Wound Closure With Acute Dermatotraction.

Many described techniques take advantage of the viscoelasticity of the human integument to assist in primary closure of fasciotomy wounds. A retrospective chart review was performed on eight patients with a total of 17 incisions who underwent fasciotomy for acute compartment syndrome. Wounds were closed with delayed primary closure (DPC). Patients were males with a mean age of 40 years (range, 21-64). Fasciotomy mean wound length and width at attempted closure was 16.1 s 6 cm and 6.3 s 2 cm, respectively. Mean time to closure after fasciotomy was 3.9 days (range, 2-8). All wounds healed, at a mean of 18.3 s 2.6 days. Patients were followed for a mean of 21 weeks (range, 3-52). The described novel sequential suturing technique can achieve closure with low risk of major complications; 100% wound healing was achieved. When used judiciously, the technique presented can achieve reliable results in selected fasciotomy wound healing. (Journal of Surgical Orthopaedic Advances 27(2):155-159, 2018).

The annular ligament-revisited.

BACKGROUND: Studies investigating the annular ligament have presented confusing information about its anatomy and nomenclature. Cadaver elbow dissections were used to clarify the anatomy and terminology of the annular ligament. METHODS: Nineteen elbows were dissected (7 fresh frozen and 12 embalmed). Target structures were identified, photographed, and measured by independent observers. RESULTS: There are 3 layers to the lateral elbow ligaments: the superficial lateral ulnar collateral and radial collateral ligament; a deeper layer of the superior oblique band (SOB) and inferior oblique band (IOB) of the annular ligament; and the deepest capsular layer. The annular ligament measured 9.5 ± 1.4 mm anteriorly. The SOB (15/19) was 3.9 ± 1.0 mm wide by 10.5 ± 3.8 mm long. The IOB (13/19) was 3.6 ± 1.1 mm wide by 11.4 ± 4.2 mm long. The IOB inserts onto the anterior proximal ulna rather than the supinator crest. The anterior oblique band (8/19) was 3.8 ± 1.7 mm wide. CONCLUSION: The SOB and IOB were present in the majority of specimens. The previously described accessory lateral collateral ligament is a localized thickening on the lateral ligament complex arising from the supinator insertion independent of the IOB that attaches to the annular ligament inferiorly and distally and attaches onto the proximal anterior ulna at the bicipital fossa floor, medial to the supinator crest.