Surgical Treatment of Medial Gastrocnemius Tear

Medial gastrocnemius tears typically occur with forced dorsiflexion while the knee is extended. Myotendinous injuries occur most commonly, which are almost always treated without surgery. If a tendinous injury or avulsion occurs, nonoperative treatment should first be attempted. However, in patients where forceful plantar flexion is required for their desired activities or occupation, surgical fixation is an important treatment option. Postoperative bracing should be used to protect the repair with a graduated therapy progression, including range of motion followed by strengthening and return to activities. This technical note describes the technique for a safe and reliable medial gastrocnemius tendinous repair using two suture anchors

Treatment of a Failed Type V Acromioclavicular Separation Due to Coracoid Fracture: Revision of Acromioclavicular-Coracoclavicular Reconstruction and Coracoid Fixation

Acromioclavicular (AC) injuries are common, especially in the young and active population. AC joint dislocations account for 8% of all joint dislocations and are even more common in contact sports. These injuries are graded as type I through type VI on the basis of the Rockwood classification method. Types I and II are generally treated without surgery whereas types IV, V, and VI are best treated operatively. Type III dislocations remain controversial in terms of treatment, and many surgeons recommend nonoperative treatment first and operative treatment in case of continued symptoms such as pain, instability, or shoulder girdle dysfunction. The goal of operative treatment is to restore AC joint stability, which involves addressing both the coracoclavicular and coracoacromial ligaments to achieve a desirable patient outcome. The objective of this Technical Note is to describe our technique for management of a failed acromioclavicular stabilization, treated with a coracoclavicular and AC joint capsular reconstruction using tibialis anterior and semitendinosus allografts