Outcomes of Zone II Flexor Tendon Repair Under General Versus Wide Awake Local Anesthesia: A Randomized Controlled Trial.

Purpose: Wide awake local anesthesia no tourniquet (WALANT) is gaining popularity with flexor tendon repair. We hypothesized that results of zone II flexor tendon repair performed under WALANT would be superior to those performed under general anesthesia (GA).

Methods: A randomized controlled trial was conducted to compare results of repair of zone II flexor tendon lacerations under WALANT versus GA.

Free Vascularized Proximal Fibular Epiphyseal Transfer For Hip Reconstruction Following Septic Necrosis In Children.

Background: Septic necrosis of the femoral head and neck in children represents a challenging problem. Several reconstructive techniques have been described but with disappointing long-term results. Vascularized epiphyseal transfer utilizing the proximal fibula have been successfully used for reconstruction of the proximal humerus and distal radius and only scarcely used for hip reconstruction.

Treatment of Concomitant Congenital Pseudarthrosis of the Fibula With Propeller Periosteal Flap.

Introduction: Congenital pseudarthrosis of the fibula is not an uncommon condition to accompany congenital pseudarthrosis of the tibia. Persistence of the fibular pseudarthrosis has been linked to inferior outcomes including tibial union and alignment, refractures, and ankle alignment. In this report, we present the results of a pedicled periosteal propeller flap technique for the treatment of fibular pseudarthrosis.

Congenital Pseudarthrosis of the Tibia: Long-term Outcome of Treatment With Intramedullary Vascularized Fibular Graft Combined With Ilizarov Distraction.

Background: Late presenting cases of congenital pseudarthrosis of the tibia, are further complicated with severe shortening. Limb length discrepancy (LLD) cannot be corrected by vascularized fibular grafting and the use of Ilizarov distraction is associated with a high rate of complications. The aim of this study was to report the long-term follow-up of a combined technique previously published under the name "telescoping vascularized fibular graft".

Long-Term Results of Microsurgical Brachial Plexus Reconstruction in Late-Presenting Cases of Brachial Plexus Birth Injury.

Purpose: The role of primary surgery in delayed presenting cases of brachial plexus birth injury is still debated. The purpose of this study was to evaluate the results of brachial plexus reconstruction performed at the age of ≥12 months.

Methods: Twenty-nine cases were included.

Arthroscopic Wafer Procedure Versus Ulnar Shortening Osteotomy for Treatment of Idiopathic Ulnar Impaction Syndrome: A Randomized Controlled Trial.

Purpose: We compared the arthroscopic wafer procedure (AWP) and ulnar shortening osteotomy (USO) for treatment of idiopathic ulnar impaction syndrome in terms of clinical, functional improvement and time of return to work.

Methods: This single-center study was conducted at an academic level 1 referral center between 2014 and 2020. Sixty patients with idiopathic ulnar impaction syndrome were prospectively randomized to treatment with either AWP or USO.

Radio-carpal wrist MR arthrography: comparison of ultrasound with fluoroscopy and palpation-guided injections.

Objective: To compare ultrasound- (US), fluoroscopy- (FL), and palpation-guided contrast injection techniques used for dorsal radio-carpal wrist MRA.

Materials And Methods: Patients with chronic wrist pain were randomized as to which injection technique they underwent into three groups of 50 participants. Dorsal radio-carpal contrast injection was performed under US, FL guidance (one radiologist for each), or palpation guidance by an orthopedic surgeon.

Traumatic Brachial Plexus Palsy in Children: Long-Term Outcome and Strategy of Reconstruction.

Background:  Traumatic brachial plexus injuries in children represent a definite spectrum of injuries between adult and neonatal brachial plexus injuries. Their characteristics have been scarcely reported in the literature. The priority of functional restoration is not clear.

Crawford Type IV Congenital Pseudarthrosis of the Tibia: Treatment With Vascularized Fibular Grafting and Outcome at Skeletal Maturity.

Background: Vascularized fibular grafting (VFG) is currently accepted as one of the best treatments for congenital tibial pseudoarthrosis (CPT). However, with longer follow-up, functional results deteriorate, and some problems become evident.

Methods: Thirty-nine patients with CPT were treated with VFG.

Long-term Evaluation of Teres Major to Infraspinatus Transfer for Treatment of Shoulder Sequelae in Obstetrical Brachial Plexus Palsy.

Background: The long-term results of soft tissue rebalancing procedures of the shoulder in obstetric brachial plexus palsy have been scarcely reported. The effect of this procedure on the evolution of secondary bone changes has been a subject of controversy.

Methods: Twenty-six children are included in this study.

MR arthrography versus conventional MRI and diagnostic arthroscope in patients with chronic wrist pain.

Objective: To assess the diagnostic accuracy of direct wrist MR arthrography (MRA) compared to conventional MRI in diagnosis of different pathologic entities causing chronic wrist pain.

Materials And Methods: 37 consecutive patients 22 males and 15 females, with age range from 16 to 49 years "mean age 28 years" complaining of unexplained chronic wrist pain were prospectively examined by using MRI and MRA with arthroscopic correlation in 25 of them. Findings were divided into 5 main groups of lesions including triangular fibrocartilage complex (TFCC) lesions, ligamentous injuries, osseous lesions, tendon pathology and ganglion.

Flexor hallucis longus transfer clinical outcome through a single incision for chronic Achilles tendon rupture.

Purpose: The aim of this study is to evaluate the clinical outcome of single-incision flexor hallucis longus tendon transfer in chronic Achilles tendon rupture.

Methods: A prospective study of a series of cases of chronic Achilles tendon rupture that were treated with single-incision flexor hallucis longus tendon transfer, from April 2015 to December 2016. The study included 21 patients (15 men and 6 women), with mean age 40.

Arthroscopic Treatment of Type 1B Triangular Fibrocartilage Complex Tear by "Outside-In" Repair Technique Using Transcapsular Transverse Mattress Suture.

Triangular fibrocartilage complex (TFCC) injuries are increasingly recognized as a cause of ulnar-sided wrist pain. Palmer grouped these tears into either traumatic or degenerative, with various subclassifications. Magnetic resonance imaging (MRI), arthrogram, and arthroscopy are the methods used to establish the diagnosis.

Short-term evaluation of arthroscopic outside-in repair of ulnar side TFCC tear with vertical mattress suture.

Background: There has been controversy regarding the pathogenesis and treatment of TFCC tear. Different surgical techniques for the treatment of TFCC are prescribed. The purpose of this study was to evaluate the short-term outcomes of arthroscopic outside-in repair of the ulnar side TFCC tear with vertical mattress suture.

Arthroscopic grading of common wrist disorders and its role in management.

Palmer devised a classification system to guide treatment of triangular fibrocartilage complex tears in 1989. The main division is between traumatic Type I and atraumatic Type II tears. The wrist arthroscopy makes diagnosis and treatment of ulnar impaction syndrome possible in a less invasive way.

Free functioning gracilis transplantation for reconstruction of elbow and hand functions in late obstetric brachial plexus palsy.

Background: In late obstetric brachial plexus palsy (OBPP), restoration of elbow and hand functions is a difficult challenge. The use of free functioning muscle transplantation in late OBPP was very scarcely reported. In this study, we present our experience on the use of free functioning gracilis transfer for restoration of elbow and hand functions in late cases of OBPP.

Delayed selective neurotization for restoration of elbow and hand functions in late presenting obstetrical brachial plexus palsy.

The published experience of obstetrical brachial plexus palsy (OBPP) cases with poor recovery and late neurosurgical intervention are sparse. This study included 19 cases who presented after the age of 1 year with poor recovery of elbow and/or hand function and electrophysiological evidence of reinnervation. Age at surgery averaged 41 months, and the follow-up averaged 50 months.

Conservative treatment of the isolated dislocation of the pisiform bone.

We report isolated dislocation of the right pisiform bone dislocated distal and medial to the triquetrum bone in a young adult after a fall. Manipulation and closed reduction under intravenous regional anaesthesia resulted in full functional recovery and a good radiological outcome.

Dorsal foot resurfacing using free anterolateral thigh (ALT) flap in children.

Very limited literature described the use of the free anterolateral thigh (ALT) among other flaps for pediatric lower limb reconstruction. The aim of this study is to present our experience using the free ALT flap for reconstruction of soft tissue defects over the dorsum of the foot and ankle in children. The study included 42 children aged 2.

Knee joint reconstruction after hemiarticular resection using pedicled patella and vascularized fibular graft.

Between 1999 and 2005, seven patients had resection of tumors around the knee joint that involved half of the articular surface of the femoral or tibial side. Average age of the patients was 28 years (range, 14-40). Tumor pathology was giant cell tumor in four patients, osteoblastoma in two, and benign fibrous histocytoma in one patient.

Total obstetric brachial plexus palsy: results and strategy of microsurgical reconstruction.

From 2000 to 2006, 35 infants with total obstetric brachial plexus palsy underwent brachial plexus exploration and reconstruction. The mean age at surgery was 10.8 months (range 3-60 months), and the median age was 8 months.

Dupuytren's disease confined to the interphalangeal joints: a case report.

A typical case of Dupuytren's contracture confined to the interphalangeal joints of the right little finger, occurred in a 79-year-old man. No past history of risk factors or family history of Dupuytren's disease could be detected. Excisions of the abnormal cords lead to good clinical outcome.

Intercostal nerve transfer in infants with obstetric brachial plexus palsy.

The use of intercostal nerve (ICN) transfer to repair brachial plexus lesions associated with root avulsions is a well known procedure in adults. However, there is a paucity of reports on the use of ICN in infants with obstetrical brachial plexus palsy (OBPP). This study included 46 infants with obstetric brachial plexus palsy who underwent 62 neurotization procedures.

Management of traumatic tibial defects using free vascularized fibula or Ilizarov bone transport: a comparative study.

There are several options for the treatment of traumatic tibial defects. Among these options, free vascularized fibula and Ilizarov bone transport are well-known and effective techniques. The differences between both techniques and the indications for each of them are not well studied in the literature.

Acute carpal tunnel syndrome secondary to calcific tendinitis: case report.

Acute carpal tunnel syndrome (CTS) secondary to calcific deposition is rarely reported. In this article we describe a case of acute CTS in the dominant hand of a 94-year-old female patient secondary to calcific tendinitis within the carpal tunnel. Diagnosis was difficult clinically and radiologically.