Arthroscopic reconstruction of a complex glenoid rim fracture using suture anchors

The gold standard for the treatment of large displaced glenoid rim fractures has been open reduction and internal fixation using cannulated screws. With the advancement in arthroscopic techniques there has been a growing trend towards arthroscopic treatment of glenoid rim fractures. This report outlines the case of 39-year-old health men who sustained a complex multifragmented displaced glenoid rim fracture after a fall on the right shoulder. The injury was diagnosed by standard radiographs and 3D-CT. An arthroscopic reconstruction including closed reduction and internal fixation using suture anchors was performed. After a follow-up of 1 year the Constant Score was 94 points, the Rowe Score 100 points and the Western Ontario Shoulder Instability Index was 99.9 points. In the Simple Shoulder Test all questions were answered with “yes”. At the latest follow-up the patient was completely painfree and regained a full work activity level. On postoperative 3D-CT imaging the fracture was consolidated in an almost anatomic position with a nearly complete reconstruction of the inferior glenoid circle. In cases of displaced glenoid rim fractures closed reduction and arthroscopic reconstruction using suture anchors can lead to excellent clinical and radiological results.     

Limited posterior approach for internal fixation of a glenoid fracture

We present the case of a patient who was treated by open reduction and internal fixation for a displaced glenoid fracture using a limited posterior approach.No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study.     

Arthroscopic repair for anterior shoulder instability with a Bigliani type I glenoid rim fracture

This case report describes arthroscopic repair for the treatment of an anterior glenoid rim fracture associated with traumatic anterior shoulder dislocation.Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 18, No 6 (July-August), 2002: pp E32     

Overlap arthroscopic Bankart repair: Reconstruction to the glenoid rim

A new arthroscopic approach for traumatic instability has been developed with which avulsed capsulolabral tissue can be effectively attached to the glenoid articular rim with sutures, providing anatomic reattachment and effective deepening of the glenoid concavity similar to that achieved by open repair. This technique does not depend on fixation devices, trans-scapular drilling, or implantation of suture anchors. The fixation of the labrum using the punch-chop needle overlap technique (Aeratec Inc, Uniondale, NY) for reattaching torn labral tissue to bone allows ease of suture placement for Bankart lesion repair, with the fixation overlapping the rim of the glenoid. The technique presented here includes preparation of the glenoid rim, drilling of the glenoid tunnels, and peripheral suturing of the labrum.Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 18, No 4 (April), 2002: E18     

Nonunion of a pertrochanteric femur fracture due to a low-velocity gunshot

The treatment of nonunions often can be a complex and challenging venture. This case report details the treatment of a young patient's pertrochanteric femoral nonunion due to a low-velocity gunshot. Fracture fixation and union were attempted with various implants, including a sliding hip screw, blade plate, and proximal femoral locking plate; however, all eventually failed. Successful union ultimately was obtained only after use of a cephalomedullary nail. There have been few reports in the literature on the failure of proximal femoral locking plates in the treatment of pertrochanteric femur fractures, though much has been published regarding the sliding hip screw and blade plate. Multiple options for use in nonunion surgery were used and discussed in this case, such as autogenous bone graft, bone morphogenic protein, and implantable bone stimulators.     

Arthroscopic repair of glenoid rim fractures: a ligamentotaxis surgical technique

Introduction

The treatment of the flexor tendon adhesions following phalanx and metacarpal fractures, in closed or open injuries, is a great challenge for the hand surgeon. The outcomes are often poor, because of the severity of the lesion and the aggressiveness of the surgical procedure of the secondary tenolysis.

Materials and methods

The authors describe the technical findings and the results of a new mini-invasive tenolysis in order to treat the adhesions in zone 1 and 2 of the fingers, following phalangeal and metacarpal fractures. With an atraumatic Allis or Duval surgical forceps, the flexor tendons are separately and gently tracted making a twisting movement on themselves until the adhesions were torn and the tendons appeared released.

Results

The relevant outcomes achieved show this technique is very useful to treat tendon adhesions, without adding trauma and scare to the tendinous canal and surrounding soft tissues.

     

Nonunion of a complex tibial plateau fracture

Nonunion of tibial plateau fractures are uncommon; only five cases have been reported in the literature. This report presents the sixth nonunion and highlights the management of an angulated, periarticular pseudoarthrosis. Pitfalls in the initial fracture treatment that contributed to the development of the pseudoarthrosis are reviewed.     

Nonunion of a Hoffa fracture in a child

The authors report a case of a Hoffa fracture of the lateral femoral condyle that subsequently went on to nonunion in an eight-year-old child. The child presented with symptoms of knee pain and snapping five years after a motor vehicle accident. The nonunion fragment involved most of the lateral femoral condylar articular surface but spared the physis. After treatment by open reduction and limited internal fixation, the nonunion has healed, and the child has virtually full range of motion of the knee and no evidence of growth disturbance.     

Osteochondral humeral head fracture after posterior shoulder subluxation: A case report

Traumatic posterior shoulder subluxations are rare entities which require clinical suspicion upon presentation. Although literature presents many sequels of posterior shoulder subluxations, we have not come across any shearing type osteochondral fracture in the literature. In this case report we present diagnosis, treatment and follow-up results of this rare fracture in a 26-year-old male following a fall from a motorcycle.     

Nonunion of a Hoffa fracture in an adult

The coronal fractures of femoral condyles, known as Hoffa fractures, are a rarity. Conservative management often leads to unsatisfactory results and nonunion. In this study, we present a case of a 35-year-old patient with an established nonunion of medial Hoffa fracture of right knee treated with open reduction and internal fixation.     

Delayed presentation of post-traumatic posterior dislocation of the hip with acetabular rim fracture

Two cases of posterior dislocation of the hip occurring some time after injury are described. Each had an associated acetabular rim fracture which was missed at the initial examination because there was no clinical indication to X-ray the hip. We have been unable to discover previous recording of traumatic posterior dislocation of the hip occurring in this manner.