Techniques in Shoulder and Elbow Surgery This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Prebending of Osteosynthesis Plates Versus Screw and Cerclage Fixation for Os Acromiale or Acromion Fracture; the 3D Technique and Mechanical Testing
This study compares the in vitro outcome parameters of 2 surgical techniques: hollow screws with cerclage fixation (HC) versus patient-specific plate osteosynthesis (PO). The techniques were tested on scapulae of 5 fresh-frozen cadavers as a treatment for symptomatic os acromiale or acromion fracture, to assess ultimate failure strength, stiffness, and fracture pattern. An existing osteosynthesis plate is preoperatively shaped by a printed 3-dimensional model of the acromion of the cadaver. The strength for the PO group [mean, 254.08±130.35 N (range, 118.12 to 404.19 N); P=0.10] was significantly different from the HC...
Source: Techniques in Shoulder and Elbow Surgery - May 2, 2018 Category: Orthopaedics Tags: Techniques Source Type: research

Isolated Traumatic Dislocation of the Radial Head in a Pediatric Patient: A Case Report and Literature Review
We report the case of an infant with isolated dislocation of the radial head treated with open reduction. Intraoperative inspection showed that the distal margin of the annular ligament was twisted proximally over the radial head. Reduction of the radial was achieved by repositioning the annular ligament around the head of the radius. One year after the injury, the patient had normal elbow function. The anatomic underlying lesion was a luxation of the radial head out of the annular ligament, which was in fact intact. The literature review shows that closed reduction is usually, but not always, possible. If closed reduction...
Source: Techniques in Shoulder and Elbow Surgery - May 2, 2018 Category: Orthopaedics Tags: Techniques Source Type: research

Arthroscopic Release of the Pronator-Flexor Origin for Medial Epicondylitis
We performed arthroscopic surgery for medial epicondylitis and evaluated pain relief, self-assessed functional outcome, and complications after the procedure. The patients included 2 males and 2 females with a mean age of 48.3 years. The average length of follow-up was 16.2 months. The pronator-flexor origin was partially released from the medial epicondyle in all elbows. In 2 cases, débridement of calcinosis in the pronator-flexor origin was also performed. In 2 of the 5 elbows, active flexion was preoperatively limited to 100 degrees, but the range of flexion recovered to the same as that on the contralateral side by th...
Source: Techniques in Shoulder and Elbow Surgery - May 2, 2018 Category: Orthopaedics Tags: Techniques Source Type: research

A Method to Facilitate Improved Positioning of a Reverse Prosthesis Stem During Arthroplasty Surgery: The Metaphyseal-centering Technique
Because humeral head offset values vary widely from patient to patient, the final position of the proximal portion of a stemmed humeral prosthesis will sometimes not align well with respect to the center of rotation of the humeral head. This is especially notable when a humeral component with limited modularity is used. To address this problem, a prosthesis-specific method is presented for orienting a reverse shoulder humeral component (AltiVate Reverse, DJO Surgical, Austin, TX). With the metaphyseal-centering technique, priority is given to the positioning of the shell portion of the prosthesis over that of the stemmed p...
Source: Techniques in Shoulder and Elbow Surgery - May 2, 2018 Category: Orthopaedics Tags: Techniques Source Type: research

The “Norris PSI”: 3D Planning and Patient-specific Instruments for Reconstruction of Large Glenoid Defects and Reverse Shoulder Arthroplasty
Large glenoid defects after revision surgery for total arthroplasty of the shoulder impose a surgical challenge. The use of a tricortical bone graft from the iliac crest has been advocated to restore osseous integrity between the scapular bone and the glenoid baseplate. However, in the absence of osseous landmarks correct base plate implantation regarding inclination and version is extremely difficult. A new technique for a staged exchange of a chronically infected shoulder prosthesis is described. After removal of all implants, 3-dimensional (3D) computed tomographies of the scapula and of the ipsilateral pelvis were obta...
Source: Techniques in Shoulder and Elbow Surgery - May 2, 2018 Category: Orthopaedics Tags: Techniques Source Type: research

Achieving the Optimum Bone Block Position in the Latarjet Procedure: Surgical Technique
We describe a new technique that allows positioning of the coracoid bone using 2 Kirschner wires inserted at the anterolateral edge of the glenoid at 4 to 5 o’clock to act as a railroad and guide exact bone block placement. We have had no recurrences of instability or any intraoperative complications since adopting this technique. (Source: Techniques in Shoulder and Elbow Surgery)
Source: Techniques in Shoulder and Elbow Surgery - May 2, 2018 Category: Orthopaedics Tags: Techniques Source Type: research

Scapular Notching in Revision Reverse Total Shoulder Arthroplasty
The primary goals of this study were to compare notching in revision and primary reverse total shoulder arthroplasty (RTSA) and to evaluate the effect of glenosphere offset in revision RTSA. Sixty-two primary and 21 revision RTSAs performed by a single surgeon with a minimum of 1-year radiographic follow-up were evaluated. Radiographs were evaluated with the Nerot-Sirveaux grading system for notching severity, and the position of glenosphere offset was noted as inferior, standard, or superior. Notching occurred in 11 (18%) primary RTSAs and 9 (43%) revisions (P=0.03). Inferior glenosphere position was associated with notch...
Source: Techniques in Shoulder and Elbow Surgery - May 2, 2018 Category: Orthopaedics Tags: Research Articles Source Type: research

Use of a Novel Hybrid Suture Technique for Arthroscopic Rotator Cuff Repair: A Biomechanical Study
Currently, arthroscopic rotator cuff (RC) repair is performed using a single row or double row suture-anchor configuration. Both of these techniques have demonstrated advantages in biomechanical pull-out strength (double row), and postoperative clinical outcomes and decreased operative time (single row). However, these separate techniques lack the advantages of the other and retear of RC repair is common in both cases with the primary mode of failure because of the suture cutting through the tendon. The aim of this study was to design 2 novel hybrid suture techniques that incorporated both double and single row concepts an...
Source: Techniques in Shoulder and Elbow Surgery - May 2, 2018 Category: Orthopaedics Tags: Research Articles Source Type: research

Aneurysmal Bone Cyst of the Clavicle
We present the rare case of a 46-year-old male patient with a clavicular ABC treated with lateral clavicle resection and reconstruction of the coracoclavicular ligaments. In addition to a review of the literature and discussion of treatment modalities, we report a new technique with reconstruction of the coracoclavicular ligaments, optimizing oncologic and functional result. (Source: Techniques in Shoulder and Elbow Surgery)
Source: Techniques in Shoulder and Elbow Surgery - January 30, 2018 Category: Orthopaedics Tags: Techniques Source Type: research

Anterolateral Approach for Distal Third Humeral Shaft Fractures: A Surgical Approach Using 3 Soft-tissue Windows
An anterolateral approach is described for the treatment of distal third humeral shaft fractures. The approach using 3 soft-tissue windows combines an anterior brachialis muscle splitting approach, a muscle interval exposure of the radial nerve between the brachialis and brachioradialis muscles, and a lateral exposure of the lateral epicondyle and the supracondylar ridge. Six patients using this approach are reported. At an average of 8 months (range, 2 to 29 mo) follow-up, all fractures had healed. The average range of motion was 11 to 132 degrees of elbow extension and flexion and 70 to 88 degrees of pronation and supina...
Source: Techniques in Shoulder and Elbow Surgery - January 30, 2018 Category: Orthopaedics Tags: Techniques Source Type: research

Failed Distal Biceps Repair With Heterotopic Ossification: A Single-stage Reconstruction Technique
We report the case of a 53-year-old man who presented with a failed primary reconstruction of a biceps brachii rupture, complicated by the formation of heterotopic ossification (HO) at the elbow in his nondominant arm. Repair of the complications of the primary surgery was undertaken in a single surgical event. The HO was taken down and then the failed biceps repair was reconstructed with a semitendinosus autograft. The patient was placed on a short course of postoperative indomethacin for 4 weeks. Follow-up at 9 months showed no radiological evidence of HO at the elbow, with return of function and strength allowing the pa...
Source: Techniques in Shoulder and Elbow Surgery - January 30, 2018 Category: Orthopaedics Tags: Techniques Source Type: research

Arthroscopic Biological Total Shoulder Resurfacing: An Alternative Surgical Technique and Treatment Option for Arthritic Shoulder Pain in Young to Middle-aged Adults
This article will discuss in detail the surgical technique, rationale, and postoperative care of this biological resurfacing technique. (Source: Techniques in Shoulder and Elbow Surgery)
Source: Techniques in Shoulder and Elbow Surgery - January 30, 2018 Category: Orthopaedics Tags: Techniques Source Type: research

Accuracy of Patient-specific Jigs for Glenoid Component Positioning in Total Shoulder Arthroplasty
Controversy remains over complication rates in total shoulder replacement prostheses, often attributed to poor glenoid component positioning and fixation. Patient-specific jigs (PSJs) offer a potential tool for improvement in the accuracy of glenoid component placement in total shoulder arthroplasty, which may improve prosthesis longevity, functional outcomes, and reduce the need for revision. Preoperative computed tomography scans of 6 pairs of dissected human cadaveric scapulae were performed. Each pair had left and right scapulae randomized to the PSJ group (N=6) or the standard procedures group (N=6). Preoperative plan...
Source: Techniques in Shoulder and Elbow Surgery - January 30, 2018 Category: Orthopaedics Tags: Research Articles Source Type: research

Primary Synovial Chondromatosis of the Shoulder With Concomitant Intra-Articular and Extra-Articular Involvement: More Than a Simple Removal of Loose Bodies
Primary synovial chondromatosis is a rare, benign disorder due to metaplastic proliferation of the synovium, leading to the formation of cartilaginous loose bodies. Typically monoarticular and intra-articular, its occurrence in the shoulder is uncommon, and concomitant extra-articular involvement is very rare. Removal of the loose bodies with synovectomy is usually the only standard form of treatment. This is the case of a 23-year-old male patient from Myanmar who presented with a 2-year history of right shoulder pain with progressive limitation of motion. Radiographic and magnetic resonance imaging findings were consisten...
Source: Techniques in Shoulder and Elbow Surgery - January 30, 2018 Category: Orthopaedics Tags: Research Articles Source Type: research

Risk Factors for Neurological Injury After Reverse Total Shoulder Arthroplasty
Nerve injury after total shoulder arthroplasty (TSA) can be a significant complication. Recent interest has been focused on the rate of nerve injury in reverse TSA (rTSA), given the anatomic changes inherent to the prosthetic design. The purpose of this study is to assess the rate of neurological injury after rTSA and correlate this with risk factors. We hypothesized that low body mass index (BMI) would be associated with an increased rate of neurological injury. A retrospective chart review of 91 consecutive rTSAs was conducted. All cases were analyzed for clinically relevant postoperative neurological injury. Sex, height...
Source: Techniques in Shoulder and Elbow Surgery - January 30, 2018 Category: Orthopaedics Tags: Research Articles Source Type: research