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 3/8â...
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 cortex and the...
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 second...
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
