The V-shaped subscapularis tenotomy for anatomic total shoulder arthroplasty.

Purpose: Management of the subscapularis tendon during anatomic total shoulder arthroplasty (TSA) remains controversial. In our unit, subscapularis tenotomy is the preferred technique; however, the potential for tendon gapping and failure is recognised. The purpose of this study is to describe and provide early clinical results of a novel, laterally based V-shaped tenotomy (VT) technique hypothesised to provide greater initial repair strength and resistance to gapping than a transverse tenotomy (TT), with both clinically and radiologically satisfactory post-operative tendon healing and function.

Total Distal Radioulnar Joint Arthroplasty for Paget's Disease of Bone.

 Distal radioulnar joint (DRUJ) and ulnocarpal pathology, such as ulnocarpal impaction, are relatively common causes of ulnar-sided wrist pain. We herein report a rare case of ulnocarpal impaction and DRUJ arthropathy due to Paget's disease of bone (PDB) in the ulna.  A 65-year-old, right-hand-dominant male was diagnosed with right-sided ulnocarpal impaction secondary to PDB.

Making Sense of Metal Allergy and Hypersensitivity to Metallic Implants in Relation to Hand Surgery.

All metals implanted into a biological system undergo some degree of corrosion depending upon its composition. The electrochemical process of corrosion produces free metal ions, which may activate the host's immune system through a variety of mechanisms. Whereas dermal metal hypersensitivity is common, affecting 10% to 15% of the population, the immune reaction from implanted metals is much less common (< 0.

The Influence of Microsurgical Training on the Practice of Hand Surgeons.

Background: The study aims to determine the effect of formal training on the long-term practice of microsurgery.

Methods: Hand surgeons completing a 1-year hand fellowship and a 5-day microsurgery rat-model training course from a single institution over a 15-year period (1996-2011) were surveyed. Patency rates (at 24 hours), additional days spent in the laboratory, and training (orthopedic [OS] vs.

Natural history of anterior chest wall numbness after plating of clavicle fractures: educating patients.

Objectives: Improved patient outcomes after plating of displaced clavicle fractures have been demonstrated by recent clinical studies. Many of these patients, however, complain of anterior chest wall numbness after this procedure; we hypothesize that numbness likely persists long term for many patients, but without effect on shoulder function.

Design: Prospective observational cohort.

Neuroforaminal chondrocyte metaplasia and clustering associated with recombinant bone morphogenetic protein-2 usage in transforaminal lumbar interbody fusion.

Background Context: Recombinant human bone morphogenetic protein-2 (rhBMP-2) is commonly used to augment posterior and interbody spinal fusion techniques and has many reported side effects. Neuroforaminal heterotopic ossification (HO) is a known cause of postoperative leg pain, but the pathohistologic composition of this material is not well understood.

Purpose: The purpose of this article was to report the histologic composition of a case of HO and lumbar radiculopathy after transforaminal lumbar interbody fusion with rhBMP-2.

Feasibility of latissimus and teres major transfer to reconstruct irreparable subscapularis tendon tear: an anatomic study.

Background: Several tendon transfers have been described to reconstruct irreparable subscapularis (SS) tears, but their outcomes are variable and unsatisfactory in the presence of anterior glenohumeral subluxation. We evaluated the anatomic feasibility of the latissimus dorsi (LD) or teres major (TM) muscle tendon transfer to reconstruct an irreparable SS tendon tear.

Materials And Methods: The dimensions of the LD and TM tendons and the distance between their insertion and the SS tendon insertion were determined In 20 cadaveric shoulders.

Lidocaine analgesia for removal of wound vacuum-assisted closure dressings: a randomized double-blinded placebo-controlled trial.

Objectives: Wound vacuum-assisted closure (VAC) is a technique used frequently by orthopedic surgeons to facilitate wound closure. Bedside VAC removal can be a source of great pain for patients, which we hypothesize can be decreased by topical lidocaine application.

Design: This was a prospective randomized double-blinded, placebo-controlled trial (registered on clinicaltrials.