RESUMO
Anterior cruciate ligament rupture is a common orthopaedic injury, with reconstruction the treatment of choice for active individuals. Graft selection is an important consideration for surgical planning. Achilles tendon allograft is a graft choice most likely used in cases of revision anterior cruciate ligament reconstruction. This technical note discusses an approach to Achilles tendon allograft preparation that respects and follows the rotation of the fibers of the Achilles tendon. Key considerations in the use of this technique include (1) identifying the rotational fiber tracks, (2) performing careful dissection along the identified tracks of the fibers, and (3) ensuring an appropriate graft width based on patient size, all of which are crucial for the success of this unique technique. The preservation of the rotational fibers provided by this technique may have the potential to result in increased tensile strength and better clinical outcomes.
RESUMO
Scapular winging is a rare disorder often caused by neuromuscular imbalance in the scapulothoracic stabilizer muscles. Lesions of the long thoracic nerve and spinal accessory nerves are the most common cause. Numerous underlying etiologies have been described. Patients report diffuse neck, shoulder girdle, and upper back pain, which may be debilitating, associated with abduction and overhead activities. Accurate diagnosis and detection depend on appreciation of the scapulothoracic anatomy and a comprehensive physical examination. Although most cases resolve nonsurgically, surgical treatment of scapular winging has been met with success.
Assuntos
Doenças Neuromusculares/diagnóstico , Escápula/inervação , Nervo Acessório/fisiopatologia , Algoritmos , Diagnóstico Diferencial , Eletromiografia , Humanos , Imageamento por Ressonância Magnética , Força Muscular/fisiologia , Músculo Esquelético/inervação , Músculo Esquelético/cirurgia , Distrofia Muscular Facioescapuloumeral/diagnóstico , Distrofia Muscular Facioescapuloumeral/fisiopatologia , Distrofia Muscular Facioescapuloumeral/cirurgia , Doenças Neuromusculares/fisiopatologia , Doenças Neuromusculares/cirurgia , Paralisia/diagnóstico , Paralisia/fisiopatologia , Paralisia/cirurgia , Articulação do Ombro/fisiopatologia , Nervos Torácicos/fisiopatologia , Tomografia Computadorizada por Raios XRESUMO
Extruded bone is a rare complication of open fractures associated with high energy. We describe a case of bony extrusion involving an osteoarticular segment of distal tibial treated with reimplantation and internal fixation with 18-month follow-up.