The Orthopedic clinics of North America
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Orthop. Clin. North Am. · Jan 2014
ReviewPerioperative upper extremity peripheral nerve traction injuries.
Peripheral nerve traction injuries may occur after surgical care and can involve any of the upper extremity large peripheral nerves. In this review, injuries after shoulder or elbow surgical intervention are discussed. Understanding the varying mechanisms of injury as well as classification is imperative for preoperative risk stratification as well as management.
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Orthop. Clin. North Am. · Jan 2014
ReviewPerioperative lower extremity peripheral nerve traction injuries.
Peripheral nerve traction injuries may occur after surgical care and can involve any of the lower extremity large peripheral nerves. In this review, the authors discuss injuries after knee or hip surgical intervention. The diagnosis, including electrodiagnostic studies, is time sensitive and also relies on a detailed history and physical examination. Successful prevention and treatment involve familiarity with risk and predisposing factors as well as prophylactic measures.
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Spondylopelvic dissociation is a complex injury pattern resulting in multiplanar instability of the lumbopelvis. These injuries have traditionally been known as "suicide jumper's fractures" and have recently increased in prevalence as a result of under-vehicle explosions seen in the past decade of military conflicts in the Middle East. The hallmarks of spondylopelvic dissociation are bilateral vertical sacral fractures with a horizontal component, resulting in lumbosacral instability in the sagittal and axial planes. Surgical treatment has evolved greatly and both percutaneous and open options are available, with triangular osteosynthesis being the most relied on method of fixation.
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Orthop. Clin. North Am. · Jan 2014
ReviewThe management of type II superior labral anterior to posterior injuries.
Arthroscopic repair of type II superior labral anterior to posterior (SLAP) tears is currently the standard of care, with most patients obtaining good to excellent surgical results. However, overhead athletes and older patients have inferior outcomes. Recent clinical studies and biomechanical data suggest that a biceps tenodesis is a suitable alternative in select patients. This article reviews the literature to identify the biomechanical and clinical indications for performing a biceps tenodesis for type II SLAP lesions.
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Adult traumatic brachial plexus injury involves injury of the C5-T1 spinal nerves. Common patterns of injury include "upper arm" and "total arm" types. The specific signs of preganglionic avulsion injury infer a poor prognosis for spontaneous recovery and surgery may be needed. ⋯ Good functional results may be achieved after multiple nerve transfers. The treatment of total arm type includes hand function reconstruction, in addition to shoulder and elbow treatment. Current options for hand function reconstruction include functioning free muscle transfers and nerve transfers.