Kangjoensen3190

Benign peripheral nerve tumours are rare lesions. The surgical treatment and clinical outcomes depend on the resectability. The aim of this retrospective study was to identify clinical or radiological features that may predict the surgical technique that should be used to improve clinical outcome. Eighty-two patients were diagnosed with solitary benign peripheral nerve tumours. Fifty-five tumours were surgically resectable, and 27 were nonresectable. Pre-operative magnetic resonance imaging and ultrasound were used, which were predictive of the neural origin of the tumours in 87% (39/45) of cases imaged. In 78% (50/64) of cases imaged, an origin from the nerve sheath (peripheral nerve sheath tumour), or from non-neural elements was possible. However, no imaging or clinical criteria were identified that could determine tumour resectability preoperatively. The diagnosis of solitary peripheral nerve tumour still relies on the macroscopic appearance and definitive histology after epineurotomy.A retrospective survey on the long-term outcomes of both proximal row carpectomy (PRC) and scaphoidectomy with 4-corner arthrodesis (4CA) was conducted. Seventeen PRC and nine 4CA wrists were retrieved with a minimal follow-up of 9 years. Pain, satisfaction and disability were not significantly different. There was a better flexion and ulnar deviation in the PRC wrists. Conclusion at long term, the outcome for PRC remains stable despite some series recently reported worsening of the results due to progressive degenerative arthritis. PRC seems to yield comparable clinical results compared to 4CA but a slightly better range of motion than 4CA.We performed a systematic review to find out the safety and efficacy of various procedures for isolated scaphotrapeziotrapezoid osteoarthritis. Eleven articles were included. The most common procedure was arthroplasty with pyrocarbon implant (28%), followed by resection of distal pole of scaphoid with proximal trapezium and trapezoid resection (18%). The other procedures included trapeziectomy with ligament reconstruction and tendon interposition (LRTI) (14%), arthroscopic resection of distal scaphoid (11%), trapezium and trapezoid resection with LRTI (10%) and arthrodesis (10%). Complications were noted in 18 (15%) patients. The most common complication (7.5%) was asymptomatic dorsal intercalated segmental instability (DISI) followed by dislocation of the pyrocarbon implant (3%). Fusion resulted in decreased range of motion and grip strength. The distal scaphoid resection was related to high rate of DISI. Although the pyrocarbon implant has a higher dislocation rate which requires revision surgery, this complication is avoidable with good surgical technique. Arthroplasty with pyrocarbon implant may be the first choice in younger patients.Outcomes of 66 Arpe prostheses in 50 patients treated for osteoarthritis of the trapeziometacarpal joint were investigated with a mean follow-up of ten years. Ten-year survival was 87% when failure was defined as implant removal followed by trapeziectomy and tendon interposition. Ten-year survival was 82% when revision of the cup was also considered as failure and it was 80% when replacement of the neck alone was also chosen as an endpoint. Of the 52 prostheses that were not revised mean DASH score was 11, mean pain score 1.2 and mean score for satisfaction 9.5. It can be concluded that the majority of patients who did not underwent revision surgery were satisfied and had little or no pain. However, long-term survival of the Arpe prosthesis was moderate and patients should be warned that after ten years the risk for reoperation might be up to 20%.Trapeziectomy with ligament reconstruction and tendon interposition and trapeziometacarpal prosthesis are two commonly used procedures for first carpometacarpal joint osteoarthritis. The purpose of this study is to compare the short-term outcome of trapeziectomy with ligament reconstruction and tendon interposition to trapeziometacarpal prosthesis. Pubmed, Cochrane library and science direct database were searched with adequate search terms. Used parameters were force, pain, mobility, functionality and complication. All papers describing short-term outcome of ligament reconstruction and tendon interposition or trapeziometacarpal prosthesis were included in this review. Trapeziometacarpal prostheses showed faster pain relief compared with trapeziectomy and ligament reconstruction and tendon interposition. Overall, there was a better strength in the trapeziometacarpal prosthesis group. A lack of information was found about the short- term functionality. The mobility recovers faster in the prosthesis group, although different scoring scales were used for measurement. We could confirm the faster pain relief in the prosthesis group and generally a faster recovery of strength and mobility. In the prosthesis group were more short-term complications. More studies are required to evaluate the short-term recovery of strength, the mobility, functionality and satisfaction.Anterior inferior tibiofibular ligament (AITFL) lesion have been shown to result in proliferation of cicatricial tissue ; concomitant insufficiency of the anterior talofibular ligament (ATFL) and AITFL Lesion may cause anterolateral syndesmotic impingement in the ankle joint of runners. Twenty-two runners with suspected syndesmotic impingement after ankle sprain were included in the study. An MRI of the ankle joint was performed followed by arthroscopy. Arthroscopy revealed an ATFL lesion in 20 patients (87%) and anterolateral syndesmotic impingement in 17 patients (77%). An ATFL lesion was detected in all patients with anterolateral syndesmotic impingement. The sensitivity of MRI was 24% (4 patients) on detecting anterolateral syndesmotic impingement, and 25% (5 patients) on ATFL lesion. A traumatic sprain of the ankle frequently results in a combined ATFL lesion and anterolateral syndesmotic impingement in runners. The abilities of MRI to detect this combined pathology are limited. Arthroscopy of the ankle joint should be performed. Study Design Case series ; level of evidence 4.Total Ankle Replacement is a recognised treatment for end-stage ankle arthritis and an alternative to arthrodesis. This study reviews a single centre series of prospectively collected outcome measures to determine whether the Mobility performs better than the Scandinavian ankle replacement. The primary outcome measure was the survivorship. Secondary outcome measures consisted of complications and international scoring systems. 147 Scandinavian and 162 Mobility ankle replacements were reviewed at a mean follow up of 12.4 and 7.7 years respectively. The revision rate, which included liner exchange, component exchange or removal of implant was at 7 years 12.3% (18) for Scandinavian and 5.2% (8) for Mobility. The complication rate was 16.5% (22) for Scandinavian compared to 9.9 % (15) for Mobility. The results of our unit compare favourably with previous published studies. In this study the Mobility has been shown to have more favourable results at 7 years compared to the Scandinavian.Closed reduction and percutaneous osteosynthesis is an alternative to the open procedure for articular fractures of distal tibia of children. Selleckchem HA130 38 patients were retrospectively reviewed. The measured parameters were the score of Gleizes and the discrepancies between preoperative radiographic and CT scan measurements and postoperative radiographs. A significant correlation was found between the gap and the step-off in preoperative radiographic and CT scan. A significant decrease of the gap and step-off displacement was noticed after surgery. The Gleizes scoring showed 35 good results, 2 average results and 1 poor result. Percutaneous fixation of ankle articular fractures in children is a simple and effective treatment giving similar results to open techniques while minimizing the risk of joint stiffness and healing complications. Growth complications are comparable with both techniques.In cases of chronic instability of the lateral ligament complex following an ankle sprain, operative stabilization should be considered when conservative treatment fails. The purpose of this study is to determine the outcome of a percutaneous stabilization of the lateral ligament complex with a gracilis tendon auto-graft, after an adjuvant arthroscopy of the ankle joint. We retrospectively reviewed the medical files of patients who underwent this surgery performed by the senior author. Between 2012 and 2015, 18 ankles were stabilized. Clinical results were assessed at final follow-up at a mean post-operative period of 25 months (range, 10-42 months). The mean post-operative AOFAS ankle-hindfoot score was 90 points (range, 48-100 points). The mean Karlsson Ankle Functional Score was 85 points (range, 37-100 points). The mean VAS score was 1.2 (range, 0-7). Concomitant procedures were performed on 14 out of 18 ankles. In conclusion, we state that this arthroscopically assisted percutaneous technique is a viable treatment option for chronic lateral ankle instability. It offers an alternative for the modified Broström procedure when tissue quality is poor and carries all the advantages of a minimally invasive procedure.Aseptic loosening of total knee arthroplasty (TKA) components is one of the frequent reasons for early revision together with infection and instability. Aseptic loosening is usually preceded by the observation of radiolucent lines (RLL) on radiographs. Radiolucent lines have conventionally been considered a sign of osteolysis due to particles disease of either polyethylene or cement wear. However, RLL can be observed quite early after TKA, way before wear and osteolysis can even occur. Immediate postoperative RLL are secondary to surgical technique with either inadequate cement penetration in sclerotic bone, insufficient preparation of the bone or malpositioning of the component relative to the bone cuts. This type of RLL can be observed radiologically but remains often without clinical symptoms. Early development of RLL, on an initially satisfying radiograph, is secondary to changes to the cement-bone interface. These are most often related to micromotion because of constraint, malalignment, remaining mechan without clinical symptoms should be analysed according to their potential reason of development and followed up closely with adequate radiological techniques. If symptoms develop or radiological imaging objectivizes failure and component mobility, revision knee arthroplasty might be necessary.Partial meniscectomy is a frequently performed treatment strategy for non-suturable meniscal tears. However, the meniscal volume which can be resected without compromising the load-bearing, shock-absorbing function of the meniscus remains a topic of ongoing research. The aim of this study was to calculate the medio-lateral meniscal volume ratio to estimate this volume. In 90 patients (98 pairs of menisci) without meniscal injury, medial and lateral menisci were segmented on MRI imaging and 3D surface models were created to calculate volume. The mean medial meniscal volume was 1928,9mm3 and the mean lateral meniscal volume was 1681,7mm3. A fixed ratio of the medial over the lateral meniscal volume was calculated to be 1,16. The standard deviation of the prediction errors based on this ratio equals 217mm3. This ratio seems a useful parameter in follow-up research to determine whether there is a critical volume which can be resected without post-operative pain and osteoarthritis.