Fibula flap in upper extremity segmental/critical size bone defects fixed with locking plates. Single-institution observational cohort.

Introduction: Management of bone defects in the upper extremity can vary depending on the size and location of the defect. Large defects may require complex reconstruction techniques. Vascularized bone grafts, mainly free vascularized fibula flap (FVFF), have many advantages in the treatment of bone or osteocutaneous defects.

Total Elbow Arthroplasty in the Context of an Olecranon Nonunion: A Surgical Technique and Report of Three Cases.

The deficiency of the triceps tendon has been considered a relative contraindication to performing a total elbow arthroplasty. One of the conditions that may compromise triceps integrity is the presence of an olecranon non-union (ON). In this scenario, the placement of a total elbow arthroplasty in a patient with end-stage elbow arthritis is a complex problem to be solved.

Description of unusual osteochondral laminar fragment patterns in Distal Radius fractures.

Background: Distal radius fracture (DRF) is one of the most common fractures and, frequently, surgical treatment is mandatory in the presence of an intra-articular fracture. However, there are some unusual intra-articular fracture patterns, were it remains challenging to properly recognize and anatomically reconstruct the articular surface. The objective of the present study is to describe an intra-articular fracture pattern of the distal radius characterized by the presence of osteochondral laminar fragments, which could potentially require a different treatment to standard stabilization.

What Is the Infection Rate of Carpal Tunnel Syndrome and Trigger Finger Release Performed Under Wide-Awake Anesthesia?

Background: High infection rates have been reported in hand procedures using the wide-awake local anesthesia no tourniquet (WALANT) method, causing some to question the validity of this approach. However, little evidence exists surrounding the direct use of WALANT compared with monitored anesthetic care (MAC). This study was conducted to directly compare the postoperative infection rates of carpal tunnel syndrome (CTS) and trigger finger (TF) release surgeries performed under WALANT and MAC.

Time until union in absolute vs. relative stability MIPO plating in simple humeral shaft fractures.

Purpose: The objective of this study is to evaluate the effect of absolute stability (AS) versus relative stability (RS) performed through a minimally invasive plate osteosynthesis (MIPO) in AO/OTA 12A1 and 12A2 fractures on healing and the time to radiographic union.

Methods: This was a retrospective cohort study of all patients treated with plate fixation for AO/OTA type 12A1-A2 fractures at a single institution. Patients were grouped according to the type of stability used in their surgery.

Trapeziometacarpal osteoarthritis: Arthroscopic hemitrapeziectomy using the Thenar Portal.

Background: Although the standard 1Radial and 1Ulnar portals allow for visualisation of most of the trapezium articular surface, the proximity of these two portals can often make arthroscopic triangulation and visualisation of the most lateral capsule and joint surface challenging. Despite its already reported advantages in improving visualisation, there is little literature reporting the clinical experience with the Thenar Portal. The purpose of this study is to describe potential complications and the short-term clinical-radiographic outcomes of arthroscopic hemitrapeziectomy using the Thenar Portal in order to determine its safety and efficacy as a standard working portal.

Treatment of terrible triad injuries at a mean follow-up of nine years.

Background: To evaluate the sustainability of the early clinical and radiological outcomes of terrible triad injuries at long-term follow-up.

Methods: Twelve consecutive patients who underwent fixation of terrible triad injuries with minimum of seven years of follow-up. Functional and radiological outcomes at one year and final follow-up were compared.

Short-term complication rate following orthopedic surgery in a tertiary care center in Argentina.

Introduction: Registration of adverse events following orthopedic surgery has a critical role in patient safety and has received increasing attention. The purpose of this study was to determine the prevalence and severity of postoperative complications in the department of orthopedic unit in a tertiary hospital.

Methods: A retrospective review from the postoperative complication registry of a cohort of consecutive patients operated in the department of orthopedic surgery from May 2015 to June 2016 was performed.

Patient-Rated Wrist Evaluation: Spanish Version and Evaluation of Its Psychometric Properties in Patients with Acute Distal Radius Fracture.

 The purpose of this paper is to validate a Spanish version of patient-rated wrist evaluation (PRWE) and evaluate its psychometric attributes in a population of patients with distal radius fracture.  A translation and cross-cultural adaptation of the PRWE to Spanish (PRWE-S) was performed according to standardized guidelines. A total of 50 patients with a distal radius fracture were included during the different steps of the study.

Volar Plate Fixation in Patients Older Than 70 Years with AO Type C Distal Radial Fractures: Clinical and Radiologic Outcomes.

 Treatment of unstable distal radial fractures (DRFs) in elderly patients is controversial, and considering the increasing life expectancy, their appropriate treatment is of growing importance. Our aim was to analyze the clinical and radiologic outcomes in the elderly patients with AO type C DRF treated with volar locking plate (VLP).  Between 2007 and 2011, 572 DRFs were operated on in our hospital with open reduction and internal fixation with VLP.

Radius Core Decompression for Kienböck Disease Stage IIIA: Outcomes at 13 Years Follow-Up.

Purpose: This study was designed to analyze the long-term clinical and radiological outcomes of a series of patients with Kienböck disease stage IIIA treated with radius core decompression.

Methods: This retrospective study included 15 patients with Kienböck disease (Lichtman stage IIIA) who underwent distal radius metaphyseal core decompression between 1998 and 2005 and who were followed-up for at least 10 years. At the last follow-up, the patients were evaluated for wrist range of motion and grip strength.

Combined Tenodesis-Capsulodesis for Scapholunate Instability: Minimum 2-Year Follow-Up.

 The aim of this study is to evaluate the clinical and radiological midterm results of a combined dorsal tenodesis-capsulodesis for static and reducible scapholunate dissociation (SLD).  We evaluated 20 of 22 consecutive patients with static SLD minimum with follow-up of 2 years operated between 2003 and 2012. The mean age was 40 years (range: 23-65 years).

The use of dynamic orthoses in the treatment of the stiff elbow.

The purpose of this study is to evaluate the outcomes of the treatment of stiff elbow with the use of dynamic orthoses. We included 30 patients with stiff elbow with an arc of mobility of 100° or less and a stable and congruent joint without heterotopic ossifications. The dynamic orthosis was designed in our service and consists of an articulated brace with springs.

Posterior minimally invasive plate osteosynthesis for humeral shaft fractures.

Fractures of the humeral shaft are common. Most of them can be successfully treated without surgery. In some cases, an operative intervention may offer faster and better functional results.

Chronic scapholunate dissociation: ligament reconstruction combining a new extensor carpi radialis longus tenodesis and a dorsal intercarpal ligament capsulodesis.

Scapholunate dissociation (SLD) is the commonest cause of carpal instability and wrist osteoarthrosis. The value of early diagnosis and treatment of this injury is well established in the literature. When a partial or total rupture of the scapholunate ligament is treated with early anatomic reduction and repair, functional results may be good to excellent.

Surgical correction of "cam-type" femoroacetabular impingement: a cadaveric comparison of open versus arthroscopic debridement.

Purpose: The goal of this study was to compare open and arthroscopic surgical techniques for "cam-type" femoroacetabular impingement in terms of feasibility and reliability.

Methods: We used 5 fresh-frozen cadaver specimens (10 hips). Anteroposterior and cross-table radiographs were taken for each.

Four-corner arthrodesis: influence of the position of the lunate on postoperative wrist motion: a cadaveric study.

Purpose: Evaluate the influence of the position of the lunate on postoperative wrist motion in four-corner arthrodesis.

Methods: Six upper cadaveric limbs were evaluated, comparing the total arc of motion in each wrist after simulating four-corner arthrodesis. The lunate was fixed in 3 different positions: neutral (0 degrees ), extended (30 degrees ), and flexed (20 degrees ).