Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament: Early Outcomes of Suture Anchor Repair with Suture Tape Augmentation

Introduction The purpose of this study was to evaluate the early outcomes of thumb metacarpophalangeal (MCP) joint ulnar collateral ligament (UCL) repair using suture anchors with suture tape augmentation. Materials and Methods Six patients underwent thumb UCL repair or reconstruction with suture tape augmentation and six patients underwent thumb UCL repair with intraosseous suture anchors between January 2013 and January 2018. The main outcome measures were range of motion, strength, Disabilities of the Arm, Shoulder, and Hand (DASH) score, and complications. Results At final follow-up for patients who had suture tape augmentation, the average thumb MCP joint and interphalangeal (IP) joint flexion were 65 and 73 degrees, respectively. The average DASH score was 4.3. At final follow-up for patients who had intraosseous suture anchor repair, the average thumb MCP joint and IP joint flexion were 50 and 60 degrees, respectively. The average DASH score was 38. There were no complications or secondary procedures in either group. Conclusion The use of suture anchor repair with suture tape augmentation for thumb UCL injuries is a treatment option that allows for early range of motion with satisfactory early outcomes that are comparable to intraosseous suture anchor repair. Level of Evidence  This is a level IV, case series article.     

Arthroscopic Rotator Cuff Repair Using the Suture Loop Shuttle Technique

With the arthroscope in the posterior portal, several suture loops are passed through the rotator cuff via the superior lateral portal before the first anchor is inserted. The suture loop is created by passing both free ends of a No. 2 monofilament (48-inch Prolene, Ethilon, or PDS; Ethicon, Somerville, NJ) suture into an arthroscopic suture passing device. The free ends and the loop of each suture loop are temporarily transferred into the anterior cannula. Anchor insertion and passage of the anchored sutures are performed from posterior to anterior. With standard suture anchors, the loop end of the suture loop must be located on the undersurface of the cuff. The suture anchors are inserted one at a time through the superior lateral portal and are placed into the prepared holes. Anchored sutures are temporarily pulled out through the inferior lateral portal. Next, the free ends of the most posterior suture loop are retrieved through the superior lateral portal. The looped end of this suture loop is retrieved through the inferior lateral portal. The suture loop is used to shuttle a single anchored suture through the rotator cuff and out through the superior lateral portal. Then, the other anchored suture is retrieved through the superior lateral portal with a suture grasper and tied.     

A Microsurgical Suture Technique Without the Need for Vascular Clamps

Vascular clamps are often used during microvascular repair and anastomosis. However, pressure exerted by the clamps may damage the vessels, which compromises patency of vessels. This article reports on a microsurgical suture technique performed without any clamp to avoid clamp-related problems.     

Suture and immobilization of acute peripheral injuries of the meniscus in rabbits

A comparative study of suturing or nonsuturing with or without immobilization of acute peripheral injuries to the medial meniscus of rabbits is reported. Artificial injuries to both knees of 44 male China Blue-Violet rabbits were sutured or left unsutured. One knee joint of each rabbit was immobilized postoperatively for 6 weeks. The maximum breaking strength was measured, pathologic examinations were performed, and healed areas were measured. The results showed that there was greater healed area, higher maximum breaking strength, earlier matured scar tissue formation, and more regular fiber alignment in the treatment groups with simple immobilization of the knee joint. These results were superior to suturing plus immobilization, suggesting that external immobilization of the knee joint is the key to the treatment of acute peripheral injuries of the meniscus. It may be the procedure of choice for clinical orthopedists dealing with such injuries. The measurement of the meniscus healed area and maximum breaking strength and the use of new material with this method of immobilization were introduced by the authors.     

美容缝合修复在急诊面部创伤中的应用效果

目的 分析美容缝合修复在急诊面部创伤中的应用效果。方法 选取2021年1月-2022年1月我院 收治的58例急诊面部创伤患者为研究对象,随机分为观察组和对照组,各29例。对照组应用传统急诊 清创缝合技术,观察组应用美容缝合修复,比较两组创面愈合情况、恢复优良率、手术时间、创面愈 合时间、焦虑评分（HAMA）以及满意度评分。结果 观察组创面愈合评分低于对照组（P＜0.05）;观 察组恢复优良率高于对照组（P＜0.05）;两组手术时间比较,差异无统计学意义（P＞0.05）;观察组创 面愈合时间短于对照组（P＜0.05）;观察组焦虑评分低于对照组（P＜0.05）;观察组满意度高于对照组 （P＜0.05）。结论 美容缝合修复应用于面部急诊患者中可以提升创伤修复效果,缩短创面愈合时间,减 轻患者的焦虑情绪,提升患者满意度,值得临床应用。     

关节镜下全内缝合法修补半月板59例疗效观察

目的探讨关节镜下全内缝合法在半月板修补中的应用及临床疗效。方法自2006年1月至2009年5月,我院对59例半月板损伤的患者采用全内缝合法进行了半月板修补。其中采用可吸收半月板箭3例,Fast-Fix全内半月板缝合系统56例。结果 59例全部得到随访,随访时间3～30个月,平均16.2个月。随访采用电话问卷、主观症状及临床检查等方式进行。主观症状和临床查体57例正常,2例在12及14个月后再次膝关节扭伤,出现症状。术前HSS评分37～62分,平均47.6分;术后HSS评分86～96分,平均93.9分。结论关节镜下全内缝合法是修补半月板损伤的理想方法,Fast-Fix系统操作简单,并发症少,疗效确切,治愈率高。     

Evaluation of a New Knotless Suture Anchor Repair in Acute Achilles Tendon Ruptures: A Biomechanical Comparison of Three Techniques

Acute ruptures of the Achilles tendon are a common injury, and debate has continued in published studies on how best to treat these injuries. Specifically, controversy exists regarding the surgical approaches for Achilles tendon repair when one considers percutaneous versus open repair. The present study investigated the biomechanical strength of 3 different techniques for Achilles tendon repair in a cadaveric model. A total of 36 specimens were divided into 3 groups, each of which received a different construct. The first group received a traditional Krackow suture repair, the second group was repaired using a jig-assisted percutaneous suture, and the third group received a repair using a jig-assisted percutaneous repair modified with suture anchors placed into the calcaneus. The specimens were tested with cyclical loading and to ultimate failure. Cyclical loading showed a trend toward a stronger repair with the use of suture anchors after 10 cycles (p = .295), 500 cycles (p = .120), and 1000 cycles (p = .040). The ultimate load to failure was greatest in the group repaired with the modified knotless technique using the suture anchors (p = .098). The results of the present study show a clear trend toward a stronger construct in Achilles repair using a knotless suture anchor technique, which might translate to a faster return to activity and be more resistant to an early and aggressive rehabilitation protocol. Further clinical studies are warranted to evaluate this technique in a patient population.     

Suture anchor repair of quadriceps tendon rupture after total knee arthroplasty

Disruption of the extensor mechanism after total knee arthroplasty (TKA) is a devastating complication, usually requiring surgical repair. Although suture anchor fixation is well described for repair of the ruptured native knee quadriceps tendon, no study has discussed the use of suture anchors in quadriceps repair after TKA. We present an illustrative case of successful suture anchor fixation of the quadriceps mechanism after TKA. The procedure has been performed in a total of 3 patients. A surgical technique and brief review of the literature follows. Suture anchor fixation of the quadriceps tendon is a viable option in the setting of rupture after TKA.     

Modified Mason-Allen Suture Bridge Technique: A New Suture Bridge Technique with Improved Tissue Holding by the Modified Mason-Allen Stitch

We present a new method of suture bridge technique for medial row fixation using a modified Mason-Allen stitch instead of a horizontal mattress. Medial row configuration of the technique is composed of the simple stitch limb and the modified Mason-Allen stitch limb. The limbs are passed through the tendon by a shuttle relay. The simple stitch limb passes the cuff once and the modified Mason-Allen stitch limb passes three times which creates a rip stop that prevents tendon pull-out. In addition, the Mason-Allen suture bridge configuration is basically a knotless technique which has an advantage of reducing a possibility of strangulation of the rotator cuff tendon, impingement or irritation that may be caused by knot.     

Suture Versus Tack Fixation of Mesh in Laparoscopic Umbilical Hernia Repair

Background and Objectives:

Mesh fixation in laparoscopic umbilical hernia repair is poorly studied. We compared postoperative outcomes of laparoscopic umbilical hernia repair in suture versus tack mesh fixation.

Methods:

Patients who underwent laparoscopic umbilical hernia repair were separated by method of mesh fixation: sutures versus primarily tacks. Medical history and follow-up data were collected through medical records. The primary outcome of this study was the recurrence rates of hernias. Postoperative major and minor complications, such as surgical site infection, small-bowel obstruction, and seroma formation, were regarded as secondary outcomes. Additionally, a telephone interview was conducted to assess postoperative pain, recovery time, and overall patient satisfaction.

Results:

Eighty-six patients were identified: 33 in the suture group and 53 in the tacks group. The number of emergent cases was increased in the tacks group (6 vs 0; P = .022). Mean follow-up time was 2.7 years for both groups. Documented postoperative follow-up was obtained in 29 (90%) suture group and 31 (58%) tacks group patients. Hernia recurrence occurred in 3 and 2 patients in the sutures and tacks groups, respectively (P was not significant). No differences were found in secondary outcomes, including subjective outcomes from telephone interviews, between groups.

Conclusions:

There are no differences in postoperative complication rates in suture versus tack mesh fixation in laparoscopic umbilical hernia repair.