Total Hip Arthroplasty in the Ankylosed Hip
Megan A. Swanson, JAAOS December 2011;19 (12) Abstract Altered biomechanics secondary to hip ankylosis often result in degeneration of the lumbar spine, ipsilateral knee, and contralateral hip and knee. Symptoms in these joints may be reduced with conversion total hip arthroplasty (THA) of the ankylosed hip. THA in the ankylosed hip is a technically challenging […]
Management of Multidirectional Instability of the Shoulder
Trevor R. Gaskill JAAOS December 2011;19 (12) Abstract Multidirectional shoulder instability is defined as symptomatic instability in two or more directions. Instability occurs when static and dynamic shoulder stabilizers become incompetent due to congenital or acquired means. Nonspecific activity-related pain and decreased athletic performance are common presenting complaints. Clinical suspicion for instability is essential for […]
Dupuytren Disease: An Evolving Understanding of an Age-old Disease
Eric M. Black. JAAOS December 2011;19 (12) Abstract Dupuytren disease, a clinical entity originally described more than 400 years ago, is a progressive disease of genetic origin. Excessive myofibroblast proliferation and altered collagen matrix composition lead to thickened and contracted palmar fascia; the resultant digital flexion contractures may severely limit function. The pathophysiology is multifactorial […]
Iliotibial Band Syndrome: Evaluation and Management
Eric J. Strauss JAAOS December 2011;19 (12) Abstract Iliotibial band syndrome is a common overuse injury typically seen in runners, cyclists, and military recruits. Affected patients report lateral knee pain associated with repetitive motion activities. The diagnosis is usually made based on a characteristic history and physical examination, with imaging studies reserved for cases of […]
Variations in Sacral Morphology and Implications for Iliosacral Screw Fixation
NULL Anna N. Miller JAAOS January 2012; 20 (1) Abstract Posterior pelvic percutaneous fixation following either closed or open reduction is a popular procedure. Knowledge of the posterior pelvic anatomy, its variations, and related imaging is critical to performing reproducibly safe surgery. The dysmorphic sacrum has several key characteristics. The upper portion of the sacrum […]
Proximal Humerus Fractures
NULL Edwin R. Cadet JAAOS January 2012; 20 (1) Abstract Displaced three- and four-part proximal humerus fractures are among the most challenging shoulder conditions to manage. Because of the risk of symptomatic malunion, nonunion, and humeral head osteonecrosis, surgical management is preferred. Locking plate technology has provided an alternative to hemiarthroplasty for certain three- and […]
Psoriatic Arthritis
Michael Sean Day JAAOS January 2012; 20 (1) Abstract Psoriatic arthritis is a chronic inflammatory arthropathy that affects approximately 6% to 48% of patients with psoriasis. Arthritis is not correlated with the extent of skin disease. Classic radiographic findings of the involved joint include erosion, ankylosis, and fluffy periostitis. Site-specific characteristic deformities such as pencil-in-cup […]
Brachial Plexus Blocks for Upper Extremity Orthopaedic Surgery
Benjamin G. Bruce JAAOS January 2012; 20 (1) Abstract Regional anesthesia of the upper extremity has several clinical applications and is reported to have several advantages over general anesthesia for orthopaedic surgery. These advantages, such as improved postoperative pain, decreased postoperative opioid administration, and reduced recovery time, have led to widespread acceptance of a variety […]
Surgical Exposures of the Wrist and Hand
Louis W. Catalano JAAOS January 2012; 20 (1) Abstract The neurovascular anatomy of the carpus and hand is complex. Therefore, precise exposures are required to avoid iatrogenic injury. In general, dorsal exposures are more forgiving than volar exposures because major neurovascular structures lie on the volar aspect of the hand and fingers; however, volar, ulnar, […]
Pediatric Disk Herniation
November 2011; 19 William F. Lavelle, Abstract Pediatric disk herniation is a rare condition that should be considered in the differential diagnosis of the child with back pain or radiating leg pain. Because pediatric disk herniation is relatively uncommon, there is typically a delay in diagnosis compared with time to diagnosis of adult disk herniation. […]