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An Approach to the Management of Bilateral Posterior Shoulder Dislocations Following Seizure: Case Report, Literature Review, and Proposed Treatment Algorithm
We report a case, describe the surgical techniques used, and propose an algorithm for managing the treatment of a young patient who presents with bilateral posterior dislocations related to a seizure. At her most recent follow-up (57 mo postoperative for the left shoulder and 41 mo postoperative for the right shoulder), she denied any apprehension or instability in either shoulder and had no further dislocations. She reported mild chronic pain in both shoulders, worse in the right than the left. She has a smooth passive range of motion with no crepitus in either shoulder. Her range of motion in forward elevation/extern...
Source: Techniques in Shoulder and Elbow Surgery - November 14, 2019 Category: Orthopaedics Tags: Techniques Source Type: research

Reconstruction of Chronic Distal Biceps Tendon Rupture With Autogenous Semitendinosis Graft Using the “Anatomic Length Method” and Concomitant Bicipital Aponeurosis Repair
We present a novel variation of a surgical technique for reconstruction of chronic distal biceps tendon ruptures using the “Anatomic Length Method.” Graft length for chronic distal biceps tendon rupture reconstruction is extremely variable and typically empirically determined by elbow position during final fixation. These techniques do not account for chronicity and varying degrees of retraction and muscle shortening. For this unique variation in the surgical technique, the graft length used is based on previous anatomic cadaveric measurements done in our center with an external distal biceps tendon length mean of 6.3...
Source: Techniques in Shoulder and Elbow Surgery - November 14, 2019 Category: Orthopaedics Tags: Techniques Source Type: research

The Mini-open Plication of Medial Collateral Ligament of the Elbow: A New Arthroscopically Assisted Technique
The stability of the medial elbow compartment is not only important for everyday life but also plays a key role in throwing gestures. Valgus stress is a fundamental part of popular sport activities (baseball, squash, tennis, and volleyball). Even the isolated medial collateral ligament (MCL) lesion might develop symptomatic medial instability, which interrupts everyday life. This instability may be symptomatic and patients may refer medial elbow pain. Several techniques for MCL treatment have been described. Most of them are reconstructions in which there are tunnels and free cylindrical grafts. The aim of our study is to ...
Source: Techniques in Shoulder and Elbow Surgery - November 14, 2019 Category: Orthopaedics Tags: Techniques Source Type: research

High-grade Common Extensor Tendon Tears Maintaining Chronic Lateral Epicondylitis: Clinical and Structural Outcome Following Knotless Suture Anchor Repair
We describe the reconstruction of high-grade extensor tendon tears using a knotless suture anchor and hypothesize that this will result in improved elbow pain and function with a high healing rate. Twenty chronic lateral epicondylitis patients with magnetic resonance imaging–confirmed high-grade extensor tendon tears underwent surgery using a knotless suture anchor technique. All underwent clinical and ultrasound assessments and completed the quick Disabilities of the Arm, Shoulder, and Hand and patient-rated tennis elbow evaluation questionnaires at final follow-up. Preoperative and postoperative Mayo Elbow Performance ...
Source: Techniques in Shoulder and Elbow Surgery - November 14, 2019 Category: Orthopaedics Tags: Techniques Source Type: research

Clinical Outcomes of Lateral Ulnar Collateral Ligament Repair of the Elbow Using a Cortical Button
The purpose of this retrospective case series was to report a new surgical technique for lateral ulnar collateral ligament (LUCL) repair using a cortical button and the clinical results. Twenty patients underwent a LUCL repair using a cortical button at a single institution were included for evaluation of the demographic, radiologic, and clinical examination data. Nine patients returned for a separate study visit for further clinical examination and outcome surveys. Eighteen patients (mean age: 48 y, 10 males) received at least 1 additional procedure other than a LUCL repair. For the 9 patients who returned for a study v...
Source: Techniques in Shoulder and Elbow Surgery - November 14, 2019 Category: Orthopaedics Tags: Research Article Source Type: research

Correction of Elbow Flexion Deformity in Patients Affected With Spasticity Through the Lateral Approach: Surgical Technique and Results
Fixed and dynamic elbow flexion deformity due to spasticity represents a common, yet challenging, clinical entity. Several surgical options have been described in literature, the majority of which utilize the anterior approach, through the antecubital fossa to release biceps. We propose a novel technique, using the lateral approach, as a safer and simpler option that allows release of the brachialis while leaving biceps intact to act as a supinator. All patients that were referred to our institution for treatment of an elbow flexion deformity due to spasticity between 2012 and 2016 were assessed. Patients with a previous h...
Source: Techniques in Shoulder and Elbow Surgery - August 1, 2019 Category: Orthopaedics Tags: Techniques Source Type: research

Reconstruction of the Acromioclavicular Joint With 360-degree Control
Conclusion: This modification of the twin-tailed Dog Bone technique using FibreTape resulted in a high patient self-rating of their shoulder function and a low rate of complications. (Source: Techniques in Shoulder and Elbow Surgery)
Source: Techniques in Shoulder and Elbow Surgery - August 1, 2019 Category: Orthopaedics Tags: Techniques Source Type: research

Anterior Capsular Reconstruction of the Shoulder for Chronic Instability Using a Dermal Allograft
Chronic anterior shoulder instability after failed surgical stabilization procedures poses a significant challenge to orthopedic surgeons. Here, a novel technique of an anterior capsular reconstruction with a dermal allograft is presented. The shoulder remained stable with no recurrent dislocations at a final follow-up of 24 months. Excellent range of motion, strength, and good patient satisfaction is noted. Outcomes following the use of a dermal allograft for anterior capsular reconstruction have not been previously reported in the literature, and its use for chronic anterior shoulder instability shows promising initial r...
Source: Techniques in Shoulder and Elbow Surgery - August 1, 2019 Category: Orthopaedics Tags: Techniques Source Type: research

Glenoid Fractures Treated by Percutaneous Osteosynthesis Under Arthroscopic Control
Glenoid fractures are scarce and their treatment is discussed. Osteosynthesis under arthroscopy has been essentially described in bony Bankart lesions. Concerning bigger fractures of the glenoid cavity, eventually combined with a scapula body fracture, the arthroscopic treatment is difficult and still less practiced. Here, we describe 3 cases of external osteosynthesis by pins and/or cannulated screws under arthroscopic control. We put forward the case of a transclavicular approach for an associated fracture of the lateral quarter of the clavicle. The radiologic and functional results are good, with a rapid recovery of usu...
Source: Techniques in Shoulder and Elbow Surgery - August 1, 2019 Category: Orthopaedics Tags: Techniques Source Type: research

Clinical Results of Conservative Treatment of Severe Proximal Humerus Fractures Requiring Surgical Treatment in Old Patients
The purpose of this study was to investigate the clinical outcomes of nonsurgically treated proximal humerus fractures that would have been otherwise treated surgically had it not been for reasons precluding surgical treatment. A retrospective search for patients treated nonsurgically for a proximal humerus fracture was performed. Injury x-rays of all patients were reviewed independently by 3 orthopedic surgeons. Patients for whom at least 2 surgeons recommended surgical treatment were included. Of 96 eligible patients, 22 patients completed the data collection. There were six 2-part, seven 3-part, five 4-part fractures, a...
Source: Techniques in Shoulder and Elbow Surgery - August 1, 2019 Category: Orthopaedics Tags: Research Articles Source Type: research

Treatment of Sagittal Split Olecranon Fractures Using Dorsal Plates Combined With Tension Band Wiring or Cerclage Wires
We evaluated the results of olecranon fractures with an intra-articular sagittal plane fracture treated by dorsal plates in combination with tension band wiring or cerclage wires. We included patients with comminuted olecranon fractures with sagittal split treated with combination fixation. Postoperative functional assessment, Mayo Elbow Performance Score (MEPS) and complications were recorded. The mean age of patients was 52 years (SD±16). There were 7 female and 5 male patients. There were 2 1B, 7 2B, and 3 3B fractures according to Mayo classification. All patient’s fractures healed satisfactorily. There was one mino...
Source: Techniques in Shoulder and Elbow Surgery - August 1, 2019 Category: Orthopaedics Tags: Research Articles Source Type: research

CT-guided Navigation in Shoulder Arthroplasty
Successful anatomic and reverse total shoulder arthroplasty require a detailed understanding of each individual patient’s pathology. Advances in preoperative imaging continue to give surgeons a greater ability to customize implants to recreate native anatomy. Technological advancements have attempted to harness this information in the form of patient-specific instrumentation and more recently computed tomography-guided navigation. However, goals of shoulder arthroplasty remain the same: precise implant placement in order to maximize glenohumeral range of motion and stability while minimizing impingement to increase impla...
Source: Techniques in Shoulder and Elbow Surgery - May 1, 2019 Category: Orthopaedics Tags: Hot Topics and Controversies Source Type: research

Patch Reinforcement of Rotator Cuff Repairs: Current Indications
Patch reinforcement of rotator cuff repairs is continuing to evolve. Patches in rotator cuff repair can be used for suture reinforcement, augmentation, or interposition. We will discuss current indications for patch reinforcement of rotator cuff repairs. (Source: Techniques in Shoulder and Elbow Surgery)
Source: Techniques in Shoulder and Elbow Surgery - May 1, 2019 Category: Orthopaedics Tags: Hot Topics and Controversies Source Type: research

When is the Reverse Shoulder Arthroplasty Indicated for Massive Rotator Cuff Tears Without Arthritis?
No abstract available (Source: Techniques in Shoulder and Elbow Surgery)
Source: Techniques in Shoulder and Elbow Surgery - May 1, 2019 Category: Orthopaedics Tags: Hot Topics and Controversies Source Type: research

Shoulder Instability: Arthroscopic Capsulolabral Repair: the Gold Standard
There still exists some skepticism in the orthopedic community regarding the effectiveness of all-arthroscopic shoulder stabilization surgeries, mostly due to older literature, which report high failure rates when compared to open surgery. We look to present the modern indications and techniques of arthroscopic shoulder stabilization and highlight recent studies which show equivalent or superior results even in the contact athlete. There exists an abundance of literature which shows arthroscopic shoulder stabilization done with proper anchor placement, incorporating capsulolabral shifts, with the patient positioned in late...
Source: Techniques in Shoulder and Elbow Surgery - May 1, 2019 Category: Orthopaedics Tags: Hot Topics and Controversies Source Type: research