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Trapezius Rotation-plasty for Complicated Acromioclavicular Joint Ganglion Cysts
The acromioclavicular joint (ACJ) ganglion (producing the “geyser sign”) produces poor quality skin and risk of infection with repeated aspirations and arthroscopic resection. The primary aim is to present our pedicled muscle flap procedure to prevent wound breakdown and recurrent infection over the ACJ. The secondary aim is to report our case series’ outcomes. By using a distally based rotation flap of the trapezius muscle to the ACJ defect after lateral clavicle excision the overlying skin can be supported by a well vascularized soft tissue bed. Included participants sustained recurrent ganglion cysts producing the...
Source: Techniques in Shoulder and Elbow Surgery - November 24, 2020 Category: Orthopaedics Tags: Techniques Source Type: research

Intramedullary Screw Fixation Supplemented by Scapular Spine Plating: A Surgical Technique for the Base of Acromion Fracture
In conclusion, intramedullary screw fixation, supplemented with plating, offers a viable surgical treatment for acromion fractures, and combined with a proper postoperative rehabilitation regime, it helps patients to achieve excellent outcomes. (Source: Techniques in Shoulder and Elbow Surgery)
Source: Techniques in Shoulder and Elbow Surgery - November 24, 2020 Category: Orthopaedics Tags: Techniques Source Type: research

The Split Capsule Technique for Chronic Anterior Shoulder Dislocation: A Novel Surgical Technique and Case Series
The authors describe a novel split capsule technique for the open treatment of chronic locked anterior shoulder dislocation. The described technique is easily reproducible and focuses on preservation of the native joint with open reduction of the humeral head and soft tissue repair. The steps entail the creation of a neocapsule of the shoulder, elimination of the pseudoglenoid space with a medial capsular repair, and a combined medial and lateral capsular shift. In the present article, the procedure is outlined in detail with technical pearls, 3 case examples, and a review of treatment options. (Source: Techniques in Shoul...
Source: Techniques in Shoulder and Elbow Surgery - November 24, 2020 Category: Orthopaedics Tags: Techniques Source Type: research

Small Fragment Instrumentation for Periprosthetic Humerus Fracture Fixation Technique
Periprosthetic humerus fractures remain problematic complications that are difficult to adequately reduce and maintain reduction. Patient-related risk factors, including poor bone quality, add an additional level of complexity to maintaining fixation in the setting of relatively narrow cortical margins adjacent to the shoulder prosthesis. Based on the challenges of obtaining adequate proximal fixation and the need to minimize dependence on cerclage fixation because of nerve injury risks and inadequate fracture reduction, the authors propose an alternative method intraoperative fixation. The technique described is a method ...
Source: Techniques in Shoulder and Elbow Surgery - November 24, 2020 Category: Orthopaedics Tags: Techniques Source Type: research

Jeffery Type II Fracture of the Radial Neck of a Child: Description of the Lesion and Novel Method of Closed Reduction
The authors describe the treatment of a 13-year-old patient with a severe, posteriorly dislocated, epiphysiolysis fracture of the proximal radius. This is called a Jeffery type II lesion when the epiphysiolysis fracture takes place at the radial neck during the reduction of elbow posterior dislocation, thus causing radial head posterior displacement. There are (Source: Techniques in Shoulder and Elbow Surgery)
Source: Techniques in Shoulder and Elbow Surgery - November 24, 2020 Category: Orthopaedics Tags: Techniques Source Type: research

“Triple Window” Surgical Approach to the Elbow: A Hybrid Exposure
We present an elbow “triple window” surgical approach that preserves the contractile medial and lateral footprints of the triceps, while affording a better in-line access than a pure “triceps-on” approach. This approach only violates 50% of the central tendinous insertion, with the remainder of the central tendon and the medial and lateral muscular extensions preserved. (Source: Techniques in Shoulder and Elbow Surgery)
Source: Techniques in Shoulder and Elbow Surgery - November 24, 2020 Category: Orthopaedics Tags: Techniques Source Type: research

Management of Supracondylar Fractures in the Prone Position: Case Series, Technique, and Literature Review
In displaced supracondylar humerus fractures, closed reduction percutaneous pinning is recommended and is most commonly performed in the supine position with the arm held in hyperflexion. The risk of iatrogenic ulnar nerve injury with medial pin placement is high in this position. We performed a retrospective case series of 149 patients with displaced supracondylar humerus fractures treated in the prone position. The aim of this study was to evaluate the incidence of iatrogenic ulnar nerve injury with medial pin placement, report our technique, and conduct a literature review to serve as historical control. The rate of iat...
Source: Techniques in Shoulder and Elbow Surgery - November 24, 2020 Category: Orthopaedics Tags: Techniques Source Type: research

A Simplified Technique for Patient Positioning During Olecranon Fracture Fixation
We describe an easy and quick surgical setup requiring only 2 total knee arthroplasty foot positioners (commonly known as “paint rollers”) attached to a surgical table with the patient in a supine position. A retrospective review of 28 patients undergoing operative fixation of olecranon fractures utilizing this positioning method was performed. No patients were found to require repositioning (ie, supine to lateral) for any reason and no airway-related or positioning-related complications were noted. This setup provides excellent exposure to the operative site and stable positioning of the arm with minimal risk to the p...
Source: Techniques in Shoulder and Elbow Surgery - November 24, 2020 Category: Orthopaedics Tags: Techniques Source Type: research

New Techniques of Olecranon Tension Band Fixation: Biomechanical Evaluation Using Finite Element Method
Various fixation methods have been used to fix olecranon fractures including the plate fixation, intramedullary screws, and tension band technique. Open reduction with tension band wire fixation (TBW) has been widely accepted for the treatment of transverse displaced olecranon fractures. The aim of this study was to determine the stress developed in different types of TBW fixations in olecranon fractures on the basis of finite element analysis. A 3-dimension model of the elbow joint was created on the basis of the computerized tomography scan images. Three different configurations of TBW fixations were evaluated in this st...
Source: Techniques in Shoulder and Elbow Surgery - November 24, 2020 Category: Orthopaedics Tags: Research Article Source Type: research

Distal Biceps Tendon Ruptures: Acute Repair Versus Chronic Reconstruction Using the “Anatomic Length Method” and Concomitant Bicipital Aponeurosis Repair: A Group-matched Comparative Retrospective Study
This study suggests that chronic reconstruction of the distal biceps tendon using the “Anatomic Length Method” is a safe technique that produces similar clinical results to acute distal biceps primary repair. (Source: Techniques in Shoulder and Elbow Surgery)
Source: Techniques in Shoulder and Elbow Surgery - November 24, 2020 Category: Orthopaedics Tags: Clinical Outcomes Source Type: research

Lateralized Versus Nonlateralized Reverse Shoulder Arthroplasty: Impact on Clinical and Functional Outcomes
In conclusion, patients who underwent RSA with a lateralized glenosphere had better internal rotation range of motion, less pain, and better function than those who received a nonlateralized prosthesis. These differences were apparent within 6 months postsurgery. (Source: Techniques in Shoulder and Elbow Surgery)
Source: Techniques in Shoulder and Elbow Surgery - November 24, 2020 Category: Orthopaedics Tags: Clinical Outcomes Source Type: research

Symptomatic Nonunion of the Medial Humeral Epicondyle Fracture: A Case Report and Review of the Literature
We described the case of 1 patient with symptomatic medial humeral epicondyle nonunion, who underwent open reduction and internal fixation with excellent clinical evolution after 1 year of follow-up from time of surgery. The purpose of this study was to evaluate the outcome of open reduction and internal fixation of a medial epicondyle nonunion fragment in 1 case and present a review of the literature. (Source: Techniques in Shoulder and Elbow Surgery)
Source: Techniques in Shoulder and Elbow Surgery - August 13, 2020 Category: Orthopaedics Tags: Clinical Outcomes Source Type: research

Chronic Tear of the Distal Triceps Tendon Treated With Suture Anchors and Fascia Lata Allograft: Case Report, Surgical Technique and Literature Review
Chronic tears of the distal triceps tendon are extremely uncommon lesions. Surgical therapy can be performed with a direct reattachment of the 2 sides of the lesion or—in case of significant tendon retraction—using grafts to fill the resulting gap. Herein, we report a case of a torn distal triceps tendon that occurred in a 33-year-old patient suffering from paraplegia. The resulting functional impairment of the elbow impeded her to use a wheelchair, causing a substantial limitation to her mobility and autonomy. Preoperative clinical evaluation, x-rays, muscle-tendon ultrasound, and magnetic resonance imagingwas been pe...
Source: Techniques in Shoulder and Elbow Surgery - August 13, 2020 Category: Orthopaedics Tags: Clinical Outcomes Source Type: research

Snapping Scapula Syndrome Caused by an Osteochondroma of the Second Rib: A Novel Surgical Technique and Case Report
Snapping scapula syndrome is characterized by painful crepitus at the scapulothoracic articulation, which is worse on movement, in the particular overhead activity. A number of bony causes of snapping scapula syndrome due to ventral scapular exostoses have been previously reported. However, we present a rare case of snapping scapula syndrome resulting from an osteochondroma of the second rib, causing pain at the superior scapula with shoulder movement. This required a novel surgical multidisciplinary approach. Surgical resection was performed via a posterior trapezius-splitting approach resulting in symptom resolution. (So...
Source: Techniques in Shoulder and Elbow Surgery - August 13, 2020 Category: Orthopaedics Tags: Technique Source Type: research

Repair of an Acute Latissimus Dorsi Tendon Rupture Using Bicortical Button Fixation
We report a case of acute rupture of the latissimus dorsi in a competitive gymnast. Initial magnetic resonance imaging confirmed the injury and showed that the tendon had retracted 6 cm. Primary repair using bicortical button fixation, a novel fixation technique, was performed. The patient successfully returned to competition and reported personal best scores on high bar and parallel bars. Cadaveric studies comparing cortical buttons to sutures and suture anchors for tendon reattachment found cortical buttons to have higher loads to failure. Overall, this suggests the technique described here may provide superior outcome...
Source: Techniques in Shoulder and Elbow Surgery - August 13, 2020 Category: Orthopaedics Tags: Research Articles Source Type: research