Minimally invasive denervation of the wrist: A cadaveric feasibility study for a single injection that targets both anterior and posterior interosseous nerves under ultrasound-guidance.

Background: Wrist osteoarthritis poses significant challenges in pain management and functional impairment. Current surgical interventions often sacrifice wrist motion and entail long recovery times. Minimally invasive denervation offers a promising alternative by targeting sensory nerves.

Equity, diversity and inclusion in simulation-based education: constructing a developmental framework for medical educators.

Background: Themes of equity, diversity and inclusion (EDI) arise commonly within healthcare simulation. Though faculty development guidance and standards include increasing reference to EDI, information on how faculty might develop in this area is lacking. With increasingly formal expectations being placed on simulation educators to adhere to EDI principles, we require a better understanding of the developmental needs of educators and clear guidance so that teams can work towards these expectations.

Semiconstrained posterior-stabilized total knee arthroplasty: indications, risks and benefits in primary and revision surgery.

Background: The constrained posterior-stabilized (CPS) implant for use in total knee arthroplasty (TKA) has a constraint level midway between that of a posterior-stabilized implant and a valgus-varus-constrained implant; there is currently no consensus on the surgical indications for use of this degree of constraint. We present our experience using this implant at our centre.

Methods: We reviewed the charts of patients who received a CPS polyethylene insert during TKA in our centre between January 2016 and April 2020.

Endosteal substitution with medial plate in the treatment of acute distal femur fracture (AO/OTA type A): surgical technique and case-series.

Introduction: Distal Femur fractures account for 4- 6% of all femur fractures and can be challenging to treat. The aims of this study are: (1) to describe a surgical technique using a medial distal femur endosteal plate to augment the stability of standard lateral plate fixation; (2) to report the results of a case-series of acute distal femur fractures (AO/OTA Type A/ Vancouver periprosthetic fractures Type C) treated using this technique.

Methods: This study describes the surgical steps for placement of a medial endosteal plate in combination with lateral locking plate in a cadaver model using fluoroscopy guidance.

Risk factors for in-patient admission among adults with intellectual disability and autism: investigation of electronic clinical records.

Adults with intellectual disability or autism are at risk of psychiatric admission which carries personal, social and economic costs. We identified 654 adults with intellectual disability or autism in the electronic clinical records of one mental health trust. We investigated the demographic and clinical factors associated with admission and readmission after discharge.

Augmented latissimus dorsi transfer: initial results in patients with massive irreparable posterosuperior rotator cuff tears.

Background: The surgical treatment of irreparable massive rotator cuff tears is challenging. The purpose of the present study was to report the initial outcomes after a modified latissimus dorsi transfer (LDT) augmented by acellular dermal allograft (ADA).

Methods: This retrospective study includes 24 patients managed with LDT using ADA augmentation as a bursal-sided onlay between March 2009 and December 2015.

The fulcrum axis: an accurate measure of glenoid version on radiographs and computed tomography.

Background: Proper glenoid position in total shoulder arthroplasty (TSA) is important. However, traditional glenoid version (GV) measurements overestimate retroversion on radiographs (XR) and computed tomography (CT).The fulcrum axis (FA) uses palpable surface landmarks and may be useful as an intra-operative guide.

Hurst revisited: Are symptoms and signs of functional motor and sensory disorders "dependent on idea"?

Introduction: Symptoms and signs of functional (psychogenic) motor and sensory disorder are often said to be dependent on the patients' idea of what symptoms should be, rather than anatomy and physiology. This hypothesis has however rarely been tested.

Materials And Methods: Inspired by a brief experiment carried out in 1919 by neurologist Arthur Hurst we aimed to assess the views of healthy non-medical adults towards paralysis and numbness and their response to tests for functional disorders when asked to pretend to have motor and sensory symptoms.

Proximity of Lateral Critical Structures to the All-Epiphyseal Outside-In Femoral Tunnels in Pediatric Anterior Cruciate Ligament Reconstruction.

Purpose: To describe the proximity of the lateral critical structures (peroneal nerve [PN], popliteus tendon [PT], lateral collateral ligament [LCL], and articular cartilage [AC]) to the femoral tunnel for outside-in all-epiphyseal anterior cruciate ligament (ACL) reconstruction in reference to knee flexion angle.

Methods: All-epiphyseal ACL reconstructions were performed in 12 human cadaveric knees using arthroscopy and outside-in drilling for anatomic femoral tunnel placement that was ensured by identifying the center of the total ACL footprint. Fluoroscopy was used to confirm tunnel position and reconstructions were performed with quadrupled semitendinosus and gracilis autograft with Xtendobutton (Smith & Nephew, Andover, MA) fixation on the femoral side.

Fractures of the greater tuberosity of the humerus: a study of associated rotator cuff injury and atrophy.

Background: This is a retrospective prognostic study on soft tissue injury following isolated greater tuberosity (GT) fractures of the proximal humerus with respect to the relationship between rotator cuff tears and GT displacement.

Methods: Forty-three patients with isolated GT fractures were recruited and evaluated with a standardized interview and physical examination, quality of life and shoulder function questionnaires (Western Ontario Rotator Cuff Index, SF-12 Version 2, Constant, Quick-Disabilities of the Arm, Shoulder and Hand, Visual Analogue Scale), standard shoulder radiographs and an ultrasound. The main outcome measurements were: incidence of rotator cuff tears and atrophy, biceps pathology and sub-acromial impingement; superior displacement of the GT fragment; and questionnaire scores.

Surgical Treatment of Displaced Greater Tuberosity Fractures of the Humerus.

Greater tuberosity fractures of the humerus can be successfully treated nonsurgically in most patients. However, as little as 3 to 5 mm of superior greater tuberosity displacement may adversely affect rotator cuff biomechanics and lead to subacromial impingement in patients who are active. In these cases, surgical treatment is recommended.

Transosseous braided-tape and double-row fixations are better than tension band for avulsion-type greater tuberosity fractures.

Introduction: The optimal treatment for avulsion-type greater tuberosity fractures is yet to be determined. Three fixation methods are tested: tension band with #2 wire suture (TB), double-row suture bridge with anchors (DR), and simple transosseous fixation with braided tape (BT).

Materials And Methods: Twenty-four porcine proximal humeri were randomised into three groups: TB, DR and BT.

Locking plate fixation provides superior fixation of humerus split type greater tuberosity fractures than tension bands and double row suture bridges.

Background: This paper aims to determine the strongest fixation method for split type greater tuberosity fractures of the proximal humerus by testing and comparing three fixation methods: a tension band with No. 2 wire suture, a double-row suture bridge with suture anchors, and a manually contoured calcaneal locking plate.

Methods: Each method was tested on eight porcine humeri.

The changing demographics of traumatic spinal cord injury: An 11-year study of 831 patients.

Context/objective: Traumatic spinal cord injuries (T-SCI) have a devastating impact and place a significant financial burden on the healthcare system. The incidence of T-SCI ranges from 10.4 to 83 cases per million and varies with age, sex, or geographical region.

Accurate Measurement of Greater Tuberosity Displacement Without Computed Tomography: Validation of a Method on Plain Radiography to Guide Surgical Treatment.

Introduction: Residual displacement of greater tuberosity (GT) fractures has been shown to negatively affect shoulder function. However, accurate measurement of GT displacement remains a problem with errors up to 13 mm on plain radiography (XR). A new GT ratio for measuring fracture displacement on XR is described, validated, and correlated with computed tomography (CT) and surgical decision making.

Occlusion of the artery of Adamkiewicz after hip and knee arthroplasty.

The artery of Adamkiewicz is the most significant tributary of the anterior spinal artery in the midthoracic region; the occlusion of this artery results in a well-described phenomenon consisting of paraplegia with loss of the sensation of pain, temperature, and touch as well as loss of sphincter control. Proprioception and vibration sense are typically preserved. Although this phenomenon has been associated with several surgeries as well as preexisting aortic abnormalities, the literature thus far has not reported this as a complication of hip or knee arthroplasty.