Does the IOFIX improve compression in ankle fusion?

Background: The new IOFIX is an intra-osseous fixation device comprising an "X-post" through which a lag screw passes to apparently improve force distribution across an arthrodesis. We conducted a novel human cadaveric study. Our null hypothesis was no difference in force exists in an ankle arthrodesis model stabilized with the IOFIX or a conventional single lag screw.

The risk of injury to the anterior tibial artery in the posterolateral approach to the tibia plateau: a cadaver study.

Background: Posterolateral tibial plateau shear fractures often require buttress plating, which can be performed through a posterolateral approach. The purpose of this study was to provide accurate data about the inferior limit of dissection.

Methods: Forty unpaired cadaver adult lower limbs were used.

Radiological landmarks for the safe extra-capsular placement of supra-acetabular half pins for external fixation.

Purpose: Low anterior external fixators are constructed by placing half pins in the dense bone tunnel of the supra-acetabular region in an anterior to posterior direction. Although the placement of these pins is extra-articular, they may still breach the hip capsule on the anterior inferior iliac spine and thus be intra-capsular. We aim to provide radiological markers for the most superior fibres of the capsule to allow safe extra-capsular pin placement within the supra-acetabular bone tunnel.

Drilling, not a benign procedure: laboratory simulation of true drilling depth.

Introduction: Drilling is an integral part of almost all boney operations. Various anatomical structures coursing close to the bone are at risk if the drill bit projects beyond the far cortex. Aim of this study was to evaluate and quantify the depth to which surgeons over drill beyond the far cortex.

Anatomical structures at risk with the proud retrograde femoral nail.

Background: Post-operative knee pain is common following retrograde nailing, with its etiology often multifactorial although a well-established cause is nail protrusion from the intercondylar notch. The aim of this study was to assess the structures at risk if the nail is left proud of the femoral articular surface.

Methods: A retrograde femoral nail (Synthes Distal Femoral Nail) was inserted into the distal femur of 15 cadaveric lower limbs using the standard technique.

Is plating of mid-shaft clavicular fractures possible with a conventional straight 3.5 millimeter locking compression plate?

Objectives: Current literature describes improved clinical outcomes and a minor rate of pseudoarthrosis following operatively treated clavicular fractures. We investigated the feasibility of using a standard 3.5 mm AO locking compression plate (LCP) of adequate length for the stabilisation of mid-shaft fractures of the clavicle.

The risk of nerve injury with minimally invasive plate osteosynthesis of distal fibula fractures: an anatomic study.

Aim: The aim of our study was to identify the structures which may be at risk of injury when using a minimally invasive technique for the osteosynthesis of the lateral malleolus and the influence of the size of the implant on the frequency of injury to these structures.

Method: Forty plates were percutaneously inserted in 20 cadaveric legs. The region around the plate was then dissected to examine the relation of nerves and soft tissues to the plate.

Accuracy of anterolateral versus posterolateral subtalar injection.

Introduction: Injections into the subtalar joint may be performed for diagnostic or therapeutic reasons. The anterolateral approach is most commonly utilised for this purpose. We evaluated the success of an intra-articular puncture by using the anterolateral in comparison to the posterolateral approach.

The risk injury to the posterior interosseous nerve in standard approaches to the proximal radius: a cadaver study.

Purpose: The aim of this study was to provide guidance on the safe zones for the exposure of the proximal radius by measuring the distance from the PIN to various anatomical landmarks in the proximal forearm in pronation and supination.

Methods: Twenty cadaveric arms were used for this study. On the anterior aspect of the forearm, the distance between insertion of the biceps tendon and the arcade of Frohse as well as the shortest distance between the PIN and the ulnar aspect of the radial neck were measured.

Morphology of the tibialis anterior muscle and its implications in minimally invasive plate osteosynthesis of tibial fractures.

We examined the variation in the origin of the tibialis anterior muscle from the lateral aspect of the tibial shaft and interosseous membrane as well as the variation in the morphology of its musculotendinous junction. Forty cadaveric lower leg specimens (20 right and 20 left) were dissected to reveal the anterior compartment. The origin of the tibialis anterior muscle and its relation to the lateral tibial shaft and interosseous membrane were determined.

Computer-assisted 3-dimensional anthropometry of the scaphoid.

Scaphoid fracture fixation using a cannulated headless compression screw and the Matti-Russe procedure for the treatment of scaphoid nonunions are performed routinely. Surgeons performing these procedures need to be familiar with the anatomy of the scaphoid. A literature review reveals relatively few articles on this subject.

Anatomical basis of the risk of radial nerve injury related to the technique of external fixation applied to the distal humerus.

Purpose: Stabilization of humeral shaft and elbow fractures can be achieved with an external-fixator. Reports about nerve injuries associated with this procedure are rare in literature. Purpose of this anatomical study was to examine the relation of the radial nerve to distal humeral half pins.

The percutaneous antegrade scaphoid fracture fixation--a safe method?

Introduction: The object of this study was to assess the risk of injury to tendons, nerves and vessels in percutaneous antegrade scaphoid fracture fixation.

Methods: Forty cadaveric forearms were used in this study. A guide wire for cannulated headless compression screws was inserted percutaneously in each scaphoid according to established surgical technique.

Various circular arc radii of the distal volar radius and the implications on volar plate osteosynthesis.

The purpose of this anatomical study was to explore the different circular arc radii of the distal volar radius and provide more detailed anatomic information that will further the understanding of volar plate osteosynthesis. The profiles of the volar distal radii of 100 cadaver specimens were measured with a common profile gauge. Profiles were copied onto paper and then matched to a best-fit circular arc template to determine the radius of curvature on the radial and ulnar sides of the distal volar radius.

Morphometric analysis of lister's tubercle and its consequences on volar plate fixation of distal radius fractures.

Purpose: The objective of this study was to measure the size and shape of Lister's tubercle and the depth of the extensor pollicis longus (EPL) groove to assess the risk of injury to the EPL tendon when performing volar plating of distal radius fractures.

Methods: The length and height of Lister's tubercle and the depth of the EPL groove were measured in 100 cadavers.

Results: The size of Lister's tubercle varied from 2 to 6 mm (average, 3.

Frequency of instrument breakage during orthopaedic procedures and its effects on patients.

Background: While breakage of an orthopaedic instrument is a relatively rare occurrence, orthopaedic surgeons need to be familiar with this complication and how to deal with it. Relatively little information about this subject has been published.

Methods: Every case of instrument breakage during orthopaedic procedures performed in two hospitals during a two-year period was documented prospectively.

The anatomy of the proximal ulna.

The posterior border of the ulna is the most important bony landmark for all dorsal surgical approaches and the guideline for open reduction, internal fixation of displaced comminuted fractures of the proximal ulna. We examined 74 cadaveric specimens to evaluate the anatomy of the proximal ulna, especially the course of the posterior border, the point of varus angulation, the width of the shaft, and the relationship of the posterior border to the interosseous and anterior ones. In 63 specimens, the mean point of varus angulation was 85.

Primary transection of the superficial peroneal nerve resulting from a distal fibula fracture.

Although a superficial peroneal nerve injury following an ankle fracture occurs frequently, primary transection of the nerve represents a rare injury. This report documents a case of primary lesion of the superficial peroneal nerve sustained following a Weber B bimalleolar ankle fracture. The nerve injury was diagnosed at the initial examination when the patient was found to have hypoesthesia in the area of her third to fifth toes.

Anatomy of the greater femoral trochanter: clinical importance for intramedullary femoral nailing. Anatomic study of 100 cadaver specimens.

Background: Fossa piriformis is considered the correct point of entry for a straight femoral nail. A trochanteric overhang may make the access to fossa piriformis difficult. We investigated the anatomy of the trochanteric region, paying special attention to the entry point for antegrade intramedullary femoral nailing.

A morphometrical study of the medullary cavity of the ulna referred to intramedullary nailing.

Intramedullary fixation is preferred for osteosynthesis in the case of long bone fractures; but the problem of the nails' adjustment to the anatomical needs remains. About 80 cadaveric ulnae were examined to elucidate the curvature of the medullary cavity, the point of varus angulation, the thickness of the radial and ulnar cortical bone and the diameter of the medullary cavity at that point. Furthermore, the point of varus angulation of the posterior border was compared to that of the medullary cavity, to evaluate if it allows any conclusion to the curvature of the medullary cavity.

Anatomic variations of the musculotendinous junction of the soleus muscle and its clinical implications.

The soleus muscle, like the gastrocnemius, is a powerful plantarflexor muscle in the lower limb. The soleus muscle joins the aponeurosis of the gastrocnemius muscle to form the calcaneal (Achilles) tendon. While the basic anatomy of the soleus muscle has been previously described, no study has addressed the anatomical variations of its distal attachment.

The triceps brachii muscle and its insertion on the olecranon.

Background: The purpose of this anatomical study was to define the insertion of the tendon of the triceps brachii muscle and the course of the lateral cubital retinaculum (LCR) as an enhancement of the triceps tendon.

Material/methods: One hundred cadaver specimens were assessed and the widths of the triceps tendon and the olecranon and the expansion of the LCR were determined.

Results: The width of the tendon ranged between 1.

Treatment of medial epicondylar apophyseal avulsion injury in children.

Objective: Surgical reduction and retention of apophyseal avulsion injuries at the medial epicondyle to prevent joint instability, lasting malalignment, or pseudarthrosis.

Indications: Absolute: intraarticular apophyseal dislocation of the medial epicondyle, complete lesion of the ulnar nerve. Relative: dislocation of the apophysis (> 4 mm) in children > 5 years of age; the need for intervention increases in children as the degree of dislocation, age, and athletic activity increase.

Delayed hypopharyngeal and esophageal perforation after anterior spinal fusion: primary repair reinforced by pedicled pectoralis major flap.

Study Design: This report documents a case of delayed hypopharyngeal and esophageal perforation after anterior spinal fusion and reviews relevant literature.

Objectives: Presentation of an alternative solution of primary repair and reinforcement of a delayed esophageal and hypopharyngeal perforation after anterior spinal fusion.

Summary Of Background Data: Anterior plating is generally used for stabilization after cervical spine trauma.