RESUMEN
BACKGROUND: Arthroscopic resection of tarsal coalitions is a relatively new technique. This systematic review aimed to investigate the post-operative complications and functional outcomes in arthroscopic resection of tarsal coalitions. METHODS: PubMed, Medline, Embase and Cochrane library were searched for studies that reported outcomes in arthroscopic resection of tarsal coalitions. RESULTS: 8 studies met the inclusion criteria. Post-operative outcomes were reported in 103 cases. The overall complication rate was 13.6%. Tibial nerve injury was reported in 1 patient. All included studies demonstrated post-operative improvement in functional outcomes. CONCLUSION: Arthroscopic resection is a feasible and effective treatment method for symptomatic tarsal coalitions.
RESUMEN
Scapholunate ligament is the most commonly injured ligament in the wrist and requires accurate diagnosis and treatment. It presents with pain, stiffness and can lead to carpal instability as well as degenerative arthritis if left untreated, with subsequent loss of function and disability. There are several management options currently available but there is no consensus on how best to manage a wrist with chronic sequelae of scapholunate ligament injury. This review explores available evidence in the literature on optimal treatment options including non-operative and operative procedures, relevant surgical techniques and their associated outcomes. A summary of the current concepts in the management of Chronic Scapholunate ligament injury is presented.
RESUMEN
Dupuytren's contracture is a common condition that has the potential to be debilitating. It presents in a variety of manners and can be mild or more aggressive in its progression. There are a large number of management options currently available. In this review of the evidence, non-operative and operative management options are examined, with a consideration of post-operative rehabilitation and complications. A summary of the current concepts in the management of Dupuytren's contracture is presented.
RESUMEN
BACKGROUND: Residual acetabular dysplasia is one of the most common complications after treatment for developmental dysplasia of the hip. The acetabular growth response after reduction of a dislocated hip varies. The options are to wait and add a redirectional osteotomy as a secondary procedure at an older age, or to perform a primary acetabuloplasty at the time of the open reduction to stimulate acetabular development. We present the early results of such a procedure-open reduction and an incomplete periacetabular acetabuloplasty-as a one-stop procedure for developmental dysplasia of the hip. PATIENTS AND METHODS: We retrospectively reviewed the results obtained with 55 hips (in 48 patients, 43 of them girls) treated between September 2004 and February 2011. This cohort included late presentations and failures of nonoperative treatment and excluded unsuccessful previous surgical treatment (including closed reductions), neuromuscular disease, and other teratological conditions. Patients were treated once the ossific nucleus was present or when they reached one year of age. 31 cases were late presentations while 17 represented failures of nonoperative treatment. The mean age of the patients at surgery was 1.3 (0.6-2.6) years. The mean follow-up period was 4 (2-8) years. According to the IHDI classification, 1 was grade I, 9 were grade II, 13 were grade III, and 32 were grade IV. Results The mean acetabular index fell from 38 (23-49) preoperatively to 21 (10-27) at the last follow-up. There were no infections, nerve palsies, or graft extrusions. None of the cases required secondary surgery for residual acetabular dysplasia. 8 patients developed avascular necrosis (AVN) of grade II or more. The incidence of AVN was significantly associated with previous, failed nonoperative treatment. 1 patient developed coxa magna requiring shelf arthroplasty 4 years after the index procedure and 1 patient with lateral growth arrest required medial screw epiphysiodesis. INTERPRETATION: This incomplete periacetabular acetabuloplasty is a reliable adjunct to open reductions, and it is followed by a rapid acetabular growth response that avoids secondary pelvic procedures. It is a one-stop surgery with predictable outcome that can be performed in 0.5- to 2.5-year-old children.
