RESUMO
Arthroscopic reconstructive surgery of the shoulder is extremely demanding. The advent of suture anchors and knot-tying instruments has greatly facilitated its development. Knowledge of the anatomy and surgical principles alone is not enough. Familiarity with specific instruments is also important. We describe our experience with the Elite Cuff Stitch Suture Relay (Smith & Nephew, London, U.K.). We describe a new concept on how to use this suture passer or similar instrument. We advocate this new concept of "concave in and concave out."
Assuntos
Artroscopia/métodos , Articulação do Ombro/cirurgia , Técnicas de Sutura/instrumentação , Humanos , Lacerações/cirurgia , Masculino , Pessoa de Meia-Idade , Manguito Rotador/cirurgia , Lesões do Manguito Rotador , Lesões do OmbroRESUMO
Accurate portal placement is crucial in diagnostic and therapeutic shoulder arthroscopy. However, knowledge of anatomy and surgical principles may not be enough. Placement of a second portal is often hindered by a small amount of bleeding. Our technique easily rectifies this frequent problem by using a simple mini-vent.
Assuntos
Artroscopia/métodos , Perda Sanguínea Cirúrgica/prevenção & controle , Drenagem/instrumentação , Agulhas , Articulação do Ombro/cirurgia , Desenho de Equipamento , HumanosRESUMO
We report on a case of a broken needle that migrated inside the knee joint of a 4-year-old girl. Searching for any small foreign body in the knee joint is not easy in either open or arthroscopic procedures. In this case, the surgery was made more difficult because of technical delays and diagnostic difficulties in defining the surgical plane of the needle. Arthroscopic expertise and some basic precautions can minimize the morbidity to a young patient and prevent migration into the knee joint proper.
Assuntos
Artroscopia , Migração de Corpo Estranho/diagnóstico , Joelho , Agulhas , Pré-Escolar , Feminino , Migração de Corpo Estranho/diagnóstico por imagem , Migração de Corpo Estranho/cirurgia , Humanos , Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Radiografia , Cirurgia Assistida por ComputadorRESUMO
We performed a prospective randomised trial to evaluate the efficacy of pre-operative skin traction for proximal femoral fractures in 311 patients. We found a significant difference in pain score on the evening of admission and the first morning after admission between the groups with traction compared the group without. However, there was no corresponding increase in analgesic requirement during this period. The peak pain score pattern also was different in our population. No other objective benefit can be shown from using skin traction, and its routine use should be abandoned.