Navigating the Murk: Ethical and Practical Considerations for the Surgical Treatment of the Sacroiliac Joint Syndrome
The field of spine surgery has many controversies. The surgical treatment of the sacroiliac (SI) joint is, too, fraught with debate. The diagnosis of painful SI joints is currently limited to relief following “diagnostic” injections and pain generated from a suite of clinical maneuvers. Diagnoses of SI joint dysfunction are dependent entirely on patient-reported responses to provocative maneuvers and invasive procedures. There is a glaring lack of objective radiographic and objective physical examination findings for this syndrome. The evidence for treatment, and specifically for the surgical treatment of the SI joint ...
Source: Techniques in Orthopaedics - May 22, 2019 Category: Orthopaedics Tags: Symposium Source Type: research
The Evidence for Sacroiliac Joint Surgery
Sacroiliac joint (SIJ) dysfunction is a condition that has a significant impact on patient’s quality of life. In the past, accurate diagnosis of this condition has proven difficult and even when diagnosed, effective treatments with acceptable morbidity have been lacking. Recently, the use of composites of various physical examination tests in conjunction with joint injections has proven capable of diagnosing the condition with acceptable degrees of sensitivity and specificity. In addition, the advent of minimally invasive techniques for the fusion of the SIJ now offer patients an effective treatment option with morbidity...
Source: Techniques in Orthopaedics - May 22, 2019 Category: Orthopaedics Tags: Symposium Source Type: research
Clinical Diagnosis of Sacroiliac Joint Pain
There is a need to establish a standardized clinical examination, based on best available evidence, that identifies those patients with persistent back and buttock pain whose symptoms arise from the sacroiliac joint. This clinical examination is the first step in the selection of patients for controlled and guided diagnostic intra-articular block (the reference standard). This in turn is the prerequisite for selection of patients for minimally invasive therapies such as intra-articular steroid injection or for surgical fusion. The use of pain location and results from pain provocation tests is described within the context ...
Source: Techniques in Orthopaedics - May 22, 2019 Category: Orthopaedics Tags: Symposium Source Type: research
Anatomy and Biomechanics of the Sacroiliac Joint
Sacroiliac (SI) joint pain is a difficult problem that is becoming increasingly recognized for its contribution to low back pain. In certain circumstances it may present independently. However, in many scenarios the SI joint represents one of many factors contributing to axial back pain and its various referral patterns. Low back pain remains a significant burden on the health care system, accounting for ∼12 million physician office visits per year in the United States. It remains among the leading causes of disability, with expenditures in excess of $80 billion dollars every year. Surgical management of low back pain re...
Source: Techniques in Orthopaedics - May 22, 2019 Category: Orthopaedics Tags: Symposium Source Type: research
The Sacroiliac Joint in 2019
No abstract available (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - May 22, 2019 Category: Orthopaedics Tags: Preface Source Type: research
Clinodactyly
describes an abnormal curvature of the digit in the coronal plane. A familial form of clinodactyly shows autosomal dominant inheritance with an incidence of 1% in healthy newborns. In syndromic populations, the incidence is much higher, especially in Down syndrome. The small finger is the most commonly involved digit and often the clinical finding is present bilaterally. Children are often brought to clinic for evaluation of the cosmetic difference. Most agree, that an angular deformity of (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - March 1, 2019 Category: Orthopaedics Tags: Symposium Source Type: research
A Novel Anterior Approach to Pediatric Dysplastic Hip Surgeries
During surgery for developmental dysplasia of the hip, the anterior approach utilizing the Smith-Peterson interval between tensor fascia lata and sartorius is often used. Exploration of the deep acetabulum is sometimes difficult and cumbersome. We have devised a more direct approach to the hip that improves the exploration of the deep acetabulum by going medial to the sartorius between it and the iliacus. We have found this approach quite useful and easy to master without any added complication. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - February 21, 2019 Category: Orthopaedics Tags: Tips and Pearls Source Type: research
Early Surgical Treatment of High-grade Multiligamentous Knee Injuries
Conclusions:
Open operative treatment within the first 3 weeks of injury with primary repair or reconstruction of all injured structures can yield outcomes similar to those reported in patients treated with delayed or staged reconstruction of ligaments. Early treatment allows definitive management of injuries that are difficult to address on a delayed basis. Complications of infection, revision because of laxity, and stiffness are uncommon with this approach. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - February 21, 2019 Category: Orthopaedics Tags: Special Technical Articles Source Type: research
Operative Technique: Autologous Impaction Bone Grafting With Uncemented Corail Stem in Primary Total Hip Arthroplasty
We describe a novel surgical technique utilizing the patient’s own femoral head as an autogenic source of cancellous bone graft, impacted into the proximal femoral metaphysis before implanting the stem, in order to improve the quality of bone envelope. This surgical technique is safe and simple to perform and may increase patient’s bone stock. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - February 21, 2019 Category: Orthopaedics Tags: Special Technical Articles Source Type: research
Cannulated System for Sequential Intramedullary Cement Extraction From Humerus During Revision Shoulder Arthroplasty
Removal of the cement mantle during revision shoulder arthroplasty is often challenging. Previous techniques utilizing a humeral window or split osteotomy have been described. These techniques can be technically challenging, put the patient at risk for nonunion or fracture, and require implants or sutures for fixation. Intramedullary techniques have been described including the use of specialized osteotomes or cement splitters as well as the use of ultrasonic cement extraction devices. However, concerns related to fracture and thermal damage to neurovascular structures remain a concern. Here we describe an intramedullary t...
Source: Techniques in Orthopaedics - February 21, 2019 Category: Orthopaedics Tags: Special Technical Articles Source Type: research
Interosseus Wiring of Distal Radius Fractures With Volar Comminution
This study describes the technique of interosseous wiring in a 75-year-old female patient with distal radius and ulnar fractures with subsequent volar locked plate placement. This technique provides an efficient and cost-effective tool to improve anatomic reduction, interfragmentary compression, and proper plate placement in distal radius fractures of this morphology. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - February 21, 2019 Category: Orthopaedics Tags: Special Technical Articles Source Type: research
Computer-assisted Surgery in Revision Total Knee Replacement: A Description of the Technique
We present a detailed description of our preoperative planning and operative technique, and results of our prospective case series. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - February 21, 2019 Category: Orthopaedics Tags: Special Technical Articles Source Type: research
Angling Technique for Removal of a Broken Cannulated Intramedullary Nail: A Technical Note
Removal of a broken nail from long bones remains a tricky situation to deal with. We are reporting a new method for retrieval of broken nails, which is technically less demanding than other methods described in the literature. Our method is similar to angling, which is a method of fishing by means of a fishhook. In this method the broken nail is hooked under image guidance and retrieved in a retrograde manner by a nail-hook made from stainless steel wire. It removes the nail noninvasively as no further exposure is required after removal of the proximal part of the nail by traditional methods. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - February 21, 2019 Category: Orthopaedics Tags: Tips and Pearls Source Type: research
A Novel Technique for Exeter Stem Extraction
We describe a new technique for extraction of the Exeter V40 stem using the readily available Exeter offset broach handle. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - February 21, 2019 Category: Orthopaedics Tags: Tips and Pearls Source Type: research
Management of Infected Nonunited Femoral Fracture With Large Bone Defects: A Technique
Conclusions:
Our method of treatment presents a new approach for management of one of the most complicated orthopedic problems ever. Our method is economic, and cost and time saving, consuming less time and materials needed for the operation. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - February 21, 2019 Category: Orthopaedics Tags: Novel Research Methods and Models Source Type: research
