Arthroscopy is recognized as an important adjunct in treatment of intra-articular fractures. The author reports on successful treatment of a displaced transverse glenoid cavity fracture, reduced and fixed with arthroscopic assist, using two cannulated screws perpendicular to the fracture surface, in a patient with frail chest. One screw passed through the Neviaser portal, and the other screw passed through the base of the coracoid process. Arthroscopy assisted reduction and 2 cannulated screw fixation through the Neviaser portal and coracoid base appears to be a good method for treatment of transverse glenoid fractures.
Arthroscopy* ; Glenoid Cavity ; Humans ; Intra-Articular Fractures ; Methods ; Thorax

Various minimally invasive repair techniques have been performed for acute Achilles tendon rupture. Despite this, it is difficult to use these techniques in common practice because of the necessity of special instruments. We propose a novel minimal invasive technique using sponge holding forceps, which are commonly used in the operating room for the acute Achilles tendon rupture.
Achilles Tendon* ; Operating Rooms ; Porifera* ; Rupture ; Surgical Instruments*

BACKGROUND: We conducted a systematic review of the literature to investigate the correlation between the interval to treatment and management of tendon avulsion ruptures in the musculotendinous junction (MTJ) of the forearm. METHODS: A thorough literatures search for studies of tendon avulsion injuries at the forearm was conducted using PubMed, MEDLINE, CINAHL, and Cochrane databases in accordance with the PRISMA guidelines. In total, five case series and 15 case reports accounting for 87 injured tendons involving 60 patients were selected for the analysis. RESULTS: Twenty-six patients had 44 tendon injuries associated with avulsion amputations, 31 patients had 38 tendon ruptures associated with closed avulsion injuries and three patients had five tendon ruptures associated with open avulsion injuries. Eighteen of the 49 (37%) patients were immediately treated for tendon ruptures and one of the 32 (3%) tendon ruptures treated via elective surgery was directly repaired. Additionally, 18 of the 30 (60%) tendons were directly repaired and 12 of the 30 (40%) tendons were transferred or side-to-side repaired in the immediately treated series. In contrast, one of the 28 (4%) tendon ruptures were directly repaired and 27 of the 28 (96%) tendons were transferred or side-to-side repaired in the electively treated series. CONCLUSION: In managing digital tendon avulsions at the MTJ, an immediate treatment could provide an opportunity to repair the ruptured tendon directly to the muscle.
Amputation ; Emergency Treatment ; Forearm ; Humans ; Methods* ; Rupture ; Tendon Injuries ; Tendons*

Some proximal humeral fractures in elderly patients are accompanied by medial metaphyseal comminution and quality of the bone is so poor that head preserving osteosynthesis seems to be amenable. In cases of medial metaphyseal comminution, lateral locking compression plate (LCP) fixation also has a tendency to become a matter of screw cut out or loss of fixation. The author reports on successful treatment of two osteoporotic proximal humeral fractures combined with medial meta-physeal comminution, with application of additional direct medial supporting plate fixation. Medial plate fixations were added when the fractures were still unstable after the conventional lateral LCP fixation and anterior circumflex humeral arteries had been ruptured before. The fixations were stable enough to start exercise immediately after surgery. The inclinations of the humeral neck were not changed until the last follow-up and clinical results were satisfactory without humeral head osteonecrosis which was a concern.
Aged ; Arteries ; Follow-Up Studies ; Fractures, Comminuted* ; Head ; Humans ; Humeral Head ; Humerus* ; Neck ; Osteonecrosis ; Osteoporosis ; Shoulder Fractures

Background: Surgical management of a massive rotator cuff tear (RCT) is always challenging. This study describes the clinical and radiological outcomes of patients who underwent bridging grafts using a plantaris tendon for an irreparable RCT. Methods: Thirteen patients with a massive RCT were treated with arthroscopic interposition of a folded plantaris tendon autograft between June 2017 and January 2020. For clinical evaluation, a visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, Disabilities of the Arm, Shoulder, and Hand (DASH) score, Constant-Murley score, and range of motion values were collected. For radiographic evaluation, standardized magnetic resonance imaging and ultrasonography were performed to check the integrity of the interposed tendon. Results: A statistically significant improvement at the final follow-up was evident in scores for the VAS (−3.0, P=0.003), ASES (24.9, P=0.002), D ASH (−20.6, P=0.001), and Constant-Murley values (14.2, P=0.010). In addition, significant improvement was shown in postoperative flexion (17.3°, P=0.026) and external rotation (27.7°, P<0.001). In postoperative radiologic evaluations, the interposed tendons were intact at the last examination in 12 of the 13 patients. No complications related to donor sites were reported. Conclusions An arthroscopic bridging graft for irreparable RCTs using a modified Mason-Allen stitch and a plantaris autograft resulted in improved short-term radiological and clinical outcomes. Graft integrity was maintained for up to 2 years in most patients.Level of evidence: IV.

BACKGROUND: We conducted a systematic review of the literature to investigate the correlation between the interval to treatment and management of tendon avulsion ruptures in the musculotendinous junction (MTJ) of the forearm.METHODS: A thorough literatures search for studies of tendon avulsion injuries at the forearm was conducted using PubMed, MEDLINE, CINAHL, and Cochrane databases in accordance with the PRISMA guidelines. In total, five case series and 15 case reports accounting for 87 injured tendons involving 60 patients were selected for the analysis.RESULTS: Twenty-six patients had 44 tendon injuries associated with avulsion amputations, 31 patients had 38 tendon ruptures associated with closed avulsion injuries and three patients had five tendon ruptures associated with open avulsion injuries. Eighteen of the 49 (37%) patients were immediately treated for tendon ruptures and one of the 32 (3%) tendon ruptures treated via elective surgery was directly repaired. Additionally, 18 of the 30 (60%) tendons were directly repaired and 12 of the 30 (40%) tendons were transferred or side-to-side repaired in the immediately treated series. In contrast, one of the 28 (4%) tendon ruptures were directly repaired and 27 of the 28 (96%) tendons were transferred or side-to-side repaired in the electively treated series.CONCLUSION: In managing digital tendon avulsions at the MTJ, an immediate treatment could provide an opportunity to repair the ruptured tendon directly to the muscle.
Amputation ; Emergency Treatment ; Forearm ; Humans ; Methods ; Rupture ; Tendon Injuries ; Tendons

Tarsal tunnel syndrome is an entrapment neuropathy of the posterior tibial nerve or its branches in the fibro-osseous tunnel beneath the flexor retinaculum. This pathology is associated with multiple etiologies, including trauma, space-occupying lesions, and impaired biomechanics. We report a case of tarsal tunnel syndrome associated with gout tophi in a patient with untreated gout along with a review of the relevant literature on tarsal tunnel syndrome.
Gout* ; Humans ; Pathology ; Tarsal Tunnel Syndrome* ; Tibial Nerve

Posttraumatic instability of the carpometacarpal joint of the thumb are rarely reported. Consequently little is known about clinical and radiologic diagnosis, natural progress or treatment method. We report three cases of chronic instability of the carpometacarpal joint of the thumb treated with Eaton and Littler's ligament reconstruction. Satisfactory thumb functions were restored without arthritic change or recurrent subluxation.
Carpometacarpal Joints* ; Diagnosis ; Ligaments ; Methods ; Thumb*

PURPOSE: This study was to evaluate the radiological and clinical mid-term results and the presence of post-traumatic osteoarthritis after osteosynthesis in patients under the age of 50 years undergoing osteosynthesis for distal femur intra-articular fractures (AO/OTA 33-B & C) from high-energy trauma. MATERIALS AND METHODS: Between January 2008 and January 2013, a total of twenty-one patients with more than three years of follow-up were enrolled. Recovery of the alignment of the lower extremity, union period, and the presence of post-traumatic osteoarthritis were confirmed by follow-up radiographs. Clinically, the range of motion, pain on fracture lesion, and Knee Society score (KSS) were evaluated. RESULTS: The average duration of union was 18.2 weeks (10-28 weeks), and the alignment of the lower extremity was within normal range in all patients. Seven patients showed post-traumatic osteoarthritis at the final follow-up after more than three years. The presence of post-traumatic osteoarthritis was associated with the classification of fractures, coronal plane fracture, and age. The average range of motion, knee score among KSS, and function score at the last follow-up were 128.7°, 86.1, and 85.1, all showing a greater improvement when compared with the one-year follow-up scores. CONCLUSION: The mid-term result was radiologically and clinically satisfactory. Furthermore, only 33.3% of patients showed a slight progress of post-traumatic osteoarthritis, which critically effects the prognosis.
Classification ; Femur* ; Follow-Up Studies ; Humans ; Intra-Articular Fractures* ; Knee ; Lower Extremity ; Osteoarthritis ; Prognosis ; Range of Motion, Articular ; Reference Values