Arthroscopic Treatment in the Distal Rupture of the Triceps Brachial Tendon in Elite Athlete: A Case Report.

Injuries (rupture, avulsion) of the triceps tendon are considered infrequent injuries, which mainly affect the male gender and are directly associated with injuries that occur during sports and in a high percentage due to the consumption of steroids. The diagnosis and treatment must be carried out early, especially in those patients with high functional demand or elite athletes, in order to obtain good functional results. The clinical examination should be accompanied by diagnostic imaging studies. There is conservative treatment for lesions affecting less than 50% of the tendon, but those lesions that compromise over 50% of the tendon, surgical treatment is the indication. It could be performed through an open approach or via arthroscopic (barely described in the literature). The time of injury is the key point the early surgical treatment has shown to have optimal outcomes. However, there is no consensus on the surgical approach and its functional outcome.

Considerations For Surgical Planning Of Humeral Osteotomy In Brachial Plexus Birth Palsy Based On The Elbow Crease And Humeral Retroversion Measurement.

In obstetric brachial plexus, injuries are characterized by contractures, weakness and an association with different bone deformities, such as elongation of the coracoid process and/or acromion, retroversion of the glenoid cavity, flattening of the humeral head and Scapular Hypoplasia with Elevation and Rotation (SHEAR). Another humeral deformity is the retroversion of the humeral head, cases of which are increased in the presence of plexus lesions. The purpose of the current manuscript is to highlight two aspects of this latter deformity. First, the importance of taking into consideration the reduction of a humeral retroversion as a quantifiable bone deformity (by medical imaging technique) along with the other bone deformities previously mentioned. Finally, the complementation of these measurements by the clinical measures of the anterior crease of the elbow to rebuild the plane of motion to a level comparable to that of the healthy side, thereby avoiding excessive exorotation, would facilitate and improve the planning of surgical strategies for each patient.

Outcome Of Dynamic Compression Plate With Dorsal Radial Sliding Graft Technique For Wrist Arthrodesis In Brachial Plexus Injury Patients.

We have meticulously read the article titled "Outcome of dynamic compression plate with dorsal radial sliding graft technique for wrist arthrodesis in brachial plexus injury patients". We would like to comment on some aspects of the study and set forth our experience in wrist arthrodesis performed to improve functional outcome in the scenarios cited above. This manuscript aims to highlight the following. First, to the best of our knowledge, there exists a paucity of comparative studies on the use of a reamer/iliac crest /radial sliding graft for total wrist arthrodesis, evaluating fusion times and complications. Second, we propose adult traumatic brachial plexus injury involves injury -particularly of the C7-C8-T1 root injury- as an indication for metacarpophalangeal arthrodesis along with wrist fusion to provide stability of thumb grasp. Third, there is no consensus on the selection criteria for metacarpophalangeal arthrodesis in patients with plexopathy, in order to improve the stability of the hand and thereby improving the activities of daily life. Long-term functional outcome follow-up and patient satisfaction over an extended time frame may also be valuable for future studies to consider.

Early Complication of Humeral Derotational Osteotomy Surgery for Obstetric Brachial Plexus as Salvage for a Failed Tendon Transfer. Case Report.

In brachial plexus injuries, external rotation in patients with a moderate to severe glenohumeral dysplasia is corrected with derotational humeral osteotomy surgery. The most frequent complications described for this procedure include keloid scar, loss of external rotation secondary to bone remodelling, loss of internal rotation, prominence of osteosynthesis, fracture distal to the plate transient ulnar paraesthesia and radial nerve palsy (1), and delayed union and non-union. Rarely, treating complications associated with derotational humeral osteotomy may require revision of osteosynthesis (2). The literature that investigates the effectiveness of derotational humeral osteotomy as a procedure to rescue dorsal infraspinatus tendon transfer is limited. This article is the first communication of a pediatric patient with an obstetric brachial plexus injury receiving a derotational osteotomy as a procedure to salvage a failed rescue Latissimus dorsi tendon transfer with a complication. This case report was performed according to the principles of the Declaration of Helsinki. Written informed consent for participation in this case report was obtained from the patient's parents.