Search

Background: The objectives of this comprehensive quantitative review of the treatment of calcific supraspinatus tendinitis were to investigate if there is a sustainable positive effect on outcomes after treatment with extracorporeal shockwave therapy (ESWT) or ultrasound (US)-guided needling and to compare these results with those of treatment with arthroscopic surgery. Method: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to conduct this review. A systematic literature search was conducted in December 2019 to identify relevant clinical articles in peer-reviewed journals with at least 3 months’ follow-up. Each article was scored using the Coleman Methodology Score. The primary endpoints were functional outcome and radiologic change in the size of the calcific deposit. Results: Twenty-four studies were included (1,509 shoulders). The mean Coleman Methodology Score for the included studies was 77.1± 9.1. Overall, good to excellent clinical outcomes were achieved after treatment with either ESWT, US-guided needling, or arthroscopic surgery, with an improvement in the Constant-Murley score ranging between 26.3 and 41.5 points after 1 year. No severe side effects or long-term complications were encountered. Conclusions: Patients can achieve good to excellent clinical outcomes after ESWT, US-guided needling, and arthroscopy for calcific tendinopathy of the shoulder. Side effects and posttreatment complications should be taken into account when a decision is being made for each individual patient. Physicians should consider ESWT and US-guided needling as minimally invasive treatment options when primary conservative treatment fails. Arthroscopy can safely be used as a very effective but more invasive secondary option, although the extent of deposit removal and the additional benefit of subacromial decompression remain unclear. Keywords: Calcific Tendinitis, Treatment, ESWT, US-PICT, Arthroscopy, supraspinatus Management UGN.

Background: Ankle arthritis is a highly frequent condition and treatment choice in young individuals may be a difficulty. Fifty percent of older people get some sort of foot or ankle arthrosis. The most prevalent cause is post-traumatic arthritis, comprising 70 percent of people with osteoarthritis. Ankle fusion gives a solid foot that is painless, plantigrade. Several various procedures for ankle fusion were documented, although, including external fixators, internal binding and intramedullary nailing, this is a rescue treatment that leads to lasting abnormalities in gait and there is a danger of worsening owing to the danger of developing ipsilateral hind foot arthritis. There are several operational procedures including open or arthroscopic methods for ankle arthrodesis. Following both techniques, successful clinical outcomes may be attained. The major purpose of this research was to assess the clinical impact of arthrodesis of the knee with transfibular fastening. Methods: Methods: This is a study of 20 patients operated on a transfibular basis at university hospitals Benha and El helal. Results and findings: Compared to the pre-operative values, the post-operative AOFAS rear foot score has been significantly improved. In 20 patients, 95% bone union was accomplished which demonstrates that ankle arthrodesis with transfibular fixation results in good clinical results. This method guarantees high bone union rate and strong stability, removes ankle discomfort, corrects deformation and enhances the ankle function substantially.

Consolidated foremost cruciate tendon remaking and average opening wedge high tibial osteotomy can create solid re-visitation of donning action. This system permits patients to recapture a steady knee at right around 10-year follow-up, with a re-visitation of wearing exercises in about 80%. A critical decline in brandishing level is not out of the ordinary, and patient guiding is significant as the preinjury movement level in the objective patient segment is high. The point of this examination was to play out a precise audit of ACL remaking and high tibial valgus osteotomy in the administration of ACL insufficient with varus knee. This survey was finished utilizing standard approach sketched out in the Cochrane Handbook and detailed the discoveries as per the Preferred Reporting Items for Systematic Reviews and Meta-examinations (PRISMA) articulation rules. The writing search were performed utilizing the accompanying hunt terms: ACL reproduction with valgus osteotomy in administration of ACL inadequacy with varus knee. Watchwords: ACL recreation, and Varus knee. This precise survey included 6 examinations Only one investigation was and the others were single armed.We inferred that consolidated front cruciate tendon recreation and average opening wedge high tibial osteotomy is a feasible choice in youthful patients influenced by foremost shakiness, with great midterm results if a right sign, preoperative arranging, and careful method are applied. Also, The bone-patella ligament bone join has a more grounded obsession With the least re tear rate. This joined system gives palatable emotional, unbiased and radiological outcomes, improves the capacity and diminishes the agony.

Metacarpal fractures comprise between 18–44 % of all hand fractures. Non-thumb metacarpals account for around 88 % of all metacarpal fractures, with the fifth finger most commonly involved. This is a comparative study between Kirschner wires and mini-set plate in management of unstable metacarpal shaft fractures. This is a review article, The search was performed in MEDLINE, Embase, Pubmed and CINAHL Plus in the same date range with the following mediacl terms: “Kirschner wires; mini-set plate; unstable; metacarpal shaft; fractures.”, including articles from 2000 to 2019, K-wire fixation is simple to manipulate and without or with little damage on fracture blood supply, and has been used extensively. Since in the K-wire fixation there is no compression on the fracture, it is difficult to control the motions of the fingers. Stiffness resulting from tendon adhesions and joint contractures is the most common complication associated with hand fractures. Conversely, fractures that require mini-plate fixation but are treated without fixation or with inadequate fixation still lead to stiffness and are associated with an increased rate of nonunion and malunion. Kirschner wires are almost always used for temporary fixation and are removed after the early appearance of fracture callus on radiographs. Despite the availability of many options for fixation, percutaneous fixation using Kirschner wires is a good method for treatment of unstable ulnar four metacarpal fractures. We recommended this technique, which is more biological, technically easier, safe, cheap and rapid to perform with good functional outcome.

Tibial plateau fractures present an important entity in orthopaedic fractures. They may be associated with other knee injuries such as meniscal tears, cruciate ligaments injuries and collateral ligaments damage. The purpose of this study was to reach the latest advances in the different methods of management of tibial plateau fractures using arthroscope and evaluate the results of arthroscopically assisted reduction and internal fixation of tibial plateau fractures on a series of patients clinicaly and radiologicaly. Our study was a prospective case series study that involved 20 patients with tibial plateau fractures presenting to Benha University Hospitals between the period of September 2017 and November 2019.All fractures were evaluated according to the Schatzker classification and there were 2 type I, 7 type II, 7 type III, 2 type IV and 2 type V. According to the clinical Rasmussen score, 15 patients [75%] had excellent results, [2 type I, 5 types II, 7 types III and 1 type IV], and 5 patients [25%] had good results [ 2 types II, 1 type IV and 2 types V]. Radiologic results were excellent in 14 cases [70 %] and good in 6 cases [30%]. There were no patients who had fair or poor results. ARIF of selected tibial plateau fractures allows anatomic reduction and rigid internal fixation with less morbidity than with ORIF, and has the advantage of superior visualization of the entire joint.

The crossing internal suture augmentation technique is an all-inside technique of anterior cruciate ligament reconstruction with augmentation of the hamstring tendon autograft with a braided ultrahigh-molecular-weight polyester–polyethylene suture tape resting on the adjustable cortical buttons on both the femoral and tibial sides. The internal suture augmentation acts as a backbone supporting and protecting the graft until the process of healing and ligamentization of the graft is completed. The ends of the suture tape are tied on the tibial button and additionally fixed to the tibia with a knotless anchor as a backup fixation with the knee in full extension. The technique has the advantages of being minimally invasive with small incisions and allowing preservation of the bone stock through the use of sockets. It also allows early return to activity thanks to the more secure rehabilitation and prevents early failure and stretching of the graft.

It has been proved by many researchers in the last few years that arthroscopic capsulolabral repair is an efficient method for surgical management of anteroinferior shoulder instability. Different arthroscopic techniques using different fixation devices and constructs have been described in the literature, but the suture anchors were the most used implants to shift the inferiorly displaced capsulolabral complex and fix it to the glenoid. In the majority of these techniques, the anchors concentrate the load at specific points (e.g., at 3 or 4 interrupted points over the glenoid directly opposite the anchors) without putting direct pressure on the area of the labral footprint that is between the anchors. We describe here a technique using 2 standard suture anchors inferiorly in conjunction with a knotless suture anchor (e.g., 3.5 mm PushLock, Arthrex, Naples, FL) superiorly. No additional separate sutures or suture tapes are required other than those already loaded in the inferior 2 anchors, which are used to compress the capsulolabral complex to the glenoid in the areas between the suture anchors, producing a uniform pressure that may contribute to better healing.

Background: Infected re-ruptured patellar tendon after avulsed distal patellar pole usually difficult to manage especially if there is bad tissue quality, patella small in size besides atrophy and adhesions of retinacula. Case presentation: Egyptian male patient 20 years old with re-ruptured repaired patellar tendon after 3 months from management by distal patellar pole excision and repair, (two months in cast and one month physiotherapy) get infected in the ligament site, the infection is treated and reconstruction of the ligament was done using semitendinosus in a figure-of-eight fashion, fixed by sutures and bone tunnels in the patella and tibial tuberosity. Conclusion: The patient get improved and regain near normal extensor mechanism function besides patellar stability and strength.