Operative Orthopädie und Traumatologie
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Oper Orthop Traumatol · Jun 2014
Review[Arthodesis of the proximal and distal interphalangeal joint].
Elimination of the fixed lesser toe deformity by arthrodesis of the proximal or distal interphalangeal joints (PIP and DIP, respectively). ⋯ Stabilisation of the toe with adequate alignment is achieved by arthrodesis of the affected joint. In general, digital fusion of the fixed lesser toe pathology shows a high subjective satisfaction rate among the patients, although the rate of pseudarthrosis in attempted PIP or DIP arthrodesis is quite high. Major reasons for postoperative dissatisfaction were swelling, wound necrosis, pin infection, floating toe, shortening and angulation of the toe.
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Arthroscopic resection of the painful and degenerative altered acromioclavicular (AC) joint without destabilization of the joint and therefore pain relief and improvement in function. ⋯ An isolated open AC joint resection was performed in 9 studies and an arthroscopic resection in 6 studies. Good and very good results were obtained in 79% (range 54-100%) in open resection and 91% (range 85-100%) in arthroscopic resections. Patients were able to return to activities of daily life more quickly after arthroscopic resections than after open surgery.
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Oper Orthop Traumatol · Jun 2014
[Arthroscopically assisted reconstruction of acute and chronic AC joint separations].
The surgical procedure aims at anatomic reduction and stabilization of the acromioclavicular joint in vertical and horizontal planes for acute separations using a trans-clavicular and trans-coracoidal suture tape fixation with additional acromioclavicular joint augmentation with a PDS cord cerclage. For chronic instability adding a tendon graft is essential for sustainable stability. ⋯ The presented surgical technique reliably stabilizes the acromioclavicular joint. It's biomechanical properties with only the single-tunnel coracoclavicular suture tapes is on the level of the native vertical stability, which can be additionally improved for better horizontal stability with the cerclage over the AC-joint.
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Reposition and fixation of unstable distal clavicle fractures with a low profile locking plate (Acumed, Hempshire, UK) in conjunction with a button/suture augmentation cerclage (DogBone/FibreTape, Arthrex, Naples, FL, USA). ⋯ Due to the fact that the described technique is a relatively new procedure, long-term results are lacking. In the short term, patients postoperatively report high subjective satisfaction without persistent pain.