ISSN:1523-9896    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Arthroscopy has revolutionized the way shoulder surgeons have addressed intra-articular pathology. Continued advancements in technique and instrumentation have resulted in more and more procedures being performed on an all-arthroscopic basis. Appropriate caution has been taken with regard to applying arthroscopic techniques for all shoulder procedures, particularly instability. We describe an arthroscopic assisted rotator interval closure technique that, in the appropriately selected patient, is effective for treating particular shoulder instability.

ISSN:1523-9896    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Os acromialeis defined as the failure of fusion of one of the ossifications centers in the acromion. The mesoacromion is the most common location for this to occur. When this unfused portion is unstable, dynamic impingement results and is often associated with rotator cuff tears. Treatment of an unstable os acromiale remains under considerable debate. Numerous authors have reported on open reduction internal fixation, resection, and subacromial decompression, with varied results. Recently, arthroscopic management of the mesoacromion has been successful using a modified arthroscopic subacromial decompression technique. The surgeon must take care to ensure that the history, physical, radiographic, and arthroscopic examinations all correlate with the diagnosis. Strict surgical indications and meticulous technique can result in successful outcomes using arthroscopic techniques in the management of a symptomatic mesoacromion.

ISSN:1523-9896    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Ruptures of the distal biceps tendon can be surgically treated with more than one technique. The success of a traditional two-incision technique combined with the evolution of soft tissue fixation options has led to an interest in using a single-incision technique. The following article will describe the indications, surgical techniques, advantages, and disadvantages for each procedure.

ISSN:1523-9896    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Because of the development of heterotopic bone formation and technical simplicity, single anterior incision techniques have again become popular. The tendon is sutured to the Endobutton via a 5-cm transverse skin incision with two number 5 Ethibond Bunnell sutures. There is no need to perform surgical repair in the depths of the bulky forearm, because the tendon is simply sutured external to the wound. The prefabricated Endobutton–tendon unit is then locked into drill holes in the proximal radius. This construct is strong enough to allow early active mobilization. This technique can also be used for partial tendon ruptures. An autologous hamstring tendon graft is used to lengthen the tendon in patients with a delayed presentation.

ISSN:1523-9896    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Fractures of the scapula are uncommon injuries that frequently present in the setting of high-energy trauma. Glenoid fractures are only one third of these injuries (1–4). Most of them are minimally displaced and amenable to nonoperative treatment. Significantly displaced glenoid neck and glenoid fossa fractures that require operative intervention are exceedingly rare and together represent approximately 1 in every 3,000 fractures (5,6). This article reviews the available literature and describes the operative techniques used in the management of these uncommon and challenging injuries.

ISSN:1523-9896    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Three-part proximal humerus fractures are severe injuries that represent a technical challenge. Evaluation of fracture displacement is the cornerstone in determining a surgical indication. Treatment selection for three-part proximal humerus fractures includes nonoperative treatment, closed reduction and percutaneous pinning, open reduction internal fixation, and hemiarthroplasty. Decision-making is based on fracture pattern, patient age, bone quality, degree of comminution, and existing comorbidities. Recent efforts at closed reduction or limited open reduction and minimal osteosynthesis are encouraging in the treatment of three-part proximal humerus fractures. The technique of closed reduction and percutaneous pinning is difficult and demanding, and careful attention must be paid to the technical considerations and the appropriate indications. Multiple treatment options must be available at the time of surgery and the surgeon should pursue the method that will facilitate anatomic fracture reduction and stability.

ISSN:1523-9896    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Massive rotator cuff tears present many technical challenges to the surgeon. Although various techniques have been described for alleviation of pain (cuff debridement) and restoration of function (tendon transfers), mobilization and repair of the transposed cuff, whenever possible, have given more satisfactory results. In massive tears, the rotator cuff tendons retract and adhere to predictable locations and therefore lend themselves to a systematic approach of mobilization and repair. This article describes in detail the indications and preoperative planning; techniques for exposure, mobilization, and repair; potential complications; and rehabilitative considerations involved in the treatment of massive rotator cuff tears.

ISSN:1523-9896    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

As the understanding of pathology of the rotator cuff has evolved, so have surgical techniques in rotator cuff surgery. The ideal rotator cuff repair should have good initial fixation strength, allowing mobilization of the extremity during the healing phase. The authors present their indications and technique for rotator cuff repair using transosseous sutures. This technique can be employed through a standard open or mini open approach. The initial strength of this repair technique allows early, aggressive rehabilitation, minimizing potential for postoperative stiffness. Furthermore, this technique has proven clinically successful in 96% of the cases in which it was used.

ISSN:1523-9896    

出版商:OVID    

年代:2002

数据来源: OVID