Acute Essex-Lopresti Syndrome: About a Case of Brachioradialis Tendon Transfer.

Background The classic treatment for acute Essex-Lopresti syndrome is closed reduction percutaneous pinning (CRPP) of the distal radioulnar joint (DRUJ). This work aimed to verify whether it was possible to add a transfer of the brachioradialis tendon to the pinning. Case Description The patient was a 39-year-old right-handed man, climbing instructor, who sustained the Mason II fracture and disjunction of the DRUJ. A transfer of the brachioradialis tendon severed from its muscle attach that was made through a bone tunnel passing through the radius and the neck of the ulna. The clinical and radiological result at the 6-month follow-up was satisfactory. Literature Review and Clinical Relevance Our results in a single case showed that the brachioradialis tendon transfer was useful in acute Essex-Lopresti syndrome.

Intramedullary percutaneous fixation of metacarpal fractures: screw versus connected K-wires.

The purpose of the present study was to determine clinical and radiographic outcomes in patients treated with limited-open retrograde intramedullary headless screw fixation for metacarpal neck and shaft fractures (group I) versus percutaneous antegrade and retrograde intramedullary double pinning linked by a connector (group II). We designed a retrospective comparative study, with the inclusion of two groups (20 patients each) of metacarpal unstable fractures. Both groups showed similar outcomes at the final follow-up, except for extension lag (significantly better in group II) and return to sport (significantly better in group I). Intramedullary screw fixation did not accelerate bone union and range of motion recovery in the early follow-up. In conclusion, limited-open retrograde intramedullary headless screw fixation and percutaneous connected antegrade and retrograde intramedullary double pinning are both reliable techniques of fixation for metacarpal neck and shaft fractures. LEVEL OF EVIDENCE: III.

Survival Rate on a 10-Year Follow-Up of Total Wrist Replacement Implants: A 23-Patient Case Series.

Background According to current literature, the estimated average survival rate for Remotion, the total wrist implants, is above 90% on an 8-year follow-up. We examined our series of Remotion to calculate its survival rate on a 10-year follow-up. Case Description A total of 23 cases of total wrist implants were reviewed. The case series included 22 patients, 18 females and 4 males, of an average age of 55 years. The case series included 19 inflammatory rheumatic diseases, 3 Kienböck disease, and 1 posttraumatic arthrosis. Conclusion The average survival rate of our case series was 95.7% on a 4-year follow-up, 91.3% on a 6-year follow-up, and 69% on a 10-year follow-up. On our review, the QuickDASH score, pain, wrist extension range of motion, and grip strength were improved postoperatively. No difference was shown between preoperative and postoperative values for wrist flexion, pronation, and supination. The case series included a septic case, treated by arthrodesis, and three total wrist implants displacements, two of which were treated by carpal implant, and the remaining one was treated by arthrodesis. Clinical Relevance The survival rate of the total wrist replacement implant Remotion was estimated to be 69%.

Radiographic measurement of the posterior femoral offset is not precise.

PURPOSE: The posterior femoral offset may significantly impact the final flexion range after total knee arthroplasty (TKA). The purpose of the present study was to compare a conventional, radiologic-based technique with an intra-operative, surgical navigation-based technique for the measurement of posterior femoral offset. The tested hypothesis was that the two measurement techniques produce different results both before and after TKA. METHODS: One-hundred consecutive cases referred for end-stage knee osteoarthritis have been studied. Posterior femoral offsets, measured pre- and post-TKA from radiographs, as well as those measured from a navigation system intra-operatively, were analysed. The pre-TKA measured offsets, post-TKA measured offsets and the changes (pre- vs. post-TKA) in the offsets were statistically compared between the radiologic and the navigated measurement techniques at a 0.05 level of significance. RESULTS: The mean paired difference between pre-TKA radiologic and navigated measurement was 4 ± 4 mm (p < 0.001). There was a significant and moderate positive correlation with a good coherence between the two measurements. The mean paired difference between post-TKA radiologic and navigated measurement was 6 ± 5 mm (p < 0.001). There was a significant and moderate positive correlation but a poor coherence between the two measurements. CONCLUSIONS: The conventional radiologic technique for the measurement of the posterior femoral offset cannot be reliably used either for pre-TKA planning of the posterior femoral resection and antero-posterior sizing of the femoral component, or for post-TKA quality control of the reconstruction of the posterior femoral offset. LEVEL OF EVIDENCE: Level IV.