Background: There is no clear consensus on whether total elbow arthroplasty (TEA) or hemiarthroplasty (HA) is superior for treating distal humerus fractures in the elderly. This study analysed the functional outcomes and re-operation rates following TEA and HA for intra-articular distal humerus fractures in patients aged ≥65 years.
Methods: 19 patients (TEA = 12, HA = 7) treated between 2016 and 2022 were retrospectively reviewed.
Background: Preoperative CT-based planning is established in shoulder arthroplasty surgery. Automated planning software has become available to assist the surgeon and may increase reliability and efficiency. This study aims to evaluate the reliability of an automated 3-dimensional (3D) planning software package (Blueprint™ v2.
View Article and Find Full Text PDFIntroduction: Concomitant acromioclavicular joint (ACJ) disruptions with coracoid base fractures are rare high energy injuries. The management of these injuries can be challenging. The aim of this study is to assess the functional and radiographic outcomes of a retrospective case series of patients presenting with concomitant ACJ and coracoid base injuries managed with a clavicle hook plate with subsequent hardware removal at a later stage.
View Article and Find Full Text PDFTennis elbow (TE) is a painful and debilitating condition of the elbow. Recently, the use of orthobiologics, such as platelet-rich-plasma (PRP), has been proposed to promote tendon regeneration. Despite their popularity, there is a paucity of updated reviews on the use of PRP compared with other treatment modalities for treating TE.
View Article and Find Full Text PDFThere is limited literature to guide shoulder surgeons in the management of juvenile idiopathic arthritis (JIA). We aim to help clinicians to formulate an approach to the surgical management of the condition through a review of the available literature on arthroplasty in JIA, general considerations when operating on patients with inflammatory arthropathy and recommendations based on the authors' experience. Four articles report formal data on arthroplasty in JIA with favourable improvements in post-operative pain and function scores after the long-term follow-up.
View Article and Find Full Text PDFIf left untreated, varus posteromedial rotatory injuries of the elbow result in poor functional outcomes. Surgical treatment allows restoration of elbow kinematics, minimizing the chances of chronic varus instability and early onset osteoarthritis. However, large exposures are associated with extensive soft tissue stripping, a high risk of infection, nerve injury, poor visualization of the articular surface and longer recovery.
View Article and Find Full Text PDFBackground: The importance of registries for collaborative quality improvement has been overlooked in low/middle-income countries (LMIC). Aga Khan University Hospital (AKUH) in Pakistan joined the Congenital Cardiac Catheterization Project on Outcomes-Quality Improvement (C3PO-QI) in March 2017 with the goal of leveraging international collaboration to improve patient care and institutional standards.
Methods: The C3PO-QI key driver-based approach was used, with certain modifications, for process re-engineering in AKUH's congenital cardiac catheterisation laboratory (CCL) to reduce radiation exposure during cardiac catheterisation procedures (the primary outcome of C3PO- QI).
Total acromionectomy is now a largely historical procedure due to a number of biomechanical sequelae caused by defunctioning of the deltoid, although its overall effect on joint kinematics is uncertain. This presents a challenge when considering arthroplasty for subsequent glenohumeral arthritis. We report on successful management of such a case, treated with resurfacing hemiarthroplasty 57 years following acromionectomy.
View Article and Find Full Text PDFJ Shoulder Elbow Surg
August 2018
Background: This study reports the outcome of resurfacing hemiarthroplasty (RHA) in a cohort of patients with juvenile idiopathic arthritis (JIA) affecting the shoulder joint METHODS: Fourteen uncemented RHA procedures were performed for 11 consecutive patients who required surgery because of JIA. Mean age at surgery was 36.4 years.
View Article and Find Full Text PDFThe posterior interosseous nerve (PIN) is susceptible to a number of traumatic and atraumatic pathologies. In this article, we aim to review our current understanding of the etiology, pathology, diagnosis, treatment options, and published outcomes of atraumatic PIN palsy. In general, the etiology of atraumatic PIN palsy can be divided into mechanical, which is caused by an extrinsic compressive force on the nerve, and nonmechanical, which is caused by an intrinsic inflammatory reaction within the nerve.
View Article and Find Full Text PDFPurpose: To describe the results and functional scores in a group of patients who underwent arthroscopic excision of a symptomatic sternoclavicular joint (SCJ) disk tear with a minimum follow-up period of 2 years.
Methods: Between April 2010 and December 2014, 14 patients underwent arthroscopic excision of a torn SCJ disk. Patients whose intended surgery was an isolated diskectomy and underwent that surgery only, with no additional procedure, were included.
The sternoclavicular joint (SCJ) has a complete intra-articular disk that can be damaged either as a result of trauma or as part of ongoing degenerative joint disease. Although often asymptomatic, SCJ disk tears may lead to mechanical symptoms and pain. Previously, isolated symptomatic SCJ disk tears have only occasionally been mentioned in the literature with a few associated case reports of diskectomy by open arthrotomy.
View Article and Find Full Text PDFTraumatic glenohumeral joint dislocation and acromioclavicular joint subluxations tend to occur in young active males. Use of the coracoid process either as a transfer in recurrent instability or in suspensory reconstructions of the coracoclavicular ligaments have gained popularity. However this requires careful consideration in the event of concomitant injuries if they both require surgery.
View Article and Find Full Text PDFThe management of glenoid bone loss is a major challenge in both complex primary and revision arthroplasty surgery. To deal with this problem, a number of techniques have been advocated, although there has been no previous systematic review of the literature. In the present review, we have attempted to identify a coherent strategy for addressing this problem, taking into account the degree of bone loss, the advantages and limits of standard implants, bone reconstruction techniques and the use of customized prostheses.
View Article and Find Full Text PDFBackground: Few series report the results of total elbow replacement (TER) in patients with juvenile idiopathic arthritis (JIA). Most report the use of a linked implant. There are theoretical benefits to using an unlinked prosthesis, and thus we report our experience of the clinical benefit and survivorship of both this implant and a linked semiconstrained prosthesis.
View Article and Find Full Text PDFBackground: We describe the clinical, radiological and surgical findings of failed distal biceps repair by gapping and report the functional outcomes following revision repair.
Methods: A retrospective review of five consecutive patients was conducted. Patients presented with radial-sided forearm pain after their distal biceps fixation.
Background: Symptomatic disorders around the sternoclavicular joint (SCJ) are relatively uncommon. Previous cadaveric and radiographic studies have suggested that asymptomatic osteoarthritic changes are relatively common, progressively increasing with age. The purpose of this study was to determine the prevalence of SCJ osteoarthritis in the general population using computed tomography (CT) scans.
View Article and Find Full Text PDFBackground: Many shoulder surgeons use intra-articular corticosteroid injections (IACI) in shoulder osteoarthritis, with the caveat that it precludes arthroplasty for at least 6 months to 12 months because of the theoretical risk of infection. To our knowledge, there is nothing available in the literature to support this notion.
Methods: We undertook a retrospective, matched cohort study of all patients who underwent shoulder arthroplasty in our unit between December 2010 and December 2013 aiming to assess whether pre-operative IACI had an impact on infective complications.
Aortic aneurysm disease is a complex condition that requires a multidisciplinary approach in management. The innovation and collaboration among vascular surgery, cardiothoracic surgery, interventional radiology, and other related specialties is essential for progress in the management of aortic aneurysms. The Fifth Liverpool Aortic Surgery Symposium that was held in May 2013 aimed at bringing national and international experts from across the United Kingdom and the globe to deliver their thoughts, applications, and advances in aortic and vascular surgery.
View Article and Find Full Text PDFJ Orthop Surg (Hong Kong)
August 2012
We present a 74-year-old woman who developed a portal vein thrombosis following an elective total knee replacement. She had atrial fibrillation for which she was taking warfarin for anticoagulation. Seven days prior to surgery, she was instructed to discontinue warfarin and replace it with prophylactic low-molecular-weight heparin.
View Article and Find Full Text PDFWe report a 31-year old woman who presented with acute onset of shortness of breath 19 years after multiple repairs of a preductal coarctation of the aorta using a Dacron tube graft. Imaging studies showed an aneurysm had developed in the tube graft. The aneurysmal tube graft was replaced during an open repair.
View Article and Find Full Text PDFIntroduction: We describe a case of rare complication of typhoid fever in a seven-year-old child and review the literature with regard to other rare causes of bleeding per rectum. Dieulafoy's lesion is an uncommon but important cause of recurrent gastrointestinal bleeding. Dieulafoy's lesion located extragastrically is rare.
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