Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Feb 2023
Posterior to anterior malleolar extended lateral approach to the ankle (PAMELA): early results of a novel approach.
In a previous cadaveric study, we described the Posterior to Anterior Malleolar Extended Lateral Approach (PAMELA) to address complex ankle fractures. It was demonstrated to provide optimal exposure of the posterior and lateral malleoli, and of the anterolateral portion of the ankle through a single incision. The aim of this study is to report the clinical results of this novel approach. ⋯ The main potential concern regarding this novel approach was the healing of the flap. Our results reject this concern and are in line with wound healing complications reported following surgical treatment of ankle fractures. This study confirms the safe in vivo feasibility of the PAMELA and opens a new perspective in the optimal management of complex fractures of the ankle. A larger prospective clinical study is ongoing in our institution.
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Arch Orthop Trauma Surg · Feb 2023
Locking suture repair versus ligament augmentation-a biomechanical study regarding the treatment of acute lateral collateral ligament injuries of the elbow.
Lateral collateral ligament (LCL) tears are frequently observed in fractures and dislocations of the elbow. Recent biomechanical evidence suggests that additional ligament augmentation may improve repair stability. The aim of this biomechanical in-vitro study was to compare the resistance of a locking suture repair of the LCL with a ligament augmentation technique. ⋯ Basic science study, biomechanics.
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Arch Orthop Trauma Surg · Feb 2023
What are the optimal targeting visualizations for performing surgical navigation of iliosacral screws? A user study.
Complex orthopaedic procedures, such as iliosacral screw (ISS) fixations, can take advantage of surgical navigation technology to achieve accurate results. Although the impact of surgical navigation on outcomes has been studied, no studies to date have quantified how the design of the targeting display used for navigation affects ISS targeting performance. However, it is known in other contexts that how task information is displayed can have significant effects on both accuracy and time required to perform motor tasks, and that this can be different among users with different experience levels. This study aimed to investigate which visualization techniques helped experienced surgeons and inexperienced users most efficiently and accurately align a surgical tool to a target axis. ⋯ Our results show that 2D bullseye views helped both experienced orthopaedic trauma surgeons and inexperienced users target iliosacral screws accurately and efficiently. These findings could inform the design of visualizations for use in a surgical navigation system for screw insertions for both training and surgical practice.
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Arch Orthop Trauma Surg · Feb 2023
Arthroscopic treatment and subacromial decompression of calcific tendinitis without removal of the calcific deposit results in rapid resolution of symptoms and excellent clinical outcomes in commercial airline pilots and cabin crew.
The purpose of this study was to report the results of subacromial arthroscopic decompression (SAD) without removal of the calcific deposits in patients with calcifying tendinitis. ⋯ The results of this study suggest excellent short- and mid-term clinical outcomes can be achieved in patients with calcific tendinitis undergoing arthroscopic debridement and subacromial decompression without removal of calcific deposits. In this patient population, early surgical intervention was a potentially viable alternative to nonoperative treatment, and allowed early return to work.