Tendon Transfers for Irreparable Rotator Cuff Tears
Reza Omid J Am Acad Orthop Surg. Vol 21 Nº 8 August 2013 Tendon transfer is one treatment option for patients with massive irreparable rotator cuff tears. Although surgical indications are not clearly defined, the traditional thought is that the ideal candidate is young and lacks significant glenohumeral arthritis. The proposed benefits of tendon transfers […]
Epinephrine in Local Anesthesia in Finger and Hand Surgery: The Case for Wide-awake Anesthesia
Donald Lalonde J Am Acad Orthop Surg. Vol 21 Nº 8 August 2013 Traditionally, surgeons were taught that local anesthesia containing epinephrine should not be injected into fingers. This idea has since been refuted in many basic and clinical scientific studies, and today, injection of lidocaine plus epinephrine is widely used for digital and hand […]
Cartilage Regeneration
Rocky S. Tuan, PhD, Abstract Cartilage damaged by trauma has a limited capacity to regenerate. Current methods of managing small chondral defects include palliative treatment with arthroscopic débridement and lavage, reparative treatment with marrow-stimulation techniques (eg, microfracture), and restorative treatment, including osteochondral grafting and autologous chondrocyte implantation. Larger defects are managed with osteochondral allograft or […]
The Adult Paralytic Foot
Sean A. Matuszak, MD, Abstract The adult paralytic foot is a common clinical entity. It has numerous neurologic, systemic, and traumatic causes that result in muscle imbalance and foot deformity. A thorough physical examination and diagnostic work-up, as well as an understanding of the relevant functional anatomy, are essential to proper management. Treatment goals include […]
Synthetic Playing Surfaces and Athlete Health
Mark C. Drakos, MD, Abstract Synthetic playing surfaces have evolved considerably since their introduction in the 1960s. Today, third-generation turf is routinely installed in professional, collegiate, and community settings. Proponents of artificial surfaces tout their versatility and durability in a variety of climates. However, the health and injury ramifications have yet to be clearly defined. […]
Transabdominal Gunshot Wounds of the Hip and Pelvis
Anna N. Miller, MD, Abstract Transabdominal gunshot wounds (GSWs) of the hip and pelvis are those that traverse the gastrointestinal system before entering the pelvis and/or hip. These injuries may be contaminated by bowel contents. Some require urgent surgical intervention; others can be managed nonsurgically. A primary survey with attention to hemodynamic status is of […]
Wrong-site Spine Surgery
Mark A. Palumbo, MD, Abstract Wrong-site spine surgery is an adverse event that has potentially devastating consequences for the patient as well as the surgeon. Despite substantial efforts to prevent wrong-site spine surgery, this complication continues to occur and has the potential for serious medical, personal, and legal repercussions. Although systems-based prevention methods are effective […]
Pronator Syndrome and Anterior Interosseous Nerve Syndrome
Craig M. Rodner, MD, Abstract Dysfunction of the median nerve at the elbow or proximal forearm can characterize two distinct clinical entities: pronator syndrome (PS) or anterior interosseous nerve (AIN) syndrome. PS is characterized by vague volar forearm pain, with median nerve paresthesias and minimal motor findings. AIN syndrome is a pure motor palsy of […]
Management of Fractures of the Proximal Ulna
Dominique M. Rouleau J Am Acad Orthop Surg March 2013 vol. 21 no. 3 Abstract Proximal ulna fractures can be difficult to manage because of the elbows complex anatomy. Advances in understanding elbow anatomy and biomechanics, however, have led to new insights. Careful preoperative evaluation is critical because failure to restore normal anatomy of the […]
Total Wrist Arthroplasty
Arnold-Peter C. Weiss J Am Acad Orthop Surg March 2013 vol. 21 no. 3 Abstract Over the past 40 years, total wrist arthroplasty (TWA) has emerged as a cost-effective treatment option for wrist arthritis. First-generation implant designs have changed tremendously; current devices are designed to enhance wrist stability, provide greater implant longevity, and minimize surgical […]