Open Ankle Arthrodesis.

First described in 1879, ankle arthrodesis is a procedure that has undergone significant advancements not only in technique but also in technology and fixation. Surgeon preference has often dictated those changes with regard to incisional approaches, fixation methods, and use of bone graft and biologics but one constant has always remained: open ankle arthrodesis is a predictable, time-tested procedure with consistent results when performed in appropriate patients. This article highlights the changes that have occurred since the introduction of this procedure and provides a brief overview of the preferred technique.

Pelvic Fixation in Adult and Pediatric Spine Surgery: Historical Perspective, Indications, and Techniques: AAOS Exhibit Selection.

Achieving solid osseous fusion across the lumbosacral junction has historically been, and continues to be, a challenge in spine surgery. Robust pelvic fixation plays an integral role in achieving this goal. The goals of this review are to describe the history of and indications for spinopelvic fixation, examine conventional spinopelvic fixation techniques, and review the newer S2-alar-iliac technique and its outcomes in adult and pediatric patients with spinal deformity. Since the introduction of Harrington rods in the 1960s, spinal instrumentation has evolved substantially. Indications for spinopelvic fixation as a means to achieve lumbosacral arthrodesis include a long arthrodesis (five or more vertebral levels) or use of three-column osteotomies in the lower thoracic or lumbar spine, surgical treatment of high-grade spondylolisthesis, and correction of lumbar deformity and pelvic obliquity. A variety of techniques have been described over the years, including Galveston iliac rods, Jackson intrasacral rods, the Kostuik transiliac bar, iliac screws, and S2-alar-iliac screws. Modern iliac screws and S2-alar-iliac screws are associated with relatively low rates of pseudarthrosis. S2-alar-iliac screws have the advantages of less implant prominence and inline placement with proximal spinal anchors. Collectively, these techniques provide powerful methods for obtaining control of the pelvis in facilitating lumbosacral arthrodesis.

History and evolution of the Sauvé-Kapandji procedure.

Arthrodesis of the distal radioulnar joint combined with the creation of a pseudarthrosis of the distal ulna is frequently referred to as the Sauvé-Kapandji procedure. This eponym is based on the 1936 report by Sauvé and Kapandji, which is believed to be the first report of this innovative technique. There has been some controversy regarding the origin of this procedure, with similar techniques described by Berry in 1930 and Steindler in 1932. This article examines the evolution of the Sauvé-Kapandji procedure and sheds light on the lives of James Allan Berry, Arthur Steindler, Louis de Gonzague Sauvé, and Mehmed Kapandji.

History of cervical disc arthroplasty.

Enthusiasm for cervical disc arthroplasty is based on the premise that motion-preserving devices attenuate the progression of adjacent-segment disease (ASD) in the cervical spine. Arthrodesis, on the other hand, results in abnormal load transfer on adjacent segments, leading to the acceleration of ASD. It has taken several decades of pioneering work to produce clinically relevant devices that mimic the kinematics of the intervertebral disc. The goal of this work is to trace the origins of cervical arthroplasty technology and highlight the attributes of devices currently available in the market.

Pan-metatarsophalangeal joint arthrodesis for the severe rheumatoid forefoot deformity.

The standard approach for correction of severe painful rheumatoid forefoot deformities has involved resection of the metatarsal heads with realignment of the lesser toe deformities and first metatarsophalangeal joint (MTPJ) arthrodesis. Modifications of this procedure may include a pan-metatarsal head resection, including the first metatarsal head, or resection of the lesser metatarsal heads in conjunction with an interpositional arthroplasty of the first MTPJ. The authors describe a novel surgical approach that involves the correction of severe rheumatoid forefoot deformities through a pan-MTPJ arthrodesis. Arthrodesis of all five MTPJs for the surgical treatment of the painful rheumatoid forefoot deformity with chronic plantar callosities and dislocated digits has yet to be reported in the scientific literature. The goal of this article is to provide the treating physician with another alternative and safe surgical approach when dealing with the painful rheumatoid forefoot deformity.

Tratamiento de la discopatía cervical: evidencia válida 50 años después / Cervical disk treatment: valid evidence 50 years after

Se comenta una revisión sistemática sobre el estado actual de la cirugía anterior del disco cervical. Los autores de la revisión trataron de determinar que método de artrodesis intersomática cervical anterior, para uno o dos niveles, tuvo la mejor evolución clínico-radiológica en pacientes con enfermedad degenerativa discal. Sólo incluyeron estudios prospectivos, aleatorizados y controlados que comparaban deversas técnicas de discectomía, artrodesis e instrumentación. Surgió de la revisión, que las evidencias disponibles para tomar una decisión terapéutica valida, en el empleo de las diferentes técnicas, fueron débiles como consecuencia de la baja calidad metodológica de los estudios en el análisis. Palabras clave: artrodesis cervical anterior - discectomía cervical anterior - instrumentación - revisión sistemática

A systematic review about the current state anterior cervical disc surgery was commented. The authors of this review tried to determine which method of anterior cervical interbody fusion at one or two-levels provided the best clinical and radiological outcome in patients with degenerative disc disease. They only included prospective, randomized and controlled studies that compared several techniques of discectomy. fusion and isntrumentation. The review showed that at most trials analyzed were of low quality the evidences available to sustain a valid therapoeutic intervention were weak. Key words: anterior cervical discectomy, anterior cervical fusion, intrumentation, systematic review.

Tratamiento de la discopatía cervical: evidencia válida 50 años después / Cervical disk treatment: valid evidence 50 years after

Se comenta una revisión sistemática sobre el estado actual de la cirugía anterior del disco cervical. Los autores de la revisión trataron de determinar que método de artrodesis intersomática cervical anterior, para uno o dos niveles, tuvo la mejor evolución clínico-radiológica en pacientes con enfermedad degenerativa discal. Sólo incluyeron estudios prospectivos, aleatorizados y controlados que comparaban deversas técnicas de discectomía, artrodesis e instrumentación. Surgió de la revisión, que las evidencias disponibles para tomar una decisión terapéutica valida, en el empleo de las diferentes técnicas, fueron débiles como consecuencia de la baja calidad metodológica de los estudios en el análisis. Palabras clave: artrodesis cervical anterior - discectomía cervical anterior - instrumentación - revisión sistemática(AU)

A systematic review about the current state anterior cervical disc surgery was commented. The authors of this review tried to determine which method of anterior cervical interbody fusion at one or two-levels provided the best clinical and radiological outcome in patients with degenerative disc disease. They only included prospective, randomized and controlled studies that compared several techniques of discectomy. fusion and isntrumentation. The review showed that at most trials analyzed were of low quality the evidences available to sustain a valid therapoeutic intervention were weak. Key words: anterior cervical discectomy, anterior cervical fusion, intrumentation, systematic review.

Tratamiento de la discopatía cervical: evidencia válida 50 años después / Cervical disk treatment: valid evidence 50 years after

Se comenta una revisión sistemática sobre el estado actual de la cirugía anterior del disco cervical. Los autores de la revisión trataron de determinar que método de artrodesis intersomática cervical anterior, para uno o dos niveles, tuvo la mejor evolución clínico-radiológica en pacientes con enfermedad degenerativa discal. Sólo incluyeron estudios prospectivos, aleatorizados y controlados que comparaban deversas técnicas de discectomía, artrodesis e instrumentación. Surgió de la revisión, que las evidencias disponibles para tomar una decisión terapéutica valida, en el empleo de las diferentes técnicas, fueron débiles como consecuencia de la baja calidad metodológica de los estudios en el análisis. Palabras clave: artrodesis cervical anterior - discectomía cervical anterior - instrumentación - revisión sistemática(AU)

A systematic review about the current state anterior cervical disc surgery was commented. The authors of this review tried to determine which method of anterior cervical interbody fusion at one or two-levels provided the best clinical and radiological outcome in patients with degenerative disc disease. They only included prospective, randomized and controlled studies that compared several techniques of discectomy. fusion and isntrumentation. The review showed that at most trials analyzed were of low quality the evidences available to sustain a valid therapoeutic intervention were weak. Key words: anterior cervical discectomy, anterior cervical fusion, intrumentation, systematic review.

[Historical development of arthrodesis of pes cavus]. / Korrigierende Arthrodesen des Klauenhohlfusses aus historischer Sicht.

In contrast to the present, the diagnosis and treatment of pes cavus was a major subject of research at the beginning of last century. This was due to the high incidence of certain neurological disorders (poliomyelitis, myelodysplasia) which led to the development of this foot deformity. Advances in anaesthetic technique and the establishment of antisepsis contributed largely to the development of the surgical treatment of pes cavus. Ladislaus Leo Freiherr von Lesser performed the first surgically induced ankylosis of the ankle by denuding the joint surfaces of cartilage followed by fixation with a metal nail. This procedure was then introduced as arthrodesis; a word derived from the Greek meaning "binding of the joint". Numerous methods and modifications of arthrodesis have been developed for the correction of foot deformities. With increasing knowledge of the pathogenesis of pes cavus, soft tissue and tendon transfer procedures were added to the surgical treatment. Today, the philosophy of arthrodesis in the treatment of foot deformity is the same, but the development of fixation techniques and implant materials could improve postoperative care and outcome.

Techniques of digital arthrodesis: revisiting the old and discovering the new.

Digital surgery is commonplace for foot and ankle surgeons. The techniques of arthrodesis are more exacting and complex than techniques of arthroplasty. They are generally performed in cases of more severe deformity or underlying biomechanical abnormalities, which strongly influence the development and propagation of the deformity. When performed properly in a patient with good compliance, the results are consistently good and rewarding to patients and surgeons. Attention to detail cannot be overemphasized in managing digital deformities. Failure to do so is likely to result in a less than satisfactory outcome for physician and patient. Traditional techniques are proven effective approaches. Meticulous attention to detail and precise execution of the procedure will minimize complications. The exact role of newer implants for fusion is yet to be determined. Further short-term and long-term experience will determine their role in foot surgery.

History of surgery for the correction of spinal deformity.

During the last century the technological advances in the field of spinal surgery had a dramatic impact on the treatment of spinal deformity in children and adults. Before the advent of medications and vaccines to treat and/or prevent tuberculosis and poliomyelitis, patients suffering from these disorders often became incapacitated by the resulting kyphoscoliosis. In the early 1900s Lange began to address this problem mechanically by using foreign materials to stabilize the spine internally. In the 1950s and 1960s, owing to the efforts of Harrington and others, the process evolved to create the first generation of modern spinal instrumentation. The Harrington rod was able to correct a spinal deformity primarily through distraction. In the next wave of advances, some of the shortcomings of Harrington rods were addressed. Segmental fixation involving sublaminar wires was introduced in the 1970s by Luque. Anterior approaches and instrumentation-related techniques developed by Zielke and colleagues as well as Dywer and coworkers in the late 1960s and mid-1970s allowed for better correction of deformity with immobilization of fewer motion segments compared with posterior surgery. Transpedicular fixation of the spine was popularized by Cotrel and Dubousset in the 1980s; they used the technique to perform segmental stabilization, which better reduces the rotational aspect of a deformity. Finally, in the mid-1990s, thoracoscopic techniques were developed and are currently in use for anterior release and placement of instrumentation. The authors review the major technical developments for the surgical treatment of spinal deformity.