scholarly journals Medial Closing-Wedge Distal Femoral Varus Osteotomy via Lateral Approach: The New Surgical Technique for Treating Valgus Osteoarthritic Knee

2021 ◽  
Author(s):  
Chaturong Pornrattanamaneewong ◽  
Pakpoom Ruangsomboon ◽  
Rapeepat Narkbunnam ◽  
Keerati Chareancholvanich
Keyword(s):  
Surgical Technique ◽  
Case Series ◽  
Lateral Approach ◽  
Joint Disease ◽  
Iliotibial Band ◽  
Varus Osteotomy ◽  
Closing Wedge ◽  
Satisfactory Outcome ◽  
The Mean ◽  
New Surgical Technique

Abstract Background and purpose: The medial closing-wedge distal femoral varus osteotomy (MCW-DFVO) was an excellent operation for painful valgus lateral unicompartmental osteoarthritic (OA) knee, especially in the young patient. Originally, it requires a medial approach that has more precarious. On top of that, releasing of the iliotibial band (ITB) that is the deforming force needs added incision. Therefore, this study aims to describe the new surgical technique of MCW-DFVO that uses a lateral approach and lateral plating to treat the valgus OA knee. Additionally, we also reveal the outcomes of our technique as the case series.Materials and method: Ten patients (12 knees) who underwent MCW-DFVO via a lateral approach were retrospectively reviewed. The inclusion criteria were age > 18 years, isolated lateral compartmental OA knee, no significant patellofemoral pain, and ROM > 90 degrees. We excluded the inflammatory joint disease, unstable knee (femorotibial joint subluxation > 1 cm), and prior surgical procedure. Demographic data, pre- and postoperative ROM, radiographic outcomes, complications, and survivorship were recorded.Results: The mean age, body mass index, and preoperative ROM were 55.3 ± 4.0 years, 25.4 ± 3.7 kg/m2and 113.3 ± 11.5 degrees, respectively. The preoperative valgus deformity was 162.3 ± 4.8 degrees, and the Final post-operative alignment was 182.3 ± 2.6 degrees. Overall mean operative time of this technique was 92.5 ± 26.7 minutes. During the follow-up period, post-operative ROM was decreased to 108.8 ± 11.7 degrees. One knee required plate removal due to hardware irritation, and another knee required subsequent total knee arthroplasty (TKA) at 1 and 8.5 years after DFVO, respectively. The survivorship of this technique was 91.7% at the mean survival time of 13.8 years (95% confidence interval, 11.9 – 15.7 years).Conclusion: This study proposed the new surgical technique of MCW-DFVO via a lateral approach. This technique provided a satisfactory outcome and excellent survivorship. However, further research with a larger sample size was required.

scholarly journals Limbal Approach Phacovitrectomy to Treat Cataract with Clinically Significant Asteroid Hyalosis—Presentation of the Technique and Preliminary Results

2021 ◽  
Vol 10 (15) ◽  
pp. 3338
Author(s):  
Agnieszka Rozegnał-Madej ◽  
Aleksandra Wlaź ◽  
Tomasz Żarnowski
Keyword(s):  
Surgical Technique ◽  
Case Series ◽  
Normal Range ◽  
Corrected Visual Acuity ◽  
Retinal Tears ◽  
Asteroid Hyalosis ◽  
The Mean ◽  
Clinically Significant ◽  
New Surgical Technique

Purpose: To assess preliminarily the efficacy and safety of a relatively new surgical modification of phacovitrectomy in eyes with cataract and visually significant asteroid hyalosis (AH). Materials and methods: Prospective, noncomparative, interventional case series of six eyes of six patients (mean age 75.6 years; 1 woman, 5 men) with cataract and visually significant AH treated with a novel surgical technique—a phacoemulsification with anterior vitrectomy through posterior capsulorhexis and intraocular lens (IOL) implantation. Main outcome measures were: best-corrected visual acuity (BCVA), intraocular pressure (IOP), IOL centration, complications. Mean follow-up was 39.17 ± 4.31 months. Results: The mean BCVA (Snellen) improved from 0.26 ± 0.18 to 0.73 ± 0.33 at the end of the follow-up. IOP was in the normal range, and no problems with IOL fixation were observed at the end of the follow-up. No post-operative complications, retinal detachment, retinal tears, macular edema or prolonged inflammation were observed. Conclusions: The presented new surgical technique seems to be a safe and efficacious method to treat cataract with visually significant asteroid hyalosis.

scholarly journals Surgical Technique for Management of Severe Calcaneofibular Impingement: Case Series

2020 ◽  
Vol 5 (4) ◽  
pp. 247301142095379
Author(s):  
Jay M. Levin ◽  
James K. DeOrio
Keyword(s):  
Surgical Technique ◽  
Case Series ◽  
Lateral Wall ◽  
Patient Characteristics ◽  
Calcaneal Fracture ◽  
Lateral Approach ◽  
Emergency Department Visits ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Calcaneal Osteotomy

Background: Calcaneofibular impingement is characterized by lateral hindfoot pain and is commonly resulting from calcaneal fracture malunion or severe flatfoot deformity. Lateral calcaneal wall decompression has been used successfully to relieve pain in patients who have calcaneofibular impingement. However, in cases of severe impingement and hindfoot valgus, lateral wall excision may leave only a small remnant of calcaneal bone for weightbearing and can lead to chronic heel pain. We describe a surgical technique using a medial displacement calcaneal osteotomy (MDCO) combined with a lateral wall exostectomy and report on the outcomes from our series of patients. Methods: Retrospective study of a single surgeon’s patients was done from 2010 to 2020 who underwent medial slide calcaneal osteotomy and lateral wall exostectomy for calcaneofibular impingement. Descriptive statistics were used to summarize patient characteristics. Our study included 9 patients, 6 females and 3 males, with a mean age of 59 years (range: 19-77) and a mean follow-up of 62 weeks (range: 6-184). Results: Five had an Achilles split approach, 2 had an oblique lateral approach, and 1 had an extensile lateral approach. Patients achieved radiographic relief of impingement and improvement in pain. Minor skin and soft tissue complications occurred in 3 patients, all of which were associated with laterally based incisions, and all resolved after a 10-day course of oral antibiotics. No major complications, emergency department visits, or readmissions occurred. Conclusions: MDCO and lateral wall exostectomy was a safe and effective treatment for severe calcaneofibular impingement. Level of Evidence: Level IV, retrospective case series.

External Fixation for Surgical Treatment of a Mallet Finger

2003 ◽  
Vol 28 (3) ◽  
pp. 228-230 ◽  
Author(s):  
T. KALELI ◽  
C. OZTURK ◽  
S. ERSOZLU
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
Interphalangeal Joint ◽  
Mallet Finger ◽  
Distal Interphalangeal Joint ◽  
Distal Interphalangeal ◽  
The Mean ◽  
Extensor Lag ◽  
New Surgical Technique

A new surgical technique is described for the treatment of mallet finger deformity which involves the application of a mini external fixator across the distal interphalangeal joint and resection of a portion of the extensor mechanism. We reviewed 19 patients who were treated with this technique, at a mean follow-up period of 36 (range, 24–48) months. The mean extensor lag was 2° (range, −7° to 13°) and the mean flexion range was 70° (range, 20°–90°).

scholarly journals Subbrachial approach to humeral shaft fractures: new surgical technique and retrospective case series study

2013 ◽  
Vol 56 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Vladimir Boschi ◽  
Zenon Pogorelic ◽  
Gordan Gulan ◽  
Katarina Vilovic ◽  
Hrvoje Stalekar ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Case Series ◽  
Humeral Shaft ◽  
Retrospective Case ◽  
Humeral Shaft Fractures ◽  
Shaft Fractures ◽  
Retrospective Case Series ◽  
Case Series Study ◽  
Series Study ◽  
New Surgical Technique

scholarly journals A new surgical technique: transvesical resection of prostate - case series

2018 ◽  
Vol 44 (5) ◽  
pp. 1023-1031 ◽  
Author(s):  
Hakan Türk ◽  
Sitki Ün ◽  
Erkan Arslan
Keyword(s):  
Surgical Technique ◽  
Case Series ◽  
New Surgical Technique

scholarly journals Preliminary results from digestive adaptation: a new surgical proposal for treating obesity, based on physiology and evolution

2006 ◽  
Vol 124 (4) ◽  
pp. 192-197 ◽  
Author(s):  
Sérgio Santoro ◽  
Manoel Carlos Prieto Velhote ◽  
Carlos Eduardo Malzoni ◽  
Fábio Quirino Milleo ◽  
Sidney Klajner ◽  
...  
Keyword(s):  
Surgical Techniques ◽  
Case Series ◽  
Albert Einstein ◽  
Plasminogen Activator Inhibitor ◽  
Plasminogen Activator Inhibitor 1 ◽  
Preliminary Results ◽  
Basic Functions ◽  
The Mean ◽  
New Surgical Technique

CONTEXT AND OBJECTIVE: Most bariatric surgical techniques include essentially non-physiological features like narrowing anastomoses or bands, or digestive segment exclusion, especially the duodenum. This potentially causes symptoms or complications. The aim here was to report on the preliminary results from a new surgical technique for treating morbid obesity that takes a physiological and evolutionary approach. DESIGN AND SETTING: Case series description, in Hospital Israelita Albert Einstein and Hospital da Polícia Militar, São Paulo, and Hospital Vicentino, Ponta Grossa, Paraná. METHODS: The technique included vertical (sleeve) gastrectomy, omentectomy and enterectomy that retained three meters of small bowel (initial jejunum and most of the ileum), i.e. the lower limit for normal adults. The operations on 100 patients are described. RESULTS: The mean follow-up was nine months (range: one to 29 months). The mean reductions in body mass index were 4.3, 6.1, 8.1, 10.1 and 10.7 kg/m², respectively at 1, 2, 4, 6 and 12 months. All patients reported early satiety. There was major improvement in comorbidities, especially diabetes. Operative complications occurred in 7% of patients, all of them resolved without sequelae. There was no mortality. CONCLUSIONS: This procedure creates a proportionally reduced gastrointestinal tract, leaving its basic functions unharmed and producing adaptation of the gastric chamber size to hypercaloric diet. It removes the sources of ghrelin, plasminogen activator inhibitor-1 (PAI-1) and resistin production and leads more nutrients to the distal bowel, with desirable metabolic consequences. Patients do not need nutritional support or drug medication. The procedure is straightforward and safe.

Managing Ahmed Glaucoma Valve tube exposure: Surgical technique

2020 ◽  
pp. 112067212092564
Author(s):  
Marco Nardi ◽  
Maria Novella Maglionico ◽  
Chiara Posarelli ◽  
Michele Figus
Keyword(s):  
Postoperative Complications ◽  
Surgical Technique ◽  
Case Series ◽  
Ahmed Glaucoma Valve ◽  
Retrospective Case ◽  
Retrospective Case Series ◽  
Interesting Alternative ◽  
New Surgical Technique

Purpose: To describe a new surgical technique for managing Ahmed Glaucoma Valve tube exposure. The technique is simple, safe, easy to perform and may be an interesting alternative to conventional covering of the tube. This technique allows unlike the classical ones to act on the cause and not only on the complication of extrusion. Materials and Methods: This study was a retrospective case series that included four eyes of four patients who presented with an Ahmed Glaucoma Valve tube exposure. Results: Surgery was uneventful in all cases and we did not observe any intraoperative or postoperative complications. After at least 1-year follow-up, no case of tube re-exposure was detected. Conclusions: Many techniques have been proposed in order to cover the extruded tubes, and different materials may be used to reinforce the coverage, but re-exposure of the tube is a possible scenario. Indeed, our technique attempts not only to cover the exposed tube but also to solve the cause of the extrusion.

The Outcomes of Distal Femoral Varus Osteotomy in Patellofemoral Instability: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 33 (05) ◽  
pp. 504-512
Author(s):  
Si Heng Sharon Tan ◽  
Si Jian Hui ◽  
Chintan Doshi ◽  
Keng Lin Wong ◽  
Andrew Kean Seng Lim ◽  
...  
Keyword(s):  
Case Series ◽  
Patellofemoral Instability ◽  
Patellar Height ◽  
Genu Valgum ◽  
Wedge Osteotomy ◽  
Opening Wedge ◽  
Chondral Lesions ◽  
Varus Osteotomy ◽  
Closing Wedge ◽  
The Status

AbstractDistal femoral varus osteotomies have been novelly described in the recent years to be successful in the management of patellofemoral instability with genu valgum. However, these publications are limited to case reports and small case series and no published literature have attempted to analyze them in totality. The current review aims to pool together these small case series to evaluate the outcomes and complications of distal varus femoral osteotomies when performed for patellofemoral instability. The review was conducted using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. All studies that reported the outcomes of distal femoral varus osteotomy for patellofemoral instability were included. A total of five publications were included in the review, which included a total of 73 patients. All of the studies reported improvement in the radiological outcomes for genu valgum correction and patellofemoral instability. One study using opening wedge osteotomy reported a decrease in Caton–Deschamps index postoperatively, while another study using closing wedge osteotomy reported maintenance of the Caton–Deschamps index postoperatively. Second look arthroscopy showed an improvement in the status of the chondral lesions of the medial facet of the patellar undersurface, the lateral facet of the patellar undersurface and the trochlear groove 2 years postoperatively. All studies also reported a decrease in the risk of recurrence of patellofemoral instability, reduction in pain, and an improvement in all the clinical outcomes knee scores. Distal femoral varus osteotomy is promising and useful in the management of patellofemoral instability with genu valgum. The procedure can allow for radiological correction of the genu valgum and patellofemoral instability, reduction in the risk of recurrence of patellofemoral instability, reduction in pain, improvement in clinical knee outcome scores, and improvement in the status of the chondral lesions in the patellofemoral joint. It is highly versatile and could accommodate varying degrees of correction. These improvements in radiological and clinical outcomes can be seen in studies for both closing wedge and opening wedge distal femoral osteotomies. However, opening wedge osteotomies appear to decrease the patellar height as compared with closing wedge osteotomies which maintain the patellar height; therefore, the patellar height should be assessed preoperatively prior to deciding whether to perform an opening wedge or closing wedge distal femoral varus osteotomy. The Level of Evidence for this study is IV.

Sign in / Sign up

Export Citation Format

Share Document