Procedural Outcomes of Double Vs. Single Fluoroscopy for Fixing Supracondylar Humerus Fractures in Children: A Case-Control Study

Background: Supracondylar humerus fractures (SHFs) are frequently seen in the pediatric population. The aim of this study was to compare single- and double-fluoroscopy methods for the closed reduction and percutaneous pinning (CRPP) of Gartland type 2 and type 3 SHFs. Materials and Methods: Forty patients who underwent surgery between March 2016 and April 2018 were evaluated retrospectively. Twenty-one patients (group 1) who received double fluoroscopy and 19 patients (group 2) who had single fluoroscopy were evaluated. The preparation period, surgical duration, radiation exposure time, fracture types, sex distributions, distribution of sides, radiologic results at the third month, cosmetic and functional results, and the incidence of complications were recorded. Results: The mean age of the patients in group 1 and group 2 was 4.76 and 4.68 years, respectively. The mean preparation time of group 1 was 11.3 min; whereas in group 2, it was 8.7 min (p < 0.01). The mean surgical duration was 31.76 min in group 1, and 40.47 min in group 2 (p < 0.01). The mean radiation exposure time in group 1 and group 2 was 41.19 and 47.36 s, respectively (p = 0.04). There were statistically significant differences between the two groups in terms of the preparation period, surgical duration, and radiation exposure time. Radiation exposure time and surgical duration were significantly shorter in group 1; the preparation period was shorter in group 2. Conclusions: The double-fluoroscopy technique can significantly reduce surgical duration and radiation exposure time during surgery while treating SHFs of children. © 2020, Indian Orthopaedics Association

Correction of more hallux valgus pathologic disorders with a single distal osteotomy a new surgical technique

Background: Hallux valgus, one of the most common deformities of the great toe, may cause pain, dysfunction, and impaired gait pattern. In this retrospective study we report the results of a new type of distal metatarsal osteotomy combined with distal soft-tissue release in patients with mild-to-moderate hallux valgus deformity. Methods: This new technique was used in the management of 32 feet of 31 patients (eight men and 23 women) with mild-to-moderate hallux valgus. Hallux valgus angle, i ntermetatarsal angl e, and distal metatarsal articular angl e were measured on preoperative, earl y postoperative (6–8 weeks), and l ate (1 year) postoperative radiographs. American Orthopaedic Foot and Ankle Society hallux metatarsophalangeal score was calculated. Sesamoid position, by considering medial sesamoid position, and metatarsal shortness were also measured. Results: Statistically significant differences were detected between the preoperative and late postoperative measurements of the hallux valgus angle, distal metatarsal articular angle, intermetatarsal angle, and sesamoid position parameters in patients operated on with this technique. Improvement was 14° for the hallux valgus angle, 4° for the distal metatarsal articular angle, and 4° for the intermetatarsal angle. Sesamoid position was also improved, and the mean American Orthopaedic Foot and Ankle Society score was significantly improved. Metatarsal shortness greater than 2 mm was observed in two patients without resulting in any clinical discomfort. Conclusions: This new technique was easy, safe, and promising in patients diagnosed as having mild-to-moderate hallux valgus deformity. © 2021, American Podiatric Medical Association. All rights reserved

Does anterolateral ligament injury change the treatment option in patients with partial ACL tears?

Patients with ACL tears with ALL injury have more clinical complaints (instability, feeling of the pop on the knee or knee sliding). patients have ALL injury with partial ACL tears, It is unclear whether the choice of treatment will be conservative or surgical. This study aimed to determine the effect of anterolateral ligament (ALL) status, whether intact or ruptured, on the choice of conservative or surgical treatment in patients with partial anterior cruciate ligament (ACL) tears. Between 2015 and 2019, patients with suspected partial ACL tears were identified on both physical examination and MR imaging. 122 patients who had partial ACL tears and also status of patient’s ALL could be evaluated by radiologist were included in the study, retrospectively. Sixty-two patients who underwent ACL reconstruction were determined as group 1, and 60 patients who did not undergo ACL reconstruction were defined as group 2. In patients with partial ACL rupture with or without ACL reconstruction, it was evaluated whether a ruptured or non-ruptured ALL was effective in this decision of conservative or surgically. The MRIs of patients with partial ACL tears were evaluated by a radiologist and it was concluded that the ALLs of 50 patients were ruptured, and 72 were intact. The ALLs of 36 patients in group 1 were ruptured, and 26 patients were intact. Fourteen patients in group 2 had ruptured ALLs, 46 patient’s ALLs were intact. Seventy-two percent of the patients with partial ACL tears who had ruptured ALLs in MRI underwent ACL reconstruction. It was found that ACL reconstruction was performed more frequently in patients with partial ACL tears with ALL rupture. Therefore, we believe that preoperative evaluations of ALLs using MRI in patients with partial ACL tears are essential for surgical planning. © 2021, Acta Orthopædica Belgica