HighlightsAnterior interosseous nerve (AIN) syndrome is a pure motor pathology.The commonest causes are compression neuropathy and brachial plexus neuritis.The optimal treatment of AIN remains unclear.Most cases of AIN syndrome resolve spontaneously.Surgical decompression is indicated in cases refractory to conservative management
In this cohort of patients, fractures that were categorized as "stable" and not requiring surgery were studied for the purpose of determining differential collapse patterns in anatomically distinct areas of the lumbar spine. We have demonstrated that the thoracolumbar junction and the midlumbar spine behave differently biomechanically and recommend that these two anatomic levels be studied independently for research purposes.
Background:Total Knee Replacement (TKR) is one of the most commonly performed orthopaedic surgery(1). Immediate postoperative portable radiographs are performed after primary TKR in order to identify any potential complications and technical flaws. It also serves as a reference for comparison with subsequent radiographs. The aim of this study was to evaluate the clinical and economical value of these radiographs in TKR. It compares the quality of the portable radiograph, taken immediately post-operation, with in-suite radiographs taken 5-7 weeks post-operationMethods:In this retrospective study, a consecutive series of 389 TKR patients from January-2011 to March-2015 were reviewed. Radiological evaluation consisted of assessing the beam angle and the exposure on the images. Implant positioning was also compared by measuring the anatomical axis to look for component alignment discrepancies.Results:The quality of the portable recovery room radiograph was overall inferior to the radiology suite radiograph regarding both beam angle and exposure. Component alignment discrepancies were also identified in the angle measurements between both types of radiographs.Conclusion:Therefore, our study demonstrated that there is no clinical or financial value obtained from postoperative portable radiograph. Furthermore, Immediate recovery room radiographs should be avoided from being performed routinely and may only be used in cases where the surgeon is utilizing a new implant or technique. No external funding was provided for this study from any source.
Injuries to the pectoralis major muscle are relatively infrequent. The mechanism of injury is usually an eccentric shortening of the pectoralis major under heavy load, such as when performing a bench press exercise. We report a case that presented to us with a history of sudden pain in the left pectoral region while doing heavy bench press exercise. The patient sustained a type III D pectoralis muscle –tendon avulsion. Surgical repair was done through a bi-cortical tendon sliding technique using two cortical buttons. In this article we describe our modifications to the previously described surgical technique for the pectoralis major tendon repair using the EndoButton and tension – slide technique, aiming to overcome the possible complications.
Background:The vast majority of biceps tendon ruptures occurs at the proximal insertion and almost always involves the long head. There are several options for long head of biceps (LHB) tenodesis with advantage and disadvantages of each technique. We believe that the suprapectoral LHB tenodesis described in this article enables the restoration of the anatomic length-tension relation in a technically reproducible manner, when following the guidelines set forth in this article, and restores biceps contour and function adequately with a low risk of complications.Method:We present a case of a young man who had a sudden jerk of his flexed right elbow, while involved in water skiing sports and sustained complete rupture of proximal end of long head of biceps tendon. In this article, we describe a modified surgical technique of open supra-pectoral long head of biceps tenodesis using an EndoButton tension slide technique, reproducing an anatomic length-tension relationship.Results:By the end of one year, patient regained symmetrical muscle bulk, shape and contour of biceps compared to other side. There were no signs of dislodgement or loosening of the EndoButton on follow-up radiographs. He regained full muscle power in the biceps without any possible complications, such as humeral fracture, infection, or nerve injury, associated with this technique.Conclusion:This technique is a safe, easy to reproduce, cost-effective, less time consuming and an effective method that uses a small drill hole, conserving bone, minimizing trauma to the tendon, and decreasing postoperative complications. It does not need any special instrumentation and is suitable especially for use in centers where arthroscopy facility or training is not available.
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