Mycobacterium tuberculosis Infection in the Shoulder after Reverse Total Shoulder Arthroplasty / 대한정형외과학회잡지

Reverse total shoulder arthroplasty has recently received attention for treatment of rotator cuff tear arthropathy. However, many complications of reverse total shoulder arthroplasty have also been reported, and infection is a major complication. We are reporting on a case of an approximately 77-year-old female patient who underwent reverse total shoulder arthroplasty with surgical site infection caused by Mycobacterium tuberculosis. The patient had undergone irrigation and debridement two times due to infectious signs at 8 months after a reverse total shoulder arthroplasty. At the last debridement operation, we performed AFB staining, culture for Mycobacterium tuberculosis and biopsy. Mycobacterium tuberculosis was cultured and we did not hesitate to administer 4 regimen therapy for tuberculosis. The outpatient follow-up result was satisfactory without recurrence. At the time of the latest follow-up, the degree of pain and function were good.

Functional Reconstruction of the Digit using Palmaris Longus Tendocutaneous Arterialized Venous Free Flap

PURPOSE: The purpose of this study was to present the results after functional reconstruction of the digits using palmaris longus tendocutaneous arterialized venous free flap in digits with compound defects. METHODS: This study is based on 29 cases of palmaris longus tendocutaneous arterialized venous free flaps harvested from the ipsilateral wrist for the reconstruction of compound defect of the digits. Over the past 10 years, we performed in 17 cases of complex defects of extensor tendon on dorsum of the digits, 7 cases of collateral ligament of the proximal or distal interphalangeal joint and 5 cases of flexor tendon defect with soft tissue defect on the palmar aspect of the digits. We assessed survival rate of the flaps and functional recovery of the digits. RESULTS: All free flaps completely survived except one with completele necrosis and another one with 50% necrosis. In cases of extensor tendon defect, the mean total active range of motion of the digits was 180degrees, in cases of flexor tendon reconstruction, it was 165degrees. In reconstruction of collateral ligament of interphalangeal joint of the thumb and digits, flexion and extension was within normal range and we got very good results without instability in all 7 cases. CONCLUSION: Palmaris longus tendocutaneous arterialized venous free flaps are very useful for reconstruction of composite defect of the digits with extensor or flexor tendons as well as collateral ligaments.