Indian J Orthop
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The most appropriate fusion levels remains challenging, especially in Lenke type 5 curves. In Lenke 5 adolescent idiopathic scoliosis (AIS) generally fusion includes the lower end vertebra (LEV). This study determines whether it is appropriate to fuse mild to moderate Lenke 5 curves to LEV-1, if possible. ⋯ Fusion to LEV-1was associated with the higher amount of LIV disc angle and LIV translation, which did not cause coronal and sagittal imbalance and decreased the quality of life scores. Hence, if intraoperatively a level disc below LIV can be achieved, fusion to LEV-1 may be an option in mild to moderate Lenke 5 curves, to save one more mobile segment.
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The treatment of comminuted tibia plafond fractures remains clinically challenging due to the complexity of the articular fracture pattern despite using the anatomically precontoured locked plates. This study describes the morphologic characteristics of the anterolateral fragment and to evaluate the fixability of the anterolateral fragment with the anatomically precontoured locked plate in the pilon fracture. ⋯ Anatomical distal tibial locked plates did not take purchase on the anterolateral fragment in pilon fracture in the best anatomical fit. Preoperative CT measurement can be used for determining a fixation strategy for the anterolateral fragment. In addition, a newly designed anterolateral distal tibia plate can be another solution when the usual anatomically precontoured distal tibia locked plate fails to cover the anterolateral fragment.
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In the current clinical scenario, restenosis following the primary surgical procedure for lumbar canal stenosis is being frequently noticed. A number of studies have evaluated the reoperation rates following different surgical procedures for lumbar canal stenosis. However, a dilemma still exists about the surgical procedures, associated comorbidities and reoperation rates. ⋯ Smoking is an independent risk factor for revision surgery. Diabetes reduces the time interval between the initial surgery and the revision surgery. This review highlights the causes of reoperations in various lumbar stenosis surgeries, associated comorbidities and expected outcome.
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Tears of the triangular fibrocartilage complex (TFCC) can result in instability of the distal radioulnar joint (DRUJ) and ulnar-sided wrist pain. This study evaluates clinical results of arthroscopic transosseous repair for both proximal and distal components of TFCC tear with DRUJ instability. ⋯ Arthroscopic one-tunnel transosseous TFCC foveal repair and simulatneous transosseous capsular repair of distal component can be a safe and effective strategy for repair of complete TFCC tear combined with DRUJ instability.
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A variety of surgical techniques for treating mallet fracture finger has been reported with different outcomes and complications. However, the optimal procedure remains controversial. This study describes surgical outcomes of mallet fractures of the finger with distal phalanx treated by modified pull-out wire fixation with Kirschner wire (K-wire) stabilization of the DIP joint in hyperextension. ⋯ Our modified pull-out wire fixation over a button and K-wire stabilization of DIP joint in hyperextension is a reliable surgical method for treating acute mallet fracture finger and DIP joint volar subluxation.