Notes

[How the life span study course standpoint transforms epidemiology].
Studies conducted on forearm bone diaphysis non-union are limited due to the rarity of this condition. The present study aimed to evaluate the outcome of our technique using autologous iliac corticocancellous bone graft fixed by locking plate system for the forearm bone diaphyseal non-union without infection.

We treated eight patients with non-union of radial or ulnar shaft fracture (four men, four women) aged 38 years (range 18-52 years) on average. The average follow-up period was 18 months (range 12-24 months). In our technique, we applied the locking plate to the diaphyseal bone fragment, before grafting the bone block to the non-union site. After excision of sclerotic ununited bone, the autologous iliac corticocancellous bone was grafted to the defect and fixed with single locking screw. Pain, grip strength, and disabilities of the arm, shoulder, and hand (DASH) score were measured and compared before and 12 months after the surgery. Radiographs were taken at each follow-up, and the time of bony union was determined.

The mean time to radiological union was 4.2 months (range 3-6 months), and bony union was achieved in all cases within 6 months. All measured values, visual analog scale, DASH score, and grip strength, were significantly improved at 12 months after surgery (p<0.05). No minor/major complications including infection, non-union, or malunion were reported.

Locking compression plate fixation and autologous iliac corticocancellous bone grafting with a holding locking screw appears to be a reliable primary procedure for non-union of the forearm diaphyseal fracture without infection.

IV; therapeutic study.
IV; therapeutic study.
Talar fracture is rare. Treatment is surgical for neck and/or body fractures with displacement. The aims of the present study were to collect epidemiological data on talar fractures, and to assess the impact of trauma via various functional scores and radiographic impact in the medium term.

Displaced talar fracture shows negative medium-term functional and radiological/clinical impact.

A multicenter retrospective study was performed with a minimum follow-up of 12 months post-trauma. Inclusion criteria included radiographic assessment at a minimum 12 months post-trauma and data on 3 functional scores SF12, AOFAS and FAAM. 225 patients were initially included, 81 of whom had follow-up with functional and radiological/clinical assessment.

Fracture reduction was anatomic in 61% of cases when CT was performed; reduction quality was independent of approach (p>0.05). 45% of patients showed subtalar osteoarthritis at a mean 2 years, significantly related to reduction defect (p<0.05). Mean AOFAS score was acceptable, at 74/100. Factors for functional prognosis comprised reduction quality, hindfoot alignment, subtalar osteoarthritis, and talar osteonecrosis with dome collapse.

Talar fracture led to late complications with socioeconomic impact. Subtalar osteoarthritis affects almost half of patients within some months of trauma. Optimal reduction is the key to fair progression. Postoperative CT assessment now seems mandatory.

IV; multicenter retrospective study.
IV; multicenter retrospective study.
The present study aimed to describe the technique of ultrasound traumatic elbow lesion assessment performed by an orthopedic surgeon.

Nine patients were included in a single-center study. Clinical examination assessed pain, ranges of elbow motion, neurovascular status and elbow ligament testing. Ultrasound was associated to radiography between days 7 and 15, screening for lesions of the bone, medial ligament (in 30-90° flexion), lateral ligament (elbow at 90° in cobra position) and epitrochlear and epicondylar muscle insertions. Ultrasound scanning time and echogenicity were assessed.

Four radial head osteochondral fractures were detected on ultrasound in addition to the 4 fractures seen on radiography, without significant difference (p=0.071). Clinical examination found 2 cases of valgus laxity and 5 of varus laxity. Ultrasound, performed blind to radiography, found 1 medial collateral ligament anterior bundle lesion (in 1 of the 2 patients with valgus laxity) and 4 lateral collateral ligament ulnar bundle lesions (in 4 of the 5 patients with varus laxity). There were no epicondylar or epitrochlear tendon lesions. Scanning time decreased significantly over the study period, from a mean 30minutes in the first 5 cases to a mean 24.8minutes in the last 5 (p=0.046). Three patients could not be put in the cobra position, and 3 showed poor echogenicity.

Ultrasound assessment of traumatic elbow lesions could be performed by an orthopedic surgeon on a well-defined protocol. Lesions on ultrasound matched clinical symptomatology. Inter- and intra-observer reproducibility remain to be assessed.

IV.
IV.
Intramedullary locked nails are mainly used for the fixation of mid-shaft fractures in the long bones. But inserting the distal locking screws by the free-hand technique may require high exposure to radiation. Our method achieves perfect circles on radiographs on the first attempt for lower limb fractures without any specific instrumentation.

We applied a geometric principle in which two lines perpendicular to another line are parallel to each other. Proximal locking, whether it is done or not, serves as a guide for the first perpendicular line to the nail. The fluoroscopy unit is aligned along the drill sleeve or the screwdriver left in place to achieve perfect circles on the first attempt.

This technique is simple, reliable, and reproducible. It does not require any specific instrumentation, allows the surgeon to choose any manufacturer's nail and reduces the operating room staff's exposure to radiation.
This technique is simple, reliable, and reproducible. It does not require any specific instrumentation, allows the surgeon to choose any manufacturer's nail and reduces the operating room staff's exposure to radiation.
There are few previous studies on traumatic supraspinatus tear with adhesive capsulitis. check details This study used arthroscopic release with single-row fixation or double-row suture bridge fixation to treat adhesive capsulitis of the shoulder with rotator cuff tears. Further, the clinical efficacy of arthroscopic release with single-row fixation and double-row suture bridge fixation was compared.

Arthroscopic release combined with single-row fixation or double-row suture bridge fixation showed good clinical outcomes in patients with traumatic supraspinatus tear with adhesive capsulitis.

A single-center prospective randomized trial was performed from June 2013 to June 2017. Of the 68 patients with traumatic supraspinatus tear and adhesive capsulitis who underwent arthroscopic release, 34 (22 with tear measuring≤3cm and 12 with tear measuring>3cm) were included in the single-row fixation group and 34 (20 with tear measuring≤3cm and 14 with tear measuring>3cm) were included in the double-row suture bridge fixation group.
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