2 research outputs found
Relapses of traumatic peroneal tendons subluxation already treated surgically: a new surgical approach
Aim To illustrate the surgical treatment of relapses of traumatic
peroneal tendons subluxation.
Methods We came across a young woman, who sustained a sprain
in her dominant ankle after a trauma; we noticed subluxation of
the peroneal tendons during eversion and extension of the foot.
She referred to a previous accident some years before with peroneal tendon subluxation treated by superior peroneal retinaculum
(SPR) sutures with a synthetic braided absorbable material. We
prescribed conventional radiography, magnetic resonance imaging
(MRI) and performed surgery: we removed scar tissue, reattached
the retinaculum using suture anchors strengthening it with an acellular dermal matrix allograft patch.
Results Periodic clinical follow-ups until 24 months were performed evaluating the stability of the ankle, checking the range of
movement, and the Visual Analogic Scale (VAS) and American
Orthopedic Foot and Ankle Society Score (AOFAS) was administered. At the first check the subluxation was resolved and the
ankle was stable. The VAS scale had the value of 0 at the 3-month
follow-up maintained until the final check.
Conclusion Relapsing traumatic peroneal tendons subluxation is
rare, as well as the possibility of a re-intervention years later. This
technique seems to guarantee an excellent result even in the long
term, allowing resolution of pain and joint stability. In fact, the use
of acellular dermal patch is an already commonly described technique for the augmentation in rotator cuff and hip capsular repair;
no reports are available in literature in relation to the use of graft
for the repair of the superior peroneal retinaculum
High results and lower cost in four-bone arthrodesis with retrograde screws
Aim To describe the technique of the four-corner fusion with two
retrograde crossed headless screws in cases of carpal collapse.
Methods This technique is a consolidated procedure performed
in cases of scaphoid non- union advanced collapse (SNAC) type
II and III, scapholunate advanced collapse (SLAC) type II and III
and in other cases of carpal collapse. Between 2017 and 2019 we
treated six male patients (a mean age of 55.0 years) with radiocarpal osteoarthritis. Our technique involves the use of two retrograde crossed headless screws; the first screw was placed distally
proximally from the uncinate to the lunate and the second screw
from the pyramidal to the capitate, crossed at approximately 90
degrees. Clinical and radiographic two-year follow-up was performed. Before the treatment and during the follow-ups VAS, PRWE
and DASH Quick score scales, measured wrist range of motion
(WROM) were administered and evaluated.
Results In all cases the X-ray consolidation of arthrodesis within
five months was noticed; in 50% patients already under 3-month
control. No observed signs of mobilization of screws and inflammatory or infectious processes were found. All patients were
satisfied (reduction/disappearance of pain). All surgically treated
patients resumed normal daily activities. These improvements
were confirmed by the results of the evaluation scale and clinical
examination.
Conclusion This technique, in our opinion, represents a gold standard. Its low costs of the material used (especially comparing to
other technique), a low prevalence of complications of materials
and fusion in 100% of cases should be also considered