-
Der Orthopade Nov 2020In the case of a rigid flatfoot deformity, joint-preserving techniques like soft-tissue balancing and osteotomies do not achieve acceptable results. This is the... (Review)
Review
In the case of a rigid flatfoot deformity, joint-preserving techniques like soft-tissue balancing and osteotomies do not achieve acceptable results. This is the indication for arthrodesis. The selection of the arthrodesis depends on the amount of deformity, localisation of the rigidity and the general health status of the patient. Isolated arthrodesis can be combined with soft-tissue reconstructions. It is functionally advantageous to preserve as many joints as possible.
Topics: Arthrodesis; Flatfoot; Humans; Osteotomy; Plastic Surgery Procedures; Treatment Outcome
PubMed: 32995906
DOI: 10.1007/s00132-020-03994-6 -
Hand Surgery & Rehabilitation Feb 2022Long considered as the ultimate surgery for limb salvage in case of brachial plexus palsy, shoulder fusion has seen its indications reduced with the development of more...
Long considered as the ultimate surgery for limb salvage in case of brachial plexus palsy, shoulder fusion has seen its indications reduced with the development of more numerous and multiple tendon transfers. This option remains valid and should always be suggested first because of its reliable effects on pain and function. However, it is a demanding surgery, the position of the fusion remains difficult to determine and the complication rate is not negligible.
Topics: Arthrodesis; Brachial Plexus; Humans; Paralysis; Range of Motion, Articular; Shoulder; Shoulder Joint
PubMed: 34147669
DOI: 10.1016/j.hansur.2018.05.009 -
European Journal of Orthopaedic Surgery... Dec 2023Arthrodesis of the ankle joint is an accepted treatment option in patients with end-stage ankle arthritis. The goal is to achieve fusion between the tibia and the talus,...
PURPOSE
Arthrodesis of the ankle joint is an accepted treatment option in patients with end-stage ankle arthritis. The goal is to achieve fusion between the tibia and the talus, thereby stabilizing the joint and alleviating pain. There might be associated limb length discrepancy, especially in post-traumatic and post-infectious cases. These patients require limb lengthening and arthrodesis. The purpose of this study is to report our experience with simultaneous ankle arthrodesis and lengthening using external fixation in adolescent and young adult patients.
METHODS
This retrospective case series included all patients treated in our hospital by concomitant ankle arthrodesis and tibial lengthening procedures on the same limb, using ring external fixation system. All surgeries included distal tibial joint surface resection and the talar dome, thereby correcting any associated deformity at the ankle. The arthrodesis was fixed and compressed using ring external fixator. A concurrent proximal tibial osteotomy was done, and limb lengthening, or bone transport was performed.
RESULTS
Eight patients operated between the years 2012-2020 were included in this study. Median patient age was 20.4 years (range 4-62 years), 50% women. Median limb lengthening was 20 mm (range 10-55 mm), and median final leg length discrepancy (LLD) was 7.5 mm (range 1-72 mm). The most common complication recorded was pin tract infection, which resolved with empiric antibiotics in all cases.
CONCLUSION
Based on our experience, combined arthrodesis and proximal tibial lengthening is efficient solution that provides stable ankle and restores length of the tibia even in complex and challenging situations.
Topics: Adolescent; Young Adult; Humans; Female; Child, Preschool; Child; Adult; Middle Aged; Male; Tibia; Ankle; Retrospective Studies; Arthritis; Talus; Ankle Joint; Arthrodesis; Treatment Outcome
PubMed: 37198500
DOI: 10.1007/s00590-023-03579-x -
Foot and Ankle Clinics Mar 2024With continuing advancements in total ankle arthroplasty (TAA), it is quickly becoming the procedure of choice for older patients with end-stage ankle arthritis.... (Review)
Review
With continuing advancements in total ankle arthroplasty (TAA), it is quickly becoming the procedure of choice for older patients with end-stage ankle arthritis. Multiple studies have been conducted on younger patients who have undergone TAA with promising results, but is it the procedure of choice? Considerations of TAA versus ankle arthrodesis, TAA implant longevity, outcomes of revision TAA, and whether patients should be offered an arthrodesis with plans for conversion to arthroplasty may help elucidate whether pursuing ankle arthroplasty in a younger, more active population is the correct approach for surgeons.
Topics: Humans; Ankle Joint; Ankle; Retrospective Studies; Arthroplasty, Replacement, Ankle; Arthritis; Arthrodesis; Treatment Outcome
PubMed: 38309803
DOI: 10.1016/j.fcl.2023.08.011 -
Hand Surgery & Rehabilitation Oct 2023The aim of this study was to analyze clinical and radiological results for 1-stage radiolunate arthrodesis and scaphoidectomy associated to the Sauvé-Kapandji...
OBJECTIVE
The aim of this study was to analyze clinical and radiological results for 1-stage radiolunate arthrodesis and scaphoidectomy associated to the Sauvé-Kapandji procedure, to alleviate pain and conserve wrist motion.
METHODS
Seven patients (8 wrists) with symptomatic osteoarthritis of the radiolunate and distal radioulnar joints were treated from 1999 to 2016. Mean age at surgery was 49 years and M/F sex ratio was 6/1. Etiologies were distal radial intra-articular malunion for 6 patients and bilateral gouty arthritis for 1. The procedure was performed by a dorsal approach in a single step. Pain was assessed on visual analogue scale (VAS). Pre- and post-operative active flexion-extension and pronation-supination were compared. The secondary endpoint was onset of postoperative complications.
RESULTS
At a mean 71 months' follow-up (range, 30-168 months), there was significant reduction in pain (VAS, 0.5/10; p < 0.0001). Motion results were satisfactory, with 32° flexion, 39° extension, for a non-significant decrease of 11° and 5° respectively; pronation and supination were significantly increased, by a mean 23° and 30° respectively. Three wrists (37.5%) required a second surgery. There were no cases of surgical site infection or non-union.
CONCLUSION
Radiolunate arthrodesis and scaphoidectomy combined to Sauvé-Kapandji procedure was an effective solution for the treatment of symptomatic radiolunate and distal radioulnar osteoarthritis.
LEVEL OF EVIDENCE
IV.
Topics: Humans; Wrist; Osteoarthritis; Arthrodesis; Radiography; Pain
PubMed: 37490952
DOI: 10.1016/j.hansur.2023.07.011 -
Journal of Feline Medicine and Surgery Sep 2019Feline carpal injuries are usually caused by falls from a height that result in hyperextension injury or antebrachiocarpal luxation or subluxation. Isolated ligamentous... (Review)
Review
PRACTICAL RELEVANCE
Feline carpal injuries are usually caused by falls from a height that result in hyperextension injury or antebrachiocarpal luxation or subluxation. Isolated ligamentous damage or fracture of the carpus is unusual; it is more common to have a combination of both in the cat. These injuries can be debilitating since cats climb and jump from great heights, and have a greater range of antebrachial pronation and supination than dogs.
ANATOMY
There are differences in the anatomy of the feline and canine carpus. In particular, cats only have a single short radial collateral ligament, also known as the medial collateral ligament. This means that, in the cat, antebrachiocarpal subluxation is possible with rupture of the dorsal joint capsule and short radial collateral ligament alone.
CLINICAL CHALLENGES
Many feline carpal injuries can be treated without performing pancarpal arthrodesis. However, determining which ligaments and joint levels are affected requires careful examination and often stress radiography. When pancarpal arthrodesis is performed in the cat, it has been reported to reduce the height of jumping and to increase reluctance to climb. This is speculated to be due to reduced pronation and supination movement of the carpus.
EVIDENCE BASE
The current evidence base for management of feline carpal injuries is grade III or IV, with most of the studies being retrospective case series involving cadaveric dissection or direct extrapolation from published information about the dog. There are few guidelines regarding the optimal treatment options for carpal injuries in the cat.
Topics: Animals; Arthrodesis; Carpus, Animal; Cats; Joint Dislocations
PubMed: 31446862
DOI: 10.1177/1098612X19870388 -
The Journal of the American Academy of... Aug 2022Thumb metacarpophalangeal (MCP) joint hyperextension is a well-established sequela of advanced carpometacarpal (CMC) joint arthritis. This deformity results in poor... (Review)
Review
Thumb metacarpophalangeal (MCP) joint hyperextension is a well-established sequela of advanced carpometacarpal (CMC) joint arthritis. This deformity results in poor patient function because the ability to perform key pinch is negatively affected. For this reason, surgeons must consider the presence of an MCP deformity when addressing CMC arthritis. A variety of nonsurgical and surgical interventions have emerged. Surgical treatments can be grouped into four main categories: (1) volar plate advancement/capsulodesis, (2) tendon transfer and tenodesis, (3) sesamoidesis, and (4) arthrodesis. Surgical intervention is based on both the degree of deformity present and the surgeon preference. This review aims to clarify indications for various treatments of MCP joint hyperextension, outline commonly performed procedures, and report the published outcomes and potential complications of these interventions.
Topics: Arthritis; Arthrodesis; Humans; Metacarpophalangeal Joint; Tendon Transfer; Thumb
PubMed: 35472011
DOI: 10.5435/JAAOS-D-21-00981 -
BMC Musculoskeletal Disorders Jul 2022Müller-Weiss disease (MWD), a rare dysplastic disorder of the foot, is characterized by deformity, sclerosis, and fragmentation of the lateral part of navicular bone....
BACKGROUND
Müller-Weiss disease (MWD), a rare dysplastic disorder of the foot, is characterized by deformity, sclerosis, and fragmentation of the lateral part of navicular bone. Arthrodesis is the mainstay treatment for MWD. Generally, arthrodesis can be achieved through internal fixation with metallic implants, and morselized chip bone may be packed into the gap for better bone union. However, with this procedure, the original foot size is not maintained and support for the foot arch is not provided. Sequela of short foot, or flatfoot is commonly observed even though these complications of surgery had not been reported with cases of MWD treated by arthrodesis. Herein, we present a retrospective analysis of treating MWD through midfoot and hindfoot arthrodesis combined with strut allograft.
METHODS
From August 2006 to June 2019, 20 patients with MWD (mean age, 59.6 years; range, 40-80 years) underwent midfoot and hindfoot arthrodesis with strut bone allograft and were followed for at least 24 months. The patients were able to ambulate and participate in rehabilitation programs 3 months postoperatively.
RESULTS
The used four radiographic parameters (Meary's angle in anteroposterior and lateral view, talonavicular coverage angle, calcaneal pitch) demonstrated significant differences (P < .05) preoperatively and postoperatively, but those between the postoperative values and the values at the last follow-up session did not, indicating that strut allograft was able to maintain normal alignment. The mean American Orthopaedic Foot & Ankle Society Ankle-Hindfoot scores at 2 years postoperatively revealed significant improvement from baseline, from 60.2 to 84.2 (P < .05). The 12-item Short Form Health Survey scores also improved significantly (P < .05). All patients reported substantial pain relief and exhibited improved functional outcomes and gait patterns.
CONCLUSIONS
For advanced-stage MWD, arthrodesis with a precisely shaped, size-matched strut allograft provided strong support for biomechanical alignment and enhanced functional performance.
Topics: Allografts; Arthrodesis; Bone Diseases; Cartilage Diseases; Foot Diseases; Humans; Middle Aged; Radiography; Retrospective Studies; Tarsal Bones; Treatment Outcome
PubMed: 35897013
DOI: 10.1186/s12891-022-05629-7 -
Hand (New York, N.Y.) Jan 2023The external rotation and abduction of shoulder are considered one of the priorities of reconstruction in brachial plexus injury. The aim of this study was to evaluate...
BACKGROUND
The external rotation and abduction of shoulder are considered one of the priorities of reconstruction in brachial plexus injury. The aim of this study was to evaluate the functional results and complications of shoulder arthrodesis in patients with brachial plexus injury to better comprehend the benefits of this procedure.
METHODS
Between 2015 and 2019, 15 shoulder arthrodesis were performed in patients with long-standing brachial plexus injury. The main indication for arthrodesis was absent or poor recovery of shoulder abduction and external rotation. Patients presented different levels of injury. Shoulder measurements of active abduction and external rotation were made based on image records of the patients. A long 4.5-mm reconstruction plate was fit along the scapular spine, acromion, and lateral proximal third of the humerus. Structured bone graft was fit into the subacromial space.
RESULTS
The mean preoperative abduction was 16°, and the mean postoperative abduction was 42°. The mean preoperative external rotation was -59°, and the mean postoperative external rotation was -13°. The mean increase in abduction and external rotation was 25° and 45°, respectively. Bone union was achieved in all cases at an average time of 5.23 months. We experienced humeral fractures in 26.66% of the cases, which were all successfully treated nonoperatively.
CONCLUSIONS
Shoulder arthrodesis is a rewarding procedure for patients with brachial plexus injuries. A marked improvement in the upper limb positioning was observed in all patients. It should be considered as the main therapeutic option in cases where nerve reconstruction is no longer possible.
Topics: Humans; Shoulder; Shoulder Joint; Brachial Plexus; Brachial Plexus Neuropathies; Arthrodesis
PubMed: 33880953
DOI: 10.1177/1558944721998008 -
Journal of the American Podiatric... Dec 2021This report discusses an unusual case of a 23-year-old woman with a painful bipartite medial cuneiform and severe arthritic and cystic changes at the partition with no...
This report discusses an unusual case of a 23-year-old woman with a painful bipartite medial cuneiform and severe arthritic and cystic changes at the partition with no history of trauma. Magnetic resonance imaging confirmed a large cyst with subchondral erosions at the dorsal and plantar segments with significant bone marrow edema. Definitive treatment consisted of arthrodesis on the dorsal to plantar segments using one lag screw, demineralized bone matrix grafting, and a bone stimulator.
Topics: Adult; Arthrodesis; Bone Marrow Diseases; Bone Screws; Female; Humans; Magnetic Resonance Imaging; Tarsal Bones; Young Adult
PubMed: 33355668
DOI: 10.7547/20-025