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Arch Orthop Trauma Surg 2021 May 11. Epub 2021 May 11.

Department of Orthopaedic and Rehabilitation,Carver College of Medicine, University of Iowa, 200 Hawkins Dr, John Pappan John Pavillion (JPP), Room 01066, Lower Level, Iowa City, IA, 52242, USA.

In this technical report study, we describe the use of a flexor tenodesis procedure in the treatment of lesser toe deformities (LTD). Using a specific implant, both the flexor digitorum longus and brevis tendons are attached to the plantar aspect of the proximal phalanx, allowing dynamic correction of flexible deformities of metatarsophalangeal and interphalangeal joints. Good clinical results and absence of complications were observed in a series of 3 patients, with considerable correction of the LTD, and absence of substantial residual floating toe or metatarsophalangeal joint stiffness. Read More

J Am Acad Orthop Surg Glob Res Rev 2020 May;4(5):e2000044

From the Department of Orthopaedic Surgery, Harbor-UCLA Medical Center, Torrance, CA (Dr. Lullo); Keck School of Medicine, University of Southern California (Dr. Nazareth, Dr. Illingworth, Dr. Abousamra, and Dr. Kay); the Children's Hospital of Los Angeles (Ms. Rethlefsen, Dr. Abousamra, and Dr. Kay); and the Children's Orthopaedic Center, Children's Hospital Los Angeles (Dr. Illingworth), Los Angeles, CA.

Introduction: The study purpose was to determine the safety/efficacy of a split anterior tibialis tendon transfer (SPLATT) to the peroneus tertius or brevis in children with static encephalopathy and varus feet.

Methods: A retrospective review of short- and long-term complications, change in ankle range of motion, strength, and gait kinematics. Predictors of postoperative varus or valgus were examined. Read More

J Clin Anesth 2021 May 5;73:110332. Epub 2021 May 5.

Department of General Anesthesia and Acute Pain Medicine, Cleveland Clinic, 9500 Euclid Ave, 44195 Cleveland, OH, United States. Electronic address:

Orthop Traumatol Surg Res 2021 May 4:102957. Epub 2021 May 4.

Service d'Orthopedie-Traumatologie, Centre Hospitalier Universitaire de Toulouse-Purpan, Toulouse, France.

Introduction: Reverse shoulder arthroplasty (RSA) is an option to conserve limb function after resection of proximal humerus malignancy. An allograft-composite RSA is an alternative to a tumor prosthesis, and can restore proximal humeral bone stock. The aim of the present study was to assess medium-term radiographic and clinical results for such composite implants. Read More

JBJS Case Connect 2021 05 7;11(2). Epub 2021 May 7.

Department of Orthopedic Surgery, OhioHealth Orthopaedic Trauma and Reconstruction Surgeons, Grant Medical Center, Columbus, Ohio.

Case: We report on the rare occurrence of first extensor compartment tendon injury at the myotendinous junction after fractures of the radial styloid and both-bone forearm in a healthy 59-year-old man. Here, a novel technique for repair of this unique injury and an additional proposed mechanism of tendon rupture are discussed.

Conclusion: We advocate for the suspicion of tendon rupture in the first dorsal compartment with fractures of the radial styloid and both-bone forearm. Read More

World J Orthop 2021 Apr 18;12(4):207-213. Epub 2021 Apr 18.

Department of Orthopedic Surgery, University of Tokyo, Tokyo 113-8655, Bunkyo-ku, Japan.

Fracture of an ossification of the Achilles tendon (OAT) is a rare entity, and its etiology, pathology, and treatment remain unclear. We reviewed and scrutinized 18 cases (16 articles) of the fracture of an OAT. The most common etiologies of the ossifications include previous surgery and trauma. Read More

Foot (Edinb) 2021 Apr 7;47:101798. Epub 2021 Apr 7.

Orthopedic Department, Assiut University Hospital, Assiut, Egypt. Electronic address:

Purpose: Adult-acquired flatfoot deformity (AAFD) requires optimum planning that often requires several procedures for deformity correction. The objective of this study was to detect the difference between MDCO versus LCL in the management of AAFD with stage II tibialis posterior tendon dysfunction regarding functional, radiographic outcomes, efficacy in correction maintenance, and the incidence of complications.

Patient And Methods: 42 Patients (21 males and 21 females) with a mean age of 49. Read More

Foot (Edinb) 2021 Apr 15;47:101802. Epub 2021 Apr 15.

Department of Orthopedic Surgery, Osaka Medical and Phamaceutical University, 2-7, Daigaku-machi, Takatsuki 569-8686, Japan. Electronic address:

Few studies have reported about isolated contracture in the extensor hallucis longus (EHL) muscle, but none of the EHL muscle contracture after distal tibial physeal injury. Two such cases in 16- and 14-year-old boys who underwent surgeries for distal physeal injury of the tibia at a previous hospital are presented. Extension contracture of the hallux appeared 1-2 months post-surgery. Read More

Acta Biomed 2021 Apr 30;92(S1):e2021151. Epub 2021 Apr 30.

Division of Hand Surgery and Microsurgery - Modena University Hospital.

Introduction: The authors discuss challenges in extensor function restoration at the finger level following distal posterior interosseous or tendon complex injuries, according to the typologies of lesions or the specific patient requirements.

Materials: The authors report on two cases describing challenging resolutions. One patient with EDC lag from zone 6B to 8 requiring FCU prolonged with cadaveric grafts. Read More

J Clin Orthop Trauma 2021 Jun 3;17:254-260. Epub 2021 Apr 3.

The James Cook University Hospital, Middlesbrough, UK.

Symptomatic irreparable rotator cuff tears pose a challenge for shoulder surgeons. Whilst reverse polarity shoulder arthroplasty is an effective option for older symptomatic patients who have exhausted conservative management, the optimal treatment for younger patients remains controversial. In this article we outline the main tendon transfer options, including anatomical considerations, indications, contraindications, surgical technique, complications and a review of the evidence. Read More

J Hand Surg Asian Pac Vol 2021 Jun;26(2):188-193

Department of Orthopedic Surgery, Nagareyama Central Hospital, Chiba, Japan.

The purpose of the present study was to assess the biomechanical strength and properties of a modified Krackow technique for side-to-side tendon repair with a short overlap length. The flexor digitorum superficialis, flexor digitorum profundus, and flexor pollicis longus muscles were harvested from 10 fresh frozen cadavers. Overall, 60 tendon repairs were divided into four groups based on the suture technique: modified Krackow technique repair (KT); weave suture repair (WS); mattress suture repair (MS); and composite technique repair (CT), a combination of the modified Krackow and weave suture techniques. Read More

Tech Hand Up Extrem Surg 2021 Apr 28. Epub 2021 Apr 28.

Shoulder Unit, Clinique Bizet, Paris Hopital Ambroise Paré, Boulogne-Billancourt, France.

The therapeutic management of the paralytic shoulder after an obstetric brachial plexus injury is complex. When nerve repair or neurotization fail, or if the biological times for nerve reconstruction is over, tendon transfer to restore active external rotation of the shoulder becomes the main surgical alternative. The purpose of this manuscript is to describe the surgical technique of the lower trapezius muscle transfer to the infraspinatus muscle, to restore active shoulder external rotation in the child with paralytic shoulder, step by step with details and pearls. Read More

J Exp Orthop 2021 Apr 29;8(1):35. Epub 2021 Apr 29.

Department of Orthopaedics and Traumatology, Bezmialem Vakıf University, Istanbul, Turkey.

Rev Esp Cir Ortop Traumatol 2021 Apr 24. Epub 2021 Apr 24.

Hospital Universitari i Politècnic La Fe, Valencia, España.

Introduction: Charcot-Marie-Tooth disease (CMT) is a hereditary motor sensory neuropathy that frequently results in a cavovarus foot in the adult. Surgical treatment allows correction of the deformity while preserving an adequate range of motion.

Objective: The objective of this study was to assess the result of posterior tibial tendon transfer, first metatarsal ascent osteotomy, and calcaneal valgus osteotomy in the treatment of cavovarus foot secondary to CMT. Read More

Hand Surg Rehabil 2021 Apr 24. Epub 2021 Apr 24.

Department of Orthopaedics and Traumatology, University Hospital Brussels (Vrije Universiteit Brussel), Pleinlaan 2, 1050 Brussels, Belgium; Department of Orthopaedics and Traumatology, Maria Middelares Hospital, Buitenring-Sint-Denijs 30, 9000 Gent, Belgium. Electronic address:

We present two recent cases of spontaneous rupture of both index finger extensor digitorum communis and extensor indices proprius tendons caused by a dorsal carpus osteophyte. Both patients had a history of scaphoid fracture non-union with evolution to scaphoid non-union advanced collapse (SNAC) of the wrist. These two cases were treated surgically with a 3-corner arthrodesis, and an interposition of a fragment of one of both ruptured tendons together with a tendon transfer of a supernumerary extensor digitorum communis of the third finger. Read More

Rev Esp Cir Ortop Traumatol 2021 Apr 23. Epub 2021 Apr 23.

Servicio de Cirugía Ortopédica y Traumatología, Hospital Fremap, Sevilla, España.

Introduction And Objectives: Rupture of distal biceps has a frequency of 1.2 cases per 100,000 population. Conservative treatment presents a loss in supination of 40% and flexion of 30%, like transfers to the brachialis. Read More

Arthroscopy 2021 May;37(5):1411-1413

Large and massive rotator cuff tears are not always reparable and present a difficult clinical problem. If surgery is warranted surgical options range from arthroscopic debridement, partial repairs, degradable spacers, tendon transfers, and more superior capsular reconstruction. The rotator cable is formed by the deep layer of the coracohumeral ligament and the crescent structure running from the anterior insertion site of the supraspinatus to the inferior border of the infraspinatus. Read More

Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2021 Apr 23;42(1):91-103. Epub 2021 Apr 23.

University Clinic for Plastic and Reconstructive Surgery, Skopje, RN Macedonia.

Brachial plexus injuries are still challenging for every surgeon taking part in treating patients with BPI. Injuries of the brachial plexus can be divided into injuries of the upper trunk, extended upper trunk, injuries of the lower trunk and swinging hand where all of the roots are involved in this type of the injury. Brachial plexus can be divided in five anatomical sections from its roots to its terminal branches: roots, trunks, division, cords and terminal branches. Read More

J Am Acad Orthop Surg 2021 May;29(9):e416-e426

From the Department of Orthopaedic Surgery (Chaudhry), University of Connecticut, Connecticut Children's Medical Center, Hartford, CT, and the Department of Hand and Microsurgery (Bhardwaj, Venkatramani, and Sabapathy), Ganga Hospital, Coimbatore, India.

Multilevel surgery for upper extremity spasticity is the current surgical standard. While the literature details surgical techniques and outcomes, a comprehensive guide to surgical planning is lacking. Patients commonly present with posturing into shoulder internal rotation, elbow flexion, forearm pronation, wrist flexion with ulnar deviation, finger flexion, and thumb adduction, although variations exist. Read More

J Bone Joint Surg Am 2021 Mar 11. Epub 2021 Mar 11.

Departments of Orthopaedic Surgery (M.F., R.P., and T.L.) and Plastic and Reconstructive Surgery (R.P. and H.B.), University of Toronto, Toronto, Ontario, Canada.

»: Nerve injuries during shoulder arthroplasty have traditionally been considered rare events, but recent electrodiagnostic studies have shown that intraoperative nerve trauma is relatively common.

»: The brachial plexus and axillary and suprascapular nerves are the most commonly injured neurologic structures, with the radial and musculocutaneous nerves being less common sites of injury.

»: Specific measures taken during the surgical approach, component implantation, and revision surgery may help to prevent direct nerve injury. Read More

J Foot Ankle Surg 2021 Mar 24. Epub 2021 Mar 24.

Assistant Lecturer, Department of Orthopaedic Surgery, Faculty of Medicine, Menoufia University, Shebin El-Kom, Menoufia, Egypt. Electronic address:

Acute Achilles tendon rupture is one of the most common tendon injuries. This prospective study aimed to evaluate the functional outcomes of augmented repair of acute Achilles tendon rupture with peroneus brevis tendon transfer and fixation to an oblique calcaneal transosseous tunnel. Functional evaluation was performed using the American Orthopaedic Foot & Ankle Society (AOFAS) score and Achilles Tendon Total Rupture Score (ATRS). Read More

J Am Podiatr Med Assoc 2021 Mar;111(2)

Longitudinal epiphyseal bracket is a rare ossification disorder of the short tubular bones. The affected bone becomes deformed as a result of the bracket. The normal growth pattern cannot occur, and when it affects the first metatarsal bone, hallux varus may develop with the abnormal growth pattern. Read More

Wounds 2021 Apr;33(4):99-105

Rubin Institute for Advanced Orthopedics, Baltimore, Maryland.

Introduction: The COVID-19 virus is caused by the new coronavirus, SARS-CoV-2. COVID-19 has drastically changed the medical landscape. Although predominantly impacting the respiratory system, COVID-19 has several non-respiratory symptoms associated with its presentation and course. Read More

J Hand Surg Am 2021 Apr 14. Epub 2021 Apr 14.

Centre Hospitalier Universitaire Vaudois, Service de Chirurgie Plastique et de la Main, Lausanne, Switzerland.

Purpose: The spiral oblique retinacular ligament (SORL) procedure acts as a dynamic tenodesis to restore distal interphalangeal joint (DIP) extension and restrain proximal interphalangeal hyperextension. Despite the ingenious technique based on the oblique retinacular ligament anatomy, obtaining strong internal fixation remains an issue during the SORL procedure. We present a modified technique using the flexor digitorum profundus (FDP) hemi-tendon transfer. Read More

Orthop Traumatol Surg Res 2021 Apr 14:102935. Epub 2021 Apr 14.

Centre Hopitalier Universitaire Necker enfants malades, 149, rue de Sèvres, 75015 Paris, France. Electronic address:

We describe a retrograde transfer of the distal tendon of the peroneus longus (PL) onto the tibialis anterior (TA) tendon to treat spastic equinovarus foot (SEVF) in adults. The fact that the distal tendon insertions of the PL and TA are a mirror image makes them antagonists. The aim is to divert the distal tendon in front the inactive distal PL tendon, by fixing to the TA in the middle third of the lower leg. Read More

BMC Musculoskelet Disord 2021 Apr 16;22(1):359. Epub 2021 Apr 16.

Department of Orthopedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland.

Background: Understanding muscle and tendon anatomy is of tremendous importance to achieve optimal surgical execution and results in tendon transfers around the shoulder. The aim of this study was to introduce and describe an additional distal muscle slip of the teres major (TM).

Methods: Sixteen fresh-frozen cadaver shoulders were dissected with the deltopectoral approach. Read More

Acta Orthop Belg 2020 Dec;86(4):697-701

A 61-year-old man who stretched in the morning presented a rupture of the tibialis anterior tendon treated by extensor hallucis longus transfer. Rupture of the tibialis anterior tendon is rare. Surgical treatment seems to be more efficient in improving the function. Read More

Orthop Traumatol Surg Res 2021 Apr 9:102927. Epub 2021 Apr 9.

Ramsay Santé, Hôpital Privé Jean-Mermoz, Centre Orthopédique Santy, 24, avenue Paul-Santy, 69008 Lyon, France. Electronic address:

We report preliminary results for a novel technique of endoscopic Whiteside transfer for massive gluteus medius tear: i.e., tendon reinsertion not or only partly feasible and/or severe fatty atrophy of the muscle. Read More

J Hand Surg Am 2021 Apr 6. Epub 2021 Apr 6.

Orthopaedics and Sports Medicine Institute, University of Florida, Gainesville, FL.

Rotator cuff pathology is the most common shoulder condition for which patients seek treatment. Schmidt et al covered the relevant anatomy, natural history, nonsurgical and surgical treatment, biological augmentation, and postoperative rehabilitation in their comprehensive review published in 2015. This current review builds upon the last update, discussing the most recent evidence-based medicine regarding rotator cuff repair: primary repair, revision repair, and reconstructive techniques for superior capsular reconstruction, subacromial balloon spacers, tendon transfer options (pectoralis major, latissimus dorsi, and lower trapezius), and reverse total shoulder arthroplasty. Read More

Ann Plast Surg 2021 Mar 24. Epub 2021 Mar 24.

From the Section of Plastic Surgery Section of Orthopaedic Surgery, Department of Surgery, Rady College of Medicine, University of Manitoba Pan Am Clinic, Winnipeg, Manitoba, Canada.

Abstract: Peroneal intraneural ganglia are rare, and their management is controversial. Presently, the accepted treatment of intraneural ganglia is decompression and ligation of the articular nerve branch. Although this treatment prevents recurrence of the ganglia, the resultant motor deficit of foot drop in the case of intraneural peroneal ganglia is unsatisfying. Read More