Level III, retrospective comparative study.

Instability surgery performed using a single arthroscopic anterior portal provided findings comparable with the literature regarding clinical outcomes, postoperative shoulder movements and low recurrence rates, emphasizing the importance of appropriate patient selection rather than the number of the portals. The use of a single portal is less invasive and reduces the surgical period.

Deep vein thrombosis (DVT) and the consequently developed pulmonary embolism are devastating complications in orthopedic surgery. DVT occurs less frequently (1-2% of all cases) in the upper extremity than the lower extremity. We report a 54-year-old male patient who developed DVT and pulmonary thromboembolism after surgical treatment of an ulnar pseudoarthrosis. The presented case suggested the use of a low molecular weight heparin prophylaxis after upper extremity surgeries necessitating long-term immobilization.

If conservative treatment is insufficient for patients with irreparable rotator cuff tears, biodegradable balloon method has yielded favorable outcomes in terms of pain and functionality in comparison with other surgical methods. Moreover, lesser morbidity, short procedure time and absence of postoperative rehabilitation requirement can be considered as advantages of this method.

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Background:Postoperative pain management is the part of shoulder surgery to improve patient satisfaction, start rehabilitation process rapidly and decrease for hospital stay. Various treatment modalities have been used for pain management, but they have some limitations, side effects and risks. Throughout intraoperative and postoperative period, nerve blocks have been used more popularly than others because of efficacy. For the regional nerve block, local anesthetic should be infiltrated close to the nerve for maximum effect. Consequently, aim of this study was to evaluate analgesic efficacy when catheters are placed with assistance of arthroscope to block suprascapular and axillary nerves in patients undergoing arthroscopic repair of rotator cuff under general anesthesia.Materials and Methods:24 patients (5 males, 19 females; mean age: 54.3 years) who underwent arthroscopic repair of rotator cuff between June 2014 and September 2014 and were catheterized to block suprascapular and axillary nerves during shoulder arthroscopy were included in the study. Clinical outcomes were assessed using visual analog scale (VAS) scores preoperatively and at 0 h, 6 h, 12 h, 18 h, 24 h, and postoperative day 2.Results:Preoperative and postoperative 0 h, 6 h, 12 h, 18 h, 24 h, and day 2 mean VAS scores were 6.38 ± 0.77, 0.44 ± 0.42, 0.58 ± 0.42, 0.63 ± 0.40, 0.60 ± 0.44, 0.52 ± 0.42, and 1.55 ± 0.46, respectively. No statistical difference was found among 0 h, 6 h, 12 h, 18 h, and 24 h time points; however, comparison of postoperative day 2 and postoperative 0 h, 6 h, 12 h, 18h and 24 h VAS scores showed statistically significant difference (P < 0.05). All patients were discharged at the end of 24 h with no complication. The mean time (in minutes) required for blocking suprascapular nerve and axillar nerve were 14.38 ± 3.21 and 3.75 ± 0.85, respectively.Conclusion:These results demonstrated that blocking two nerves with arthroscopic approach was an excellent pain management method in postoperative period. Accordingly, patients could recover rapidly and patients’ satisfaction could be improved.

Iatrogenic peripheral nerve injuries can result from numerous medical procedures, particularly transection, stretching, compression, injections, heat, radiation, and the use of anticoagulant agents. Late diagnosis may lead to atrophy of the motor endplate and result in poor outcomes. We report a case in which the posterior tibial nerve was accidentally sectioned as the posterior tibial tendon for transfer to the anterior tibial tendon in the reconstruction of drop foot. This iatrogenic complication ultimately required foot amputation. Physicians must be aware of the anatomy of the posterior tibial nerve in order to avoid such complications.

Distal chevron osteotomy (DCO) is used more frequently than other methods for the correction of mild-tomoderate hallux valgus deformity because it is markedly more stable. Here, we evaluated the use of a capsuloperiosteal flap to stabilize DCO and presented our last longer follow-up. Methods: This study included a total of 57 patients (86 feet) made up of 50 women (79 feet) and 7 men (7 feet) with a mean age of 37.8 years who were diagnosed with hallux valgus and met the inclusion criteria. These patients received treatment using a capsuloperiosteal flap to stabilize DCO from 1994 to 2000. Clinical outcomes of the patients were assessed using the American Orthopaedic Foot and Ankle Society hallux scale. Results: The mean follow-up duration was 14.8 years. The score increased from a preoperative mean of 52 points to a mean of 90.5 points at last follow-up. The mean hallux valgus angle changed from 30.3 preoperatively to 14.4 postoperatively at the last follow-up. The first to second intermetatarsal angle changed from 13.6 preoperatively to 10.5 postoperatively. The correction in the range of motion proved to be consistent with only an average of 1 correction loss and 5.5 loss. Eighty-four feet (97.6%) were pain-free. Discomfort with shoe wear was absent in 82 feet (95.3%) postoperatively, and 23 of 24 (95.8%) patients were fascinated cosmetically. Conclusion: Correction of mild-to-moderate hallux valgus deformity with the use of capsuloperiosteal flap for stabilization of DCO provided findings comparable with the literature regarding clinical and radiological outcomes at long-term follow-up.