Biomechanical Comparison of Pronator Quadratus Repair Techniques in the Modified Henry Approach for Distal Radius Fracture
Conclusions: This cadaveric study shows that if deemed necessary for soft tissue coverage or for biological aid in fracture healing, suture anchor is the strongest repair choice for pronator quadratus. This conclusion must be weighed against the fact that no in vivo tensile strength value sustained by the pronator quadratus is known in the literature and that simple suture could be sufficient to hold the repaired muscle while the wrist is immobilized postoperatively. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - November 29, 2020 Category: Orthopaedics Tags: Tips and Pearls Source Type: research

Hydrodissection and Hydrodelineation of Hamstring Tendons: Novel Technique for Graft Harvesting
Hamstring graft harvest is an important step in modern day arthroscopic anterior cruciate ligament reconstruction surgery. Various techniques of hamstring graft harvest has been reported. We have described a novel method of graft harvesting which eases the identification of the desired tendons and offers protection to saphenous nerve and superficial medial collateral ligament, which could be damaged. Our method is easy to perform after some training and does not require any additional equipment. It is also reproducible as the structures over the medial side of the tibia have a consistent anatomic pattern. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - November 29, 2020 Category: Orthopaedics Tags: Tips and Pearls Source Type: research

A Useful Tip for Removal of a Well-fixed Trabecular Metal Tibial Cone
We present a technique for removal of a well-fixed porous tantalum tibial cone in the setting of a revision total knee arthroplasty. The following case is of a 56-year-old man who required a repeat 2-stage revision of an infected total knee implant that included a porous tantalum tibial cone (Trabecular Metal). The patient had previously undergone a 2-stage revision and achieved excellent fixation with a stemmed, posterior stabilized, rotating platform revision implant, and a well-ingrown porous tantalum tibial cone. To potentiate a successful outcome and avoid further bone loss, this technique was implemented for tibial c...
Source: Techniques in Orthopaedics - November 29, 2020 Category: Orthopaedics Tags: Tips and Pearls Source Type: research

Femoral Derotation for the Acutely Malrotated Femur Following Intramedullary Nail Fixation
Clinically significant malrotation is one of the common complications following intramedullary treatment of femoral shaft fractures. We provide our experience revising an acutely malrotated femoral shaft fracture treated by intramedullary nail fixation. Following clinical examination, radiographic evaluation must include computed tomography scan for evaluation of femoral torsion. Derotation should be pursued after discussion of risks and benefits with the patient, if the malrotation exceeds 15 degrees in comparison with the uninjured limb. Revision surgery must include careful intraoperative clinical examination, as well a...
Source: Techniques in Orthopaedics - November 29, 2020 Category: Orthopaedics Tags: Tips and Pearls Source Type: research

Efficiency of Power Versus Hand Screwdriver for Cortical Lag Screw Insertion
Conclusions: The difference in time between the actual techniques of using power or manual tools is marginal as accuracy is the most important factor for screw insertion efficiency. We propose that surgeons utilize the modality they are more accurate with to prevent misdirected screws and increase efficiency in the operating room. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - November 29, 2020 Category: Orthopaedics Tags: Special Technical Articles Source Type: research

A New Joystick Technique for the Reduction of Unstable Trochanteric Hip Fractures: Especially With Rotational Deformity
We are performing surgical treatment of trochanteric hip fractures using an intramedullary nail. There are irreducible fractures in which the correct reduction cannot be performed with the usual traction and internal rotation. In particular, the rotational deformity is difficult to reduce. One of the causes of this is the instability and uncontrollability of the proximal bone fragment. To address this problem, we devised a new joystick technique. From the same skin incision as used for inserting the intramedullary nail, a 3.0 mm Kirschner wire (K-wire) is inserted into the femoral neck perpendicularly. A K-wire is i...
Source: Techniques in Orthopaedics - November 29, 2020 Category: Orthopaedics Tags: Special Technical Articles Source Type: research

Technical Tip: Talar Neck Fixation Strategy Based on Fracture Variants
We present a reliable observation of the morphology of talar neck fractures and demonstrate how this can be used to justify a pragmatic fixation method. The “anatomic” versus the “surgical” neck can be determined from the routine preoperative imaging. Appreciation of which fracture variant is present guides the fixation strategy as outlined. Our department has adopted this fixation principle over a 5-year period for a consecutive series of 8 talar neck fractures. Over our series we have not observed any loss in reduction or avascular necrosis. We would propose that talar neck fixation should be base...
Source: Techniques in Orthopaedics - November 29, 2020 Category: Orthopaedics Tags: Special Technical Articles Source Type: research

Hook Plate Fixation of Medial Malleolar Fractures
The objective of this study is to describe the hook plate technique for open reduction and internal fixation of medial malleolar fractures and present outcomes in 2 patients who underwent this procedure. Hook plate fixation of medial malleolar fractures results in acceptable outcomes and is be a good alternative to traditional methods of fixation in patients. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - November 29, 2020 Category: Orthopaedics Tags: Special Technical Articles Source Type: research

Anteriorization of the Tibial Tubercle With Osteotomy, Combined With Cartilage Restoration in the Patellofemoral Joint: A Surgical Technique
We describe a surgical technique for tibial tubercle anteriorization in conjunction with autologous chondrocyte implantation for the treatment of PF cartilage lesions. In our opinion, a distal realignment procedure should be routinely performed for any cartilage restoration procedure of the PF joint as it may delay the onset of osteoarthritis. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - November 29, 2020 Category: Orthopaedics Tags: Special Technical Articles Source Type: research

Internal Fixation of Nondisplaced Intracapsular Hip Fractures in Older Patients
This study was based on the computerized databases of the Orthopedic Outpatient Clinic. In 73 (66%) of the patients, internal fixation utilized cannulated screws, and, in 37 (34%), the Targon femoral neck nail was used. The rate of revision surgery during the 5-year follow-up was similar for the 2 subsets (16.4% vs. 10.8%, P=0.429). Secondary outcomes such as avascular necrosis, nonunion, infection, and mechanical sequels did not differ significantly in the 2 groups. The 2 types of internal fixation did not differ significantly in their outcome when used for nondisplaced intracapsular hip fractures. No variance was shown i...
Source: Techniques in Orthopaedics - November 29, 2020 Category: Orthopaedics Tags: Special Technical Articles Source Type: research

Fracture Risk Through Oblique External Fixator Pin Tracks
A known complication following removal of an external fixator is fracture through a pin track. Certain advantages are granted by inserting external fixator half-pins at oblique (not orthogonal) angles, such as increased pull-out strength and increased stability against torsional strain with divergent half-pins. We sought to determine if oblique pin tracks also had protective properties against secondary fracture through the pin track after half-pin removal. Acrylic plastic tubing was used to evaluate the effects of pin track obliquity on load to failure after drilling pin tracks. Tubing of 5/8″ outside diameter with ...
Source: Techniques in Orthopaedics - November 29, 2020 Category: Orthopaedics Tags: Special Technical Articles Source Type: research

Medial Approach for Total Elbow Arthroplasty: A New Surgical Technique for Tumor Resection and Joint Replacement
We describe for the first time a medial approach to the elbow/distal humerus for TEA that preserves full range of motion and extension strength. Although this approach may not be appropriate for all patients undergoing TEA, it is quite useful in procedures requiring a wide field of exposure of the elbow joint such as malignant neoplasms or extensively comminuted distal humerus fractures. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - November 29, 2020 Category: Orthopaedics Tags: Special Technical Articles Source Type: research

Finger Trap Traction and Distal Radius Fractures
Distal radius fractures are among the most common fractures worldwide. Initial first aid treatment for any fracture is reduction, then to hold the reduction and then rehabilitate. It is common practice to attempt manual manipulation and if satisfactory reduction is not achieved the reduction is abandoned in favor of a manipulation in theater with or without K-wire fixation or open reduction and internal fixation. The finger trap method of applying traction to distal radius fractures is a technique many of us are aware of but have not actually attempted in clinical practice. Furthermore, there are no easily accessible artic...
Source: Techniques in Orthopaedics - November 29, 2020 Category: Orthopaedics Tags: Special Technical Articles Source Type: research

The Application of Henna (Lawsonia inermis) in Orthopedics
We describe the use of Henna (Lawsonia inermis) paste as a durable, readily available, and cost-effective material for preoperative skin marker in various orthopedic surgeries. Patients and Methods: We performed a retrospective review of prospectively collected data of 50 cases with various indications of preoperative localization of skin incision and divided them in 2 groups: Group A (n=25) were the patients where Henna was to be used as marker and group B (n=25) were the ones where permanent skin marking pen was decided to be used for the purpose of skin marking. The groups were compared for the instances of mark ...
Source: Techniques in Orthopaedics - November 29, 2020 Category: Orthopaedics Tags: Novel Research Methods and Models Source Type: research

Sedation Analgesia for Orthopedic Procedures: An Analysis of Cost and Length of Stay in a Level 1 Trauma Center
Orthopedic reductions can be performed using a wide range of sedation types. Ideally, minimal sedation is applied in the emergency department (ED). In our institution, however, conscious sedation is performed in the ED but is largely unavailable in our trauma center (TC). Therefore, we retrospectively evaluated clinical outcomes and monetary costs associated with identical procedures performed in these different locations. A total of 297 patients were identified: 189 were treated in the TC, and 108 were managed in the ED. A subset of patients were matched by age, injury, and Injury Severity Score. Medical charts were revie...
Source: Techniques in Orthopaedics - November 29, 2020 Category: Orthopaedics Tags: Novel Research Methods and Models Source Type: research

The Economics of New Technology
This article reviews the available evidence with regards to the hospital, surgeon, and total cost when comparing lengthening over a nail versus MLN in the femur and lengthening and then nailing versus MLN in the tibia. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - August 30, 2020 Category: Orthopaedics Tags: Symposium Source Type: research

Motorized Intramedullary Lengthening Nails: Outcomes and Complications
The outcomes of motorized intramedullary lengthening nails are overwhelmingly good with acceptable complication rates and high surgeon satisfaction. While patients report overwhelming approval to surgeons, universal orthopedic outcomes scores fail to capture the true benefits of these procedures. Many studies have been cited in table format in this report. Pearls from experienced surgeons are reviewed and include the benefits of antegrade nailing over retrograde, prophylactic soft tissue release, and blocking screw use. Pitfalls are explored to keep the reader vigilant for mechanical failure of the nail, delayed healing, a...
Source: Techniques in Orthopaedics - August 30, 2020 Category: Orthopaedics Tags: Symposium Source Type: research

Bone Transport With Internal Devices
This article describes a patient selection, indications, devices, techniques, complications, and our suggested treatment protocol. The nails allow for combinations of transport and lengthening, avoiding the use of external fixators and their inherent drawbacks: pin track infection, scarring, and the inconvenience of carrying an external device for a prolonged time. Modern implants allow full weight-bearing during treatment. Meticulous surgical planning, infection prophylaxis, healthy soft tissues, vigorous training, and rehabilitation are essential for good outcomes. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - August 30, 2020 Category: Orthopaedics Tags: Symposium Source Type: research

Compression of Nonunions With the PRECICE Magnetic Intramedullary Compression Nail
The magnetic intramedullary lengthening nail can be predistracted and used to compress bony interfaces to assist in the healing of nonunions of long bones and to accelerate union at difficult to heal fractures and osteotomy sites. This requires no special implant apart from the lengthening nail. Technical considerations include predistraction of the nail on the back table, overreaming of the canal, shortening at the defect site, and applying compression over several days. Patients can weight-bear immediately and often return to work quickly. The same nail can be used for bone lengthening, after union is achieved, by creati...
Source: Techniques in Orthopaedics - August 30, 2020 Category: Orthopaedics Tags: Symposium Source Type: research

Motorized Internal Lengthening of Long Bones: Residual Limb Lengthening
Distraction osteogenesis can be performed for transfemoral amputees using a motorized intramedullary limb lengthening nail (LLN) such as the 14×130 mm NuVasive Freedom nail. Despite being the shortest commercially available LLN, some patients have even shorter residual femurs, making it impossible to link the bone to the nail by the standard technique of inserting a cross-locking bolt through the proximal and distal nail holes. Two modified techniques of linking a very short femur to a LLN are introduced in this manuscript. The triple cable lasso technique passes 2 cerclage cables transversely through the cort...
Source: Techniques in Orthopaedics - August 30, 2020 Category: Orthopaedics Tags: Symposium Source Type: research

Stryde Weight-bearing Internal Lengthening Nail
Since May 2018, 106 patients (187 limb segments) have completed internal lengthening with the Stryde implant. Fifty-seven skeletally mature patients (12 female and 45 male) underwent cosmetic stature lengthening of the femur (41), tibia (4), or combined bilateral femur and tibia (12). Forty-nine other patients (ages 9 to 60 y) with a variety of limb length discrepancy etiologies including metabolic, congenital, genetic, and posttraumatic, underwent unilateral lengthening of the femur (37) or tibia (12). All patients undergoing lengthening alone were allowed immediate full weight-bearing as tolerated. Patients with s...
Source: Techniques in Orthopaedics - August 30, 2020 Category: Orthopaedics Tags: Symposium Source Type: research

Extramedullary Internal Limb Lengthening
Extramedullary implantable limb lengthening (EMILL) uses an implantable nail attached to the bone like and internal-external fixator. Cantilever forces can be neutralized by inserting a small diameter solid rod as a guide inside the medullary canal. EMILL expands the indications for internal limb lengthening to younger children with smaller diameter and length bones and to bones with impassable medullary canals. One must follow the same principles as with external fixation lengthening including prevention of joint subluxation and contracture by preparatory surgery (eg, pelvic osteotomy), soft tissue releases, temporary art...
Source: Techniques in Orthopaedics - August 30, 2020 Category: Orthopaedics Tags: Symposium Source Type: research

Long Bone Lengthening in Children
Intramedullary lengthening nails have revolutionized the field of limb lengthening. Although pediatric patients can benefit from this new technology, the size of the bones and the presence of open physes create potential impediments that must be recognized by the surgeon. This review of pediatric intramedullary limb lengthening describes the key elements and nuances that will help guide the surgeon towards a successful outcome. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - August 30, 2020 Category: Orthopaedics Tags: Symposium Source Type: research

Antegrade Humeral Lengthening With the Motorized Internal Lengthening Nail
Humerus lengthening with internal lengthening nails (ILNs) has been used with success to avoid complications associated with lengthening using external fixators (eg, soft tissue tethering). ILNs can be used in skeletally mature patients with humeral shortening who have an intramedullary canal wide enough to fit the nail, and who has no active infection. Associated deformity (angular or rotational) can be corrected acutely using the ILN as long as it would be tolerated by the neurovascular structures. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - August 30, 2020 Category: Orthopaedics Tags: Symposium Source Type: research

Tibial Lengthening Technique
Lengthening of the tibia with a motorized internal nail is effective and has advantages over the traditional use of external fixation. Since nail entry is through the proximal end of the bone, it is indicated for skeletally mature patients. Principles of leg-lengthening must be followed but the techniques have been modified from those of external fixation. Fibula relationship to the tibia is protected with fibula length stabilization screws. If there is a deformity, then fixator assisted nailing and the use of blocking screws are used to acutely correct the alignment, and then gradual lengthening follows. Judicious use of ...
Source: Techniques in Orthopaedics - August 30, 2020 Category: Orthopaedics Tags: Symposium Source Type: research

Retrograde Femur Technique for Motorized Internal Limb Lengthening
Deformities of the femur that combine deviations of axis and torsion with length discrepancies are seen quite often. Nevertheless, the surgical treatment can be demanding, especially if fully implantable lengthening nails are used for simultaneous lengthening and deformity correction. The technique of retrograde insertion of a lengthening nail into the femur offers a wider range for correction and allows the treatment of even complex deformities with a single-step procedure. The key to successful application of the technique is meticulous preoperative analysis and planning. The surgical procedure should follow a standardiz...
Source: Techniques in Orthopaedics - August 30, 2020 Category: Orthopaedics Tags: Symposium Source Type: research

The Antegrade Femur Technique
In this chapter, we examine the antegrade technique of insertion of magnetically controlled intramedullary lengthening implants. We discuss the indications, preoperative planning, surgical technique, and postoperative management, as well as tips and tricks for success. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - August 30, 2020 Category: Orthopaedics Tags: Symposium Source Type: research

Principles of Motorized Internal Lengthening of Long Bones
Motorized intramedullary lengthening nails (ILNs) have revolutionized limb lengthening surgery and led to an expansion of indications utilizing them for both upper and lower limb lengthening, fracture compression, and nonunion treatment. There are biological and mechanical differences between using ILNs and using external fixators for lengthening surgery that the treating surgeon must be familiar with. Biological factors include regenerate quality, healing indices, and regenerate complications. Mechanical differences pertain to the lengthening axis, stability, and postoperative weight-bearing. Practical principles of ILNs ...
Source: Techniques in Orthopaedics - August 30, 2020 Category: Orthopaedics Tags: Symposium Source Type: research

Motorized Internal Limb Lengthening: International Perspectives
No abstract available (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - August 30, 2020 Category: Orthopaedics Tags: Preface Source Type: research

Preface
No abstract available (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - August 30, 2020 Category: Orthopaedics Tags: Preface Source Type: research

Hip Arthroscopy Technique for Acetabular Osteochondral Loose Bodies After Combined Lower Extremity Trauma
We describe a case of an acetabular fracture and ipsilateral open tibia/fibula fracture with osteochondral loose bodies in the hip joint inhibiting physical therapy potential, treated successfully with arthroscopic removal using an adjusted skeletal traction method. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - May 22, 2020 Category: Orthopaedics Tags: Special Technical Articles Source Type: research

Surgical Technique for Closed Reduction and Percutaneous Pinning of Pediatric Lateral Humeral Condyle Fractures
Lateral condyle fractures are intra-articular injuries of the distal humerus and are the second most common elbow fracture in pediatric patients. When these fractures involve significant displacement, anatomic reduction of the lateral condyle fragment is commonly achieved using open reduction techniques. Although a technique for closed reduction of lateral condyle fractures has been proposed in the literature, an instructional, step-by-step description of such a technique has yet to be published. We have built upon the previously published closed reduction technique by focusing on the pathomechanism of injury, with the goa...
Source: Techniques in Orthopaedics - May 22, 2020 Category: Orthopaedics Tags: Special Technical Articles Source Type: research

Manual of Wiring Techniques for Orthopedic Surgery
Cerclage and tension band wiring techniques can be inexpensively and effectively utilized in orthopedic surgical procedures, many of which are enumerated in this article. The following cerclage wiring configurations are described and demonstrated in accompanying videos: wrapped around once and wrapped around twice patterns locked with a symmetric twist, knot twist, eyelet bend-back, or crimped double barrel sleeve; doubled symmetric twist; hairpin loop; and Mittelmeier’s double loop bend-back with twist. Tension band wiring variations are also described and illustrated. Modes of wire failure are discussed and display...
Source: Techniques in Orthopaedics - May 22, 2020 Category: Orthopaedics Tags: Special Technical Articles Source Type: research

Does Patella Resurfacing Affect Postoperative Blood Loss in Patients Undergoing Total Knee Replacement?
Patella resurfacing in total knee arthroplasty remains a surgeon-specific decision. Possible benefits of resurfacing include decreased knee pain and rate of reoperation, while complications can occur. No study has assessed postoperative blood loss and transfusion rate as a function of patella resurfacing. Certain patient groups such as elderly patients, Jehovah’s Witnesses, and coagulopathy patients may especially benefit from decreased blood loss during orthopedic surgeries. A retrospective chart review of patients with total knee arthroplasty performed by a single surgeon was conducted. In total, 124 patients were ...
Source: Techniques in Orthopaedics - May 22, 2020 Category: Orthopaedics Tags: Special Technical Articles Source Type: research

Treatment of Periprosthetic Patella Fractures Using a Lag Screw and Neutralization Plate Construct: A Novel Surgical Technique
In this report, we present a novel fixation method for transverse peri-prosthetic patella fractures that was utilized in 3 knees with resurfaced patellas in 2 patients and has yielded good clinical results. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - May 22, 2020 Category: Orthopaedics Tags: Tips and Pearls Source Type: research

The Cost of Postoperative Infection Following Orthopaedic Fracture Surgery
The objective of this paper is to describe the costs associated with postoperative infection following orthopedic fracture surgery. The data provided is based on a narrative review and an analysis of national claims and discharge databases in the United States. The narrative research specifically evaluated the costs associated with postoperative infections following the treatment of proximal femur, tibia, humerus, and ankle fractures. Two US databases were used to estimate the annual incidence of a deep surgical site infection following fracture treatment and the costs associated with that treatment. Previous studies sugge...
Source: Techniques in Orthopaedics - May 22, 2020 Category: Orthopaedics Tags: Symposium Source Type: research

Current Treatments of Tibial Surgical Site Infection and Osteomyelitis After Fracture Surgery
Infections after tibia fracture are one of the most challenging areas of orthopedic care. Specialized techniques are required to achieve resolution of the infection and bony union. We detail here our strategies for infection debridement, temporary skeletal stabilization, antibiotic administration, and definitive reconstruction. Special emphasis is on the treatment of osteomyelitis of the tibial shaft; however, these same techniques can be applied to other areas of the skeleton as well. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - May 22, 2020 Category: Orthopaedics Tags: Symposium Source Type: research

Best Practices and Evolving Techniques for Preventing Infection After Fracture Surgery
Orthopedic trauma-related infections remain one of the major complications in modern trauma and orthopedic surgery. Despite current preventive practices, infection rates range from ~1% after operative fixation of closed low-energy fractures to>30% in complex open tibia fractures. Fracture-related infections negatively impact clinical outcome with lifelong functional impairment and significantly increase health care expenditure. In addition, the escalating issue of antimicrobial resistance continues to pose a challenge to clinicians. Unfortunately, in orthopedic trauma, only a few preventive measures are strongly support...
Source: Techniques in Orthopaedics - May 22, 2020 Category: Orthopaedics Tags: Symposium Source Type: research

Will My Fracture Surgery Get Infected? Evidence-based Risk Factors
We present a narrative review of the literature to facilitate evidence-based risk stratification for patients undergoing fracture fixation. Risk factors, including diabetes, hyperglycemia, end-stage renal disease requiring hemodialysis, human immunodeficiency virus, acquired immunodeficiency syndrome, hepatitis C, and alcohol abuse, have consistently been shown to increase infection risk in orthopedic surgery. Other risk factors, including smoking, obesity, and the use of immunomodulatory medications, have been shown to have varying direct impact on postoperative SSI depending on the study and the specific fractures examin...
Source: Techniques in Orthopaedics - May 22, 2020 Category: Orthopaedics Tags: Symposium Source Type: research

Non–culture-based Methods to Aide in the Diagnosis of Implant-associated Infection After Fracture Surgery
Implant-associated infection after fracture surgery is an unfortunate reality for patients and physicians that has long-term, far-reaching implications for treatment, functional recovery, and health care costs. Classically, culture-based methods are used for diagnosis, though “culture-negative” infection is not an uncommon clinical scenario. On the other side, false-positive results can lead to unnecessary antibiotic treatment or surgical intervention. For all parties involved, timely, accurate, and noninvasive diagnostic methods are desirable. It is recognized that bacterial biofilms complicate culture-based d...
Source: Techniques in Orthopaedics - May 22, 2020 Category: Orthopaedics Tags: Symposium Source Type: research

How to Diagnose Surgical Site Infection After Fracture Surgery: We Have a Problem!
Infections after fracture are often devastating complications and despite widespread efforts to these infections, there are still 100,000 cases of reported fracture-related infection yearly in the United States. Although infection after fracture surgery is common, there is important uncertainty regarding various aspects of diagnosing these infections including a lack of standardization of what the definition of an infection should be in this setting. Most infections after fracture surgery present with obvious clinical signs of infection, but sometimes the signs are more subtle. Furthermore, it is not possible to obtain dia...
Source: Techniques in Orthopaedics - May 22, 2020 Category: Orthopaedics Tags: Symposium Source Type: research

In Memory of Mark Shirtliff, PhD: Modern Concepts in Diagnosis, Treatment, Prevention, and Cost of Infection After Fracture Surgery
No abstract available (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - May 22, 2020 Category: Orthopaedics Tags: Preface Source Type: research

Radiographic Evaluation of the Distal Radioulnar Joint: Technique to Detect Sigmoid Notch Intra-Articular Screw Breach in Distal Radius Fractures
Conclusions: The “extended tangential view” and the “sunrise view” improved one's ability to identify DRUJ screw breach and for directing screw repositioning over standard views. We recommend the “sunrise” and “extended tangential” view be obtained intraoperatively to help guide clinical decision-making. Although the “extended tangential view” is more easily obtained with a mini c-arm than the “sunrise view,” both views should be considered to fully evaluate the DRUJ joint. Clinical Relevance: Both the “extended tangential” and “...
Source: Techniques in Orthopaedics - February 21, 2020 Category: Orthopaedics Tags: Special Technical Articles Source Type: research

Total Hip Arthroplasty in Untreated Ankylosing Spondylitis: Tips and Tricks to Avoid Complications
Ankylosing spondylitis (AS) is a seronegative inflammatory disease that progressively affects the spine and sacroiliac joints and is more common in men with the B 27 human leucocyte antigen. This leads to inflammation, synovitis and, eventually, secondary arthritis in the hips of those affected. Hips of those affected are often completely ankylosed at time of presentation to the orthopedic surgeon. Total hip arthroplasty offers a stable mobile hip for patients who are functionally disabled due to their debilitating disease. As disease progresses, the native hip anatomy, which is familiar to orthopedic surgeon in routine to...
Source: Techniques in Orthopaedics - February 21, 2020 Category: Orthopaedics Tags: Special Technical Articles Source Type: research

A Comparison of Adjuvant Techniques on Setting Time of Octyl-2-Cyanoacrylate (DERMABOND Advanced)
Octyl-2-cyanoacrylate is a topical skin adhesive (TSA) that has gained popularity over the last decade for wound and incisional wound closure. TSAs have been used with or without suture when closing lacerations or operative incisions. One brand of octyl-2-cyanoacrylate, DERMABOND, was shown to have high wound bursting strength and tensile force, large number of normal tensile loading cycles to failure, long time to failure, and short setting time. Many intraoperative methods have been used by surgical staff in an effort to reduce curing time (ie, time for the tissue adhesive to set), including waving a hand or towels over ...
Source: Techniques in Orthopaedics - February 21, 2020 Category: Orthopaedics Tags: Special Technical Articles Source Type: research

Trochanteric-sparing Proximal Femoral Resection for Arthritic Spastic Hips
Progressive hip subluxation or dislocation leading to degenerative disease, in neuromuscular disease, is a significant cause of morbidity to the patient and burden to the caretaker. Surgical salvage procedures have unpredictable success. We hypothesized that modifying the Castle-type proximal femoral resection by securing a retained greater trochanter with its musculature to the capsular arthroplasty and femoral shaft would compartmentalize the femur to decrease proximal femoral migration and heterotopic ossification (HO), thereby precluding the need for traction and HO prophylaxis while improving pain and caretaker satisf...
Source: Techniques in Orthopaedics - February 21, 2020 Category: Orthopaedics Tags: Special Technical Articles Source Type: research

Simple Suction Tube Tensioning Technique for Anterior Cruciate Ligament (ACL) Grafts
No abstract available (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - February 21, 2020 Category: Orthopaedics Tags: Tips and Pearls Source Type: research

The Transtrochanteric Approach to the Total Femur Replacement: A Novel Technique
Nononcologic total femur replacement (TFR) secondary to periprosthetic fracture, aseptic loosening or infection has had many surgical approach options provided in the literature. No single approach has been proven to be superior in preventing postoperative complications due to its rare and complex nature, however. Therefore, we believe that a successful outcome following a previously undescribed approach for a TFR is valuable contribution to the current literature. Technique, in the following report, we present is a transtrochanteric approach to a TFR. This approach involved a vertical transtrochanteric osteotomy which all...
Source: Techniques in Orthopaedics - February 21, 2020 Category: Orthopaedics Tags: Tips and Pearls Source Type: research

An Easy Positioning Technique for Complex Proximal Tibia Fractures
No abstract available (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - February 21, 2020 Category: Orthopaedics Tags: Tips and Pearls Source Type: research

Use of a 3D-Printed Custom Reverse Shoulder Arthroplasty
Reverse shoulder arthroplasty is an established treatment for rotator cuff tear arthropathy of the shoulder. In cases of deformity of the glenoid with limited bone stock, implantation of a noncustomized glenoid implant could be challenging. In this technique article, we report 2 cases with severe glenoid deformity. The first case is a 74-year-old woman presenting with rotator cuff tear arthropathy of the shoulder with a severly deformed glenoid. The second case is a 63-year-old woman with deformity of the glenoid after hemiarthroplasty of the shoulder. Both patients were succesfully treated with a 3D-printed customized gle...
Source: Techniques in Orthopaedics - February 21, 2020 Category: Orthopaedics Tags: Tips and Pearls Source Type: research