The rotator cuff footprint in Filipinos: A cadaveric study

Introduction@#Rotator cuff tears are one of the common etiologies of shoulder pain. Rotator cuff repair is recommended for a patient who failed conservative treatment. Proper knowledge of the rotator cuff footprint is needed in restoring correct anatomy during the repair. The size of the footprint is important in determining the kind of repair.@*Objective@#This study aimed to define the average measurements of the rotator cuff footprint on the humerus in Filipino cadavers.@*Methods@#This is a descriptive, cross-sectional study of preserved human cadaver upper extremity specimens. We measured the length, width, and shape of the supraspinatus, infraspinatus, subscapularis, and teres minor.@*Results@#We obtained 27 upper extremity specimens. The median age of the source cadavers was 50.5 years with the equal male-to-female distribution. The mean measurement of the supraspinatus is 22.92 mm in length and 10.17 mm in width. The shape of the supraspinatus was found to be trapezoidal. The infraspinatus length was found to be 17.20 mm and the width at 10.72 mm. Its shape was found to be trapezoidal. The teres minor length was measured at 15.15 mm and the width at 11.04 mm. The shape was mostly trapezoidal but some were triangular. Finally, the subscapularis length was 17.68 mm while the width was 11.26 mm. The shape was trapezoidal or comma-shaped.@*Conclusion@#The average measurement of the rotator cuff footprint was found to be smaller in our study than reported in terms of length and width. The footprint shape was similar to the studies reported.

Clinical outcome of the latissimus dorsi muscle flap in orthopedic reconstruction

INTRODUCTION@#The latissimus dorsi muscle has been the “workhorse” of reconstructive surgery because of its predictable neurovascular anatomy and ability to perform both wound coverage and restoration of function. @*OBJECTIVES@#We determined the flap viability, complications, and muscle function (if used as muscle transfer) of our latissimus dorsi flaps for orthopedic reconstruction.@*METHODS@#This is a retrospective review of all cases done in the Microsurgery Unit of the Philippine General Hospital and The Medical City from January 2005 to present using the latissimus dorsi muscle for reconstructive surgery. All patients were followed-up for six months.@*RESULTS@#There were 14 patients who had reconstructive surgeries using the latissimus dorsi muscle. Three patients had traumatic brachial plexus injuries where the latissimus dorsi muscle was used for the reconstruction of elbow flexion. Eleven patients required coverage of a large defect, where seven were secondary to tumor resection and four were secondary to trauma. Of the fourteen patients, nine were pedicled flaps and five were free flaps. We had one failure (free flap group/tumor resection). The rest of the flaps survived completely. The smallest flap was 10 x 8 cm, and the largest flap was 28 x 24 cm.@*CONCLUSION@#The latissimus dorsi muscle remains to be a versatile muscle in the field of orthopedic reconstructive surgery.

Effect of a consignment policy on outcomes of orthopedic emergency trauma patients in a tertiary hospital

OBJECTIVES@#Implants for traumatic orthopedic injuries are costly, and usually borne by the patient. We determined whether a consignment policy decreases morbidity and mortality rates, decreases length of stay, and decreases total expenditure of our patients.@*METHODS@#This is an ambispective cohort study comparing patients whose orthopedic implant surgeries were done before consignment policy and thus paid for out-of-pocket (Group A), and patients whose surgeries were done under the policy, and whose implants were paid for by hospital funding (Group B). Patient records and hospital bills were reviewed. A total of 206 patients were included in the study, and we gathered data from department and hospital records regarding the incidence of morbidity, mortality, length of stay, and total hospital expenditure.@*RESULTS@#In this study, we demonstrate no difference in the incidence of morbidities and mortalities between the two groups. There was also no significant difference in the total hospital expenditure of both. There is a slightly shorter preoperative stay, and significantly longer postoperative and total hospital stays for Group B patients.@*CONCLUSION@#The consignment policy, in its first year of implementation, demonstrated no difference in the incidence of morbidity and mortality, or total hospital expenditures. Further long-term studies may be undertaken to improve accuracy of results.