A study on Subscapularis augmented Bankart repair (SB) vs capsulo-labral Bankart repair (CB) for recurrent anterior shoulder dislocation with moderate glenoid bone loss (< 20 %) in non-athletepopulation.

Introduction- Subscapularis augmented Bankart repair (SB) is a novel arthroscopic technique of tenodesis of upper 1/3rd fibers of subscapularis tendon to capsulo-labral repair of Bankart lesion. Treatment of Bony Bankart lesion with glenoid bone loss % (GBL%) 10%-20 % is still a grey zone where bone augmentation procedures are an overtreatment and capsulo-labral repair is associated with high recurrence. Methodology: A retrospective study of 30 patients with h/o anterior instability with GBL%<20 % were classified into two groups. SB group included patients managed with arthroscopic subscapularis augmentation while CB group included patients managed with arthroscopic capsulo-labral repair. These patients were followed up after a minimum of 24 months post-surgery and functional outcomes evaluated using WOSI, ASES and ROWE scores. Results: Patients in the SB group showed superior functional outcomes for WOSI and ROWE scores. Considering postoperative shoulder pain, the median ROWE-P (pain) score was better for SB group (10/10) when compared to CB group (5/10). Patients under SB group were more comfortable with physical symptoms of their shoulder (WOSI-P average 60/1000) and were more likely to continue their recreational sports activity (WOSI- sports for SB 63.7 and CB 119.5. In our study, none of the 15 SB patients had any restriction in range of shoulder movements [ROWE-M score of 10]. Subscapularis augmented Bankart repair is associated with minimal restriction of shoulder range, better pain relief, better acceptability and smoother return to daily living and occupation and can be considered as a routine for every patient with GBL<20 %.

Intraosseous Retrieval of Broken Guide Wire while Fixing Proximal Femur Fractures - A Report of 2 Cases and Review of Literature.

Introduction: Hardware breakage during surgery is a known risk that may result in serious complications. Drill bits and guide wires are particularly prone to breakage, and if not promptly recognized and removed, can cause damage to intrapelvic structures, or may lead to hip arthritis later. Herein, we present two cases in which broken guide wire fragments were safely retrieved through the same incision, resulting in good outcomes and reduced morbidity. Case Report: In the first case, a broken guide wire piece that had been pushed into the hip joint during intertrochanteric fracture surgery was retrieved using disc forceps after reaming over the same guide tract. In the second case, the broken tip of a partially withdrawn guide wire was removed from a transcervical femur fracture using a cannulated drill bit. Conclusion: Our approach highlights the importance of attempting retrieval of broken hardware through the same tract using unconventional instruments, such as disc forceps, before resorting to more invasive methods, such as arthrotomy or separate incisions. These cases demonstrate the feasibility of this approach and its potential to reduce morbidity associated with hardware retrieval.