Bilateral Luxatio Erecta – Etiology, Diagnosis and Management

Luxation erecta is a rare form of shoulder dislocation, bilateral inferior shoulder dislocation is very rare and few cases have been published in the literature. We present a case of a male, fell down the ladder, presented with bilateral luxation erecta treated with close reduction, immobilisation and rehabilitation

Early failure of coracoclavicular ligament reconstruction using TightRope system

This prospective study reports the results of early failure of coracoclavicular (CC) ligament reconstruction using TightRope.Nine consecutive patients who had CC ligament reconstruction using TightRope or GraftRope were assessed for radiological and functional outcomes using DASH and Oxford Shoulder scores. With an average age was 38.4 (21-70) years, four patients had type III injuries, two type IV and two type V injuries. The mean follow-up was 22.8 (12-42) months. In 7 out of 9 patients, secondary progressive loss of reduction was observed at an average of 3.1 (1-7) months. Three patients underwent revision. The mean DASH score at latest follow-up was 27.45 (19.6-35) & Oxford shoulder score was 30.5 (20-43).Coraco-clavicular reconstruction with TightRopeor GraftRope appears to result in failure with progressive AC joint subluxation perhaps due to ‘windscreen wiper’ micromotion. Surgeons should be wary of this potential problem whilst choosing this method of reconstruction for CC ligament reconstructions.

Determining risk factors for surgical wound dehiscence: a literature review

Postoperative wound healing plays a significant role in facilitating a patient's recovery and rehabilitation. Surgical wound dehiscence (SWD) impacts on mortality and morbidity rates and significantly contributes to prolonged hospital stays and associated psychosocial stressors on individuals and their families. A narrative review of SWD was undertaken on English-only studies between 1945 and 2012 using three electronic databases Ovid CINHAL, Ovid Medline and Pubmed. The aim of this review was to identify predisposing factors for SWD and assessment tools to assist in the identification of at-risk patients. Key findings from the included 15 papers out of a search of 1045 revealed the most common risk factors associated with SWD including obesity and wound infection, particularly in the case of abdominal surgery. There is limited reporting of variables associated with SWD across other surgical domains and a lack of risk assessment tools. Furthermore, there was a lack of clarity in the definition of SWD in the literature. This review provides an overview of the available research and provides a basis for more rigorous analysis of factors that contribute to SWD