Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2021
"Reverse miss-a-nail technique" of reconstruction nailing for successful fixation of the ipsilateral femoral neck and shaft fracture.
Although reconstruction nails have an advantage of single-construct fixation in ipsilateral femoral neck and shaft fractures, they have not been used widely due to the technical challenges associated with their placement. Reduction is particularly demanding in patients with displaced neck fractures after nailing of the shaft fracture, and can be resulted in nonunion, malunion, and osteonecrosis. We report a new technique of reconstruction nailing after the provisional reduction and fixation of a neck fracture to achieve successful healing of this injury. ⋯ Provisional fixation after reduction of a femoral neck fracture may facilitate successful reconstruction nailing in the ipsilateral fractures of the femoral neck and shaft. This "Reverse Miss-a-Nail Technique" may minimize complications and maximize the radiologic and functional outcomes of patients who experience this injury.
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Arch Orthop Trauma Surg · Jun 2021
Extracorporal noninvasive acute retraction of STRYDE® for continued lengthening in cases with limited nail stroke: a technical less invasive solution to reload the STRYDE®.
With STRYDE® nails (NuVasive Specialized Orthopedics, San Diego, CA), lengthening nails for full weight-bearing during callus distraction have been available CE-certified since February 2019 in Europe. At present only antegrade femur nails and tibia nails with various lengths and diameters are available. Due to a mismatch of bone length and realizable (implantable) nail length e.g., in cases of skeletal dysplasia or achondroplastic dwarfism, it may happen that a desired lengthening of 6-8 cm cannot be realized because of a nail stroke from only 5 cm. ⋯ The acute reload of the STRYDE nail stroke for further distraction is possible without skin incision or invasive soft tissue approaches. Application of the fast distractor extracorporeal within a few minutes is described in detail. The intervention is technically reproducible and can be performed for the proximal femur with antegrade STRYDE nails as well as for the distal femur with retrograde STRYDE nails in adult patients.
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Arch Orthop Trauma Surg · Jun 2021
Increased articular exposure of the lateral elbow joint with the anconeus approach compared to the Kocher approach: a cadaver study.
The Kocher approach is the workhorse approach to the lateral elbow. However, the exposure is often limited, particularly for open reduction. The purpose of this study is to quantitatively compare the articular exposure of the anconeus and Kocher approaches to the lateral elbow. ⋯ The Anconeus approach provides superior exposure of the lateral elbow joint compared with the Kocher approach. We recommend consideration of the anconeus approach for treatment of select traumatic injuries of the lateral elbow requiring increased access to the ulnohumeral and radiocapitellar joints.
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Arch Orthop Trauma Surg · Jun 2021
Early clinical and radiological outcomes of a new tapered fluted titanium monobloc revision stem in hip arthroplasty.
A new fluted, titanium, monobloc stem with a three degree taper has been designed in an attempt to overcome the challenges associated with femoral reconstruction in the setting of extensive bone loss. The aim of this study was to report its early clinical and radiographic outcomes. ⋯ Positive early clinical and radiological outcomes have been observed with this tapered, fluted, titanium, monobloc stem. Based on these results, this implant may be considered as a viable option in the majority of uncemented femoral revisions.
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Biomechanical evaluation of the viscoelastic properties tissue deformation, stiffness, and maximum breaking load of the human A2 pulley. We hypothesized that the A2 pulleys of index, middle, and ring fingers exhibit no difference regarding the aforementioned biomechanical parameters. ⋯ Assessment of the viscoelastic properties of the A2 finger pulley promotes precise diagnosis of pulley lesions and will help to optimize treatment.