Management of Fracture lateral malleolus using Minimally Invasive Percutaneous Technique Overview guidelines.

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Mohamed ELsoufy ◽  
Ahmed Gaber ◽  
Wael Alshammakhi ◽  
Tarek Elhewala
Keyword(s):  
Minimally Invasive ◽  
Lateral Malleolus ◽  
Percutaneous Technique

scholarly journals Accuracy of Percutaneous Lateral Release for Hallux Valgus: An Anatomic Study

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0010
Author(s):  
Lara C. Atwater ◽  
Matthew R. McDonald ◽  
Patrick J. Maloney ◽  
Rebecca A. Cerrato
Keyword(s):  
Soft Tissue ◽  
Minimally Invasive ◽  
Proximal Phalanx ◽  
Lateral Collateral Ligament ◽  
Cutaneous Nerve ◽  
Lateral Release ◽  
Soft Tissue Release ◽  
Percutaneous Technique ◽  
Fresh Frozen ◽  
Bunion Correction

Category: Bunion; Other Introduction/Purpose: Minimally Invasive Chevron and Akin (MICA) surgery is growing in popularity. There are now multiple studies comparing minimally invasive bunion correction to traditional open techniques. Many of these studies include percutaneous lateral soft tissue release using a specific blade, while others use an open technique. To our knowledge, there is no prior study confirming the accuracy of soft tissue release via percutaneous technique. Our objective was to evaluate the precision of the percutaneous release, both the structures released and percent release. Additionally, we identified adjacent nerves potentially at risk with a lateral soft tissue release, measuring their proximity to the incision and if they were damaged. Methods: Sixteen fresh frozen cadaveric foot specimens (8 paired limbs) underwent percutaneous lateral release utilizing a beaver blade under fluoroscopic guidance by two Foot and Ankle Fellowship Faculty who regularly perform the procedure. As described in early MICA technique papers by Redfern and Vernois, the blade was inserted into the plantar plate between the lateral sesamoid and the proximal phalanx. Then the blade was rotated laterally while the hallux was directed into varus. The goal was to release the lateral head of the Flexor Hallucis Brevis (FHB) without violating the Lateral Collateral Ligament (LCL). During our experiment the sesamoids were able to be successfully reduced after each release. The specimens were then dissected to reveal the extent of release of the FHB and LCL. Distance was measured between the blade path and the dorsal digital branch of the deep peroneal nerve, as well as the plantar digital nerve. Results: The FHB was at least partially released in 15/16 specimens. It was completely released in two specimens. 5/16 specimens had greater than 50% but less than 100% release and 8/16 specimens had <50% release. The LCL was completely intact in 8/16 specimens. It was partially released in 8/16 specimens (5 less than 50% released and 3 greater than 50% released). There was no correlation between percent of FHB release and the likelihood of LCL release. The dorsal cutaneous nerve was consistently near the path of the beaver blade, with a median distance of 2mm (range 1-8mm). However, the nerve was never found to be incised or transected. Likewise, the plantar nerve was never injured. Conclusion: This study sought to verify the effectiveness of percutaneous lateral release. We found the FHB to be at least partially released in all but one case, resulting in adequate clinical correction of sesamoid position. Full FHB release may not be necessary to achieve the clinical objective of sesamoid reduction. There was no correlation between percent of FHB release and concomitant release of the LCL, which demonstrates the challenge of an isolated FHB release. The dorsal cutaneous nerve was consistently near the blade path but was never injured, suggesting patients should be counseled regarding the risk. [Table: see text]

scholarly journals TL 18237 - First metatarsophalangeal joint arthrodesis using a minimally invasive technique

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 112S
Author(s):  
Luiz Carlos Ribeiro Lara ◽  
Lúcio Carlos Torres ◽  
Gabriel Cervone ◽  
Juan Antonio Grajales ◽  
Fabio Lemos Rodrigues
Keyword(s):  
Minimally Invasive ◽  
Metatarsophalangeal Joint ◽  
Hallux Rigidus ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Percutaneous Technique ◽  
First Metatarsophalangeal Joint ◽  
The Mean ◽  
Larger Sample

Introduction: Metatarsophalangeal joint arthrodesis (MTPA) is a surgical technique indicated for the treatment of hallux rigidus with advanced arthrosis and for rheumatic diseases. This classic surgery is widely used and effective; however, the use of a minimally invasive technique remains mostly unknown. Objective: To present the outcome of MTPA performed using a percutaneous technique. Methods: Hallux MTPA was performed in 8 feet from 4 patients with hallux rigidus and 4 with rheumatoid arthritis, with a higher prevalence of women than men (5 vs. 3) and a mean postoperative follow-up time of 1.5 years. The outcomes were evaluated using a modified version of the American Orthopedic Foot and Ankle Society (AOFAS) questionnaire and the union time. Results: All patients who underwent surgery showed improvements in pain and arthrodesis union at approximately 8 weeks. The mean AOFAS score increased to 85 points (of a total of 90 possible points). There were no complications, such as infection, nonunion or persistent pain. Conclusion: The percutaneous technique of hallux MTPA was effective, with satisfactory outcomes, reduced surgical invasiveness, immediate walking, rapid union with “arthrodesis take” and significant improvement in pain. However, a larger sample is required to confirm the outcomes.

Early Start of CAPD with the Seldinger Technique

2005 ◽  
Vol 25 (6) ◽  
pp. 556-559 ◽  
Author(s):  
Oktay Banli ◽  
Hasan Altun ◽  
Aysegul Oztemel
Keyword(s):  
Peritoneal Dialysis ◽  
Minimally Invasive ◽  
Seldinger Technique ◽  
Percutaneous Technique ◽  
Minimally Invasive Techniques ◽  
Early Start ◽  
A Prospective Study ◽  
Invasive Techniques ◽  
Ideal Method ◽  
The Ideal

The ideal method for inserting continuous ambulatory peritoneal dialysis (PD) catheters remains debatable. Minimally invasive techniques are becoming more popular. The routine recommendation for starting PD is 4 – 6 weeks after catheter insertion. We planned a prospective study to evaluate whether this waiting period is necessary. From January 2003 to July 2004, 42 double-cuff Tenckhoff CAPD catheters were inserted into 41 patients. Percutaneous technique was used and PD was started on the sixth day. Only 2 pericatheter leakages (4.8%) were detected. This procedure is comparatively safe, simple, and less costly than surgical and peritoneoscopic placement. The rate of early pericatheter leakage may be lowered with this technique and PD may be started earlier.

scholarly journals Medium-Long-Term Clinical and Radiographic Outcomes of Minimally Invasive Distal Metatarsal Metaphyseal Osteotomy (DMMO) for Central Primary Metatarsalgia: Do Maestro Criteria Have a Predictive Value in the Preoperative Planning for This Percutaneous Technique?

2018 ◽  
Vol 2018 ◽  
pp. 1-12
Author(s):  
Carlo Biz ◽  
Marco Corradin ◽  
Wilfried Trepin Kuete Kanah ◽  
Miki Dalmau-Pastor ◽  
Alessandro Zornetta ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Predictive Value ◽  
Preoperative Planning ◽  
Callus Formation ◽  
Demographic Data ◽  
Percutaneous Technique ◽  
Consecutive Series ◽  
Metatarsal Bones

Background. The purpose of this prospective study was first to evaluate the safety and effectiveness of Minimally Invasive Distal Metatarsal Metaphyseal Osteotomy (DMMO) in treating central metatarsalgia, identifying possible contraindications. The second objective was to verify the potential of DMMO to restore a harmonious forefoot morphotype according to Maestro criteria. Methods. A consecutive series of patients with metatarsalgia was consecutively enrolled and treated by DMMO. According to Maestro criteria, preoperative planning was carried out by both clinical and radiological assessment. Patient demographic data, AOFAS scores, 17-FFI, MOXFQ, SF-36, VAS, and complications were recorded. Maestro parameters, relative morphotypes, and bone callus formation were assessed. Statistical analysis was carried out (p < 0.05). Results. Ninety-three patients (93 feet) with a mean age of 62.4 (31-87) years were evaluated. At mean follow-up of 58.7 (36-96) months, all of the clinical scores improved significantly (p < 0.0001). Most of the osteotomies (76.3%) had healed by 3-month follow-up, while ideal harmonious morphotype was restored only in a few feet (3.2%). Clinical and radiological outcomes were not different based on principal demographic parameters. Long-term complications were recorded in 12 cases (12.9%). Conclusion. DMMO is a safe and effective method for the treatment of metatarsalgia. Although Maestro criteria were useful to calculate the metatarsal bones to be shortened and a significant clinical improvement of all scores was achieved, the ideal harmonious morphotype was restored only in a few feet. Hence, our data show that Maestro criteria did not have a predictive value in clinical outcomes of DMMO.

scholarly journals Assessment of the outcome of percutaneous pedicle screws in management of degenerative and traumatic dorsal and lumbar pathologies

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Ayman Hussein ◽  
Hamdy Ibrahim ◽  
Hazem Mashaly ◽  
Sameh Hefny ◽  
Abdelrahman El Gayar
Keyword(s):  
Minimally Invasive ◽  
Functional Outcome ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Spinal Instrumentation ◽  
Pedicle Screws ◽  
Pedicle Screw Fixation ◽  
Morbidity Rate ◽  
Percutaneous Technique ◽  
Percutaneous Pedicle Screw

Abstract Background Percutaneous pedicle screw technique is relatively a recent technique that evolved the concept of posterior spinal instrumentation, utilizing familiar fluoroscopic landmarks to guide the procedure of screws insertion, which despite being technically demanding, it avoids the Musculo-ligamentous damage associated with the conventional posterior technique. Aim of the work This study aims to report our experience in managing traumatic and degenerative spine pathologies by the minimally invasive percutaneous technique and assessing its radiological and functional outcome. Materials and methods A prospective observational study that included the analysis of the functional, operative, biochemical, and radiological outcomes of 20 patients who underwent uniplanar fluoroscopic-guided dorsal and/or lumbar percutaneous pedicle screw fixation procedures with or without fusion using the sextant, longitude, and Spineart system and any reported complications between January 2018 and December 2019. Results The clinical and radiological analysis of 100 percutaneous pedicle screws in degenerative (n:11) and traumatic (n:9) dorsal and/or lumbar cases revealed that the biomechanical stabilizing characteristics are comparable to the conventional posterior approach with the added benefits of the paraspinal muscle-sparing. Satisfactory functional outcome represented in the improvement of the postoperative back pain visual analog score and Oswestry Disability Index Score with acceptable morbidity and complications rate was noticed. Conclusions Percutanous pedicle screw fixation is a landmark in the evolution of the minimally invasive spine surgery which can be a safe alternative to the conventional posterior muscle stripping technique with a comparable functional and radiological outcome and good biomechanical profile and an acceptable morbidity rate.

scholarly journals PO 18220 - Talocalcaneal tibio arthrodesis with percutaneous retrograde intramedullary nail

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 50S
Author(s):  
Jorge Eduardo De Schoucair Jambeiro ◽  
Tavares Cordeiro Neto ◽  
Fernando Delmonte Moreira ◽  
José Augusto De Oliveira ◽  
Felipe Fernande Leão
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Intramedullary Nail ◽  
Functional Limitations ◽  
Weight Bearing ◽  
Radiographic Evaluation ◽  
Full Weight Bearing ◽  
Percutaneous Technique ◽  
One Year

Introduction: Primary osteoarthritis, post-traumatic lesions, Charcot arthropathy and rheumatoid arthritis are some of the causes of ankle and hind foot osteoarthritis that result in pain and sometimes functional limitations in patients affected by such pathology. The therapeutic options vary from conservative treatment (painkillers, bracing and nonsteroidal anti-inflammatory drugs) and surgical treatment. The objective of this present study is to report three cases of patients with ankle osteoarthritis who had undergone minimally invasive surgery (MIS) for tibio-talocalcaneal arthrodesis with an intramedullary nail, with the use of a retrograde blocked intramedullary nail and screws as fixation. Methods: Clinical and radiographic evaluations were conducted of three cases treated using this technique at our institution in 2017, who were allowed full weight bearing postoperatively The AOFAS questionnaire and radiographic evaluation were employed in two orthogonal incidences of the ankle, evaluated after one year postoperatively. Results: We obtained AOFAS scores between 68 and 86 after one year postoperatively with this study technique, and the radiographic consolidation index was observed in 100% of cases (between 6 and 12 weeks) postoperatively. There were no complications. Conclusion: We obtained good results with minimally invasive surgery (MIS) for tibio-talocalcaneal arthrodesis, with satisfactory consolidation presenting no complications. However, there are an insufficient number of studies in the literature demonstrating superiority of the percutaneous tibio-talocalcaneal arthrodesis technique over the open technique. We believe that the percutaneous technique is a recent method fir study that may be added to the therapeutic arsenal.

scholarly journals Dual-incision minimally invasive fasciotomy of the anterior and peroneal compartments for chronic exertional compartment syndrome of the lower leg

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Christoph Grechenig ◽  
Epaminondas Markos Valsamis ◽  
Amir Koutp ◽  
Gloria Hohenberger ◽  
Theresa di Vora ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Peroneal Nerve ◽  
Lower Leg ◽  
Lateral Malleolus ◽  
Invasive Technique ◽  
Superficial Peroneal Nerve ◽  
Medial Dorsal ◽  
Exertional Compartment Syndrome ◽  
Extensor Compartment ◽  
Dual Incision

Abstract To evaluate the risk of iatrogenic injury when using a dual-incision minimally invasive technique to decompress the anterior and peroneal compartments of the lower leg. Forty lower extremities from 20 adult cadavers, embalmed with Thiel’s method, were subject to fasciotomy of the anterior and peroneal compartment using a dual-incision minimally invasive fasciotomy. The first incision was made 12 cm proximal to the lateral malleolus to identify and protect the superficial peroneal nerve (SPN). The second incision was made at the mid-point of the Fibula (half-way between the fibular head and the lateral malleolus). Release of the anterior and peroneal compartments was successful in all specimens. Two nerve injuries of the superficial peroneal nerve were reported. More precisely, in these cases the medial dorsal cutaneous nerve got injured during the fascial opening of the extensor compartment. Two incision minimally invasive fasciotomy to decompress the anterior and peroneal compartments of the lower leg appears to be safe with regard to the results of this study.

IDENTIFICATION OF TEMPERATURE-DEPENDENT PARAMETERS IN LASER-INTERSTITIAL THERMO THERAPY

2012 ◽  
Vol 22 (09) ◽  
pp. 1250019 ◽  
Author(s):  
OLIVER TSE ◽  
RENÉ PINNAU ◽  
NORBERT SIEDOW
Keyword(s):  
Optimal Control ◽  
Optimal Control Problem ◽  
Minimally Invasive ◽  
Control Problem ◽  
Thermal Denaturation ◽  
Tumor Ablation ◽  
Percutaneous Technique ◽  
Temperature Dependent ◽  
Laser Applications ◽  
Irradiation Planning

Laser-induced thermotherapy (LITT) is an established minimally invasive percutaneous technique of tumor ablation. Nevertheless, there is a need to predict the effect of laser applications and optimize irradiation planning in LITT. Optical attributes (attenuation, absorption, scattering) change due to thermal denaturation. The work presents the possibility to identify these temperature-dependent parameters from given temperature measurements via an optimal control problem. The solvability of the optimal control problem is analyzed and results of successful implementations are shown.

Sign in / Sign up

Export Citation Format

Share Document