotomy on Hallux Valgus Correction After Scarf Osteotomy With Hallux Valgus Interphalangeus. [Journal Article]
- FAFoot Ankle Int 2019 Jun 14; :1071100719855043
- CONCLUSIONS: In cases with a PDPAA above 8 degrees, we recommend a combined scarf/akin osteotomy to diminish the potential for loss of correction.
- Elastic Stable Intramedullary Nailing for Treatment of Pediatric Femoral Fractures; A 15-Year Single Centre Experience. [Journal Article]
- BEBull Emerg Trauma 2019; 7(2):169-175
- CONCLUSIONS: The ESIN for treatment of femoral fractures shows very good functional and cosmetic results. It allows an early functional and cast-free follow-up with a quick pain reduction. Because of the excellent objective and subjective results, the operative stabilization of femoral fractures with ESIN should be recommended to all pediatrics patients.
- [Arthroscopic GraftLink technique reconstruction combined with suture anchor fixation for anterior cruciate ligament and medial collateral ligament injuries]. [Journal Article]
- ZXZhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2019 Jun 15; 33(6):685-688
- CONCLUSIONS: The method of ACL reconstruction via arthroscopic GraftLink technique with PLT and MCL repair via suture anchor fixation has the advantages of less knee injury and faster recovery, and there is no significant impact on ankle function after tendon removal.
- Valgus intertrochanteric osteotomy for femur neck pseudoarthrosis: a simple solution to a complex problem that has stood the test of time. [Review]
- IOInt Orthop 2019 Jun 14
- Femoral neck nonunion in young patients has always been a difficult problem to deal with for surgeons. Numerous surgical procedures to address either the biological or mechanical issues at the nonuni…
Femoral neck nonunion in young patients has always been a difficult problem to deal with for surgeons. Numerous surgical procedures to address either the biological or mechanical issues at the nonunion have been described and most of them have been associated with variable results. Isolated biological augmentation is often associated with poor results and some techniques like vascularized grafting may require not so commonly available expertise. Valgus osteotomy is aimed to correct the abnormal fracture biomechanics associated with femoral neck fractures. By altering the nature of force transmission across the nonunion, shear forces are converted into compressive forces that lead to rapid osseous union without the need for bone grafting. Though the principles are sound and were described a long time ago, the technical aspects have evolved over time. Various modifications have been described to overcome shortcomings such as limb length discrepancy, reduction of femoral offset, alteration in mechanical axis, and the overall proximal femur anatomy. In this review, we look back at the fundamental principles and recent literature on the results of valgus intertrochanteric osteotomy for femoral neck pseudoarthrosis. We also highlight the important need for accurate preoperative planning and surgical execution. Lastly, we elaborate on the technical improvisations that have happened over time in order to improve functional results and to minimize complications and poor outcome after a valgus osteotomy.
- One-stage Surgical Treatment of Simultaneous Osteotomy and Asymmetric Lengthening on Short Femur with Severe Deformity of Genu Valgus. [Journal Article]
- SRSci Rep 2019 Jun 13; 9(1):8602
- This study aimed to discuss the effects of one stage surgical treatment by simultaneous osteotomy and asymmetric lengthening by Ilizarov external fixator on short femur with severe deformity of genu …
This study aimed to discuss the effects of one stage surgical treatment by simultaneous osteotomy and asymmetric lengthening by Ilizarov external fixator on short femur with severe deformity of genu valgus. A total of 12 cases with unilateral deformities treated by simultaneous osteotomy and Ilizarov asymmetric lengthening on short femur with severe deformity of genu valgus were retrospectively analyzed from January 2006 to April 2015. The affected limbs were 2.5-11 cm (5.2 cm on average) short, the femorotibial angle was 135°-158° (146.3° on average), and the ankle interval was 15-43 cm (24.7 cm on average). The Paley method was used to determine the osteotomy plane (distal femur) of genu valgus. According to this standard, the bone union results were as follows: 11 had excellent and 1 had good, where 7 patients had excellent and 5 had good functional outcomes. One stage surgical treatment by simultaneous osteotomy and asymmetric lengthening on short femur with severe deformity of genu valgus was considered to be an effective and reliable method with better osteotomy union, less trauma and fewer complications.
- StatPearls: Elbow Trauma [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- Elbow trauma is a common entity in the acute care setting. In general, these injuries encompass a vast array of injury patterns from mild soft tissue injuries and contusions to complex osseoligament…
Elbow trauma is a common entity in the acute care setting. In general, these injuries encompass a vast array of injury patterns from mild soft tissue injuries and contusions to complex osseoligamentous injury patterns and terrible triad injuries. In the adult patient, most of these acute injuries occur secondary to high energy mechanisms such as falls from height or motor vehicle accidents (MVAs). Elderly patients, however, are at risk for elbow injuries and traumatic fractures following even low-energy falls. The latter occurs secondary to a multitude of factors, including deconditioning, decreased agility and balance, poor vision, decreased muscle mass, and osteopenia or osteoporosis. Anatomy overview The elbow joint is one of the most complex joints in the human body, comprised of three distinct articulations: ulnohumeral, radiohumeral, and proximal radioulnar joints. The anterior aspect of the proximal ulna (i.e., the trochlear notch or semilunar notch) articulates with the trochlea of the distal humerus on the medial side of the elbow joint. The capitellum, a distinct ossification center located at the lateral distal humerus, articulates with the radial head. The radial neck and the proximal radial metaphyseal region includes the radial tuberosity, the site of attachment of the distal biceps tendon. The ulnar collateral ligament (UCL) and lateral collateral ligament (LCL) complex play an important role in stabilizing the joint to valgus and varus stress throughout the arc of motion, respectively. Moreover, these ligamentous structures contribute to the physiologic rotational stability of the elbow joint. The transition between the upper arm and the forearm is the region of the antecubital fossa, which contains the radial nerve, brachial artery, and median nerve.
- StatPearls: Adult Acquired Flatfoot (AAFD) [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- Adult acquired flatfoot (AAFD), first described as posterior tibial tendon dysfunction (PTTD), is a complex pathology defined by the collapse of the medial longitudinal arch of the foot with continue…
Adult acquired flatfoot (AAFD), first described as posterior tibial tendon dysfunction (PTTD), is a complex pathology defined by the collapse of the medial longitudinal arch of the foot with continued progressive deformity of the foot and ankle. Adult acquired flatfoot is a debilitating condition that affects up to 5 million people within the US. The anatomy of the foot and ankle are complex, with multiple structures involved in the stability and function needed to walk and bear weight. A structure principally involved in the development of adult acquired flatfoot is the posterior tibial tendon. In addition to plantar flexion, the posterior tibial tendon is the primary inverter of the foot. The posterior tibial tendon inserts principally on the navicular tuberosity, but also has lesser insertions on to other tarsal and metatarsal structures. The spring and deltoid ligaments are crucial to the stability of the foot and ankle. The spring ligament, which is the ligament most frequently involved in adult acquired flatfoot, supports the ankle by connections from the sustentaculum tali of the calcaneus to the navicular. The primary role of the spring ligament is to support the head of the talus. The deltoid ligament is usually affected later in the progression of adult acquired flatfoot. The superficial deltoid ligament has a wide insertion on the navicular to the posterior tibiotalar capsule. It is the primary support against tibiotalar valgus angulation. The deep deltoid ligament prevents axial rotation of the talus, where it inserts, from its origin on the intercollicular groove and posterior colliculus. The deltoid ligament as a whole is critical in supporting the articulating surfaces of the ankle and the spring ligament. Acquired flatfoot grading is by the Johnson and Strom classification system, which has classification grades of I to III. Myerson added a fourth grade in 1997. The classification system aids practitioners in identifying AAFD severity and also can guide treatment plans. Stage I disease characteristically presents with posterior tibial tendon tenosynovitis with no arch collapse. Patients with stage II adult acquired flatfoot will have foot collapse and will be unable to perform a single leg heel rise. This stage further subcategorizes into stage IIa and IIb. Stage IIa is foot collapse with valgus deformity of the hindfoot but no midfoot abduction, while in stage IIb midfoot abduction is present. Patients with stage III adult acquired flatfoot will have fixed deformity with hindfoot valgus and forefoot abduction. Patients with stage IV deformity will have ankle valgus secondary to deltoid ligament attenuation.
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- Have the difficulties and complications of surgical treatment for chondroblastoma of the adjoining knee joint been overestimated? [Journal Article]
- JBJ Bone Oncol 2019; 17:100240
- CONCLUSIONS: Intraregional aggressive curettage, phenolization, and allogeneic bone grafting are effective for treatment of chondroblastoma of the adjoining knee joint.