Journal of Research in Orthopedic Science
Volume:5 Issue: 3, Aug 2018

Recently, minimally invasive surgical (MIS) techniques have become more common in orthopedics and traumatology practice. MIS techniques may also reduce complications in the treatment of tibial plateau fractures (TPFs).
The aim of this study was to compare the radiological and functional outcomes of TPF, treated by MIS techniques and the conventional approach (open reduction and internal fixation).
The patients were divided into two groups, receiving either MIS (group A) or conventional treatment (group B). Each group consisted of 20 patients. The mean age of patients was 46.8 ± 2.85 years in group A and 50.3 ± 2.41 years in group B. Incision-healing complications were classified based on severity. Functional outcomes were evaluated using the Lysholm scale in the first year.
Complete healing without incision-healing complications was reported in all patients from group A, whereas nine incision-healing complications were found in group B (P Widespread use of MIS can be promoted in order to reduce incision-healing complications in TPF. However, further prospective studies with a larger sample size are needed to confirm our results.

In the patients with osteoporotic vertebral compression fracture (OVCF) treated conservatively, significant progression of the local kyphosis due to an impaired healing leads to reduction in the quality of life. Thus, it is of critical value to identify the predictors of this major complication.
The current prospective cohort study aimed at evaluating the predictors of progression in the local kyphosis in a series of patients with acute OVCF undergoing conservative treatment.
Eligible patients with OVCF were identified and local kyphosis progression was evaluated after four months of conservative treatment. Demographic characteristics such as gender, age, and body mass index (BMI), as well as radiographic characteristics such as the location of fracture, bone mineral density (BMD), and serum 25 (OH) vitamin D level were compared between the patients with local kyphosis angle (LKA) progressed ≥ 30° (group A) and the patients with LKA remained From a total of 60 patients with OVCF, LKA progressed ≥ 30° in 19 patients (31.7%). The mean change of LKA was 16.2° ± 7.2° in group A and 1.92° ± 2.7° in group B (P Significant progression of LKA following conservative treatment of OVCF is correlated with the level of fractured vertebra, BMI, and age of the patients.These factors could be used to select patients most benefit from conservative treatment.

Lateral lumbar interbody fusion (LLIF) is increasingly being utilized in isolation to achieve a large surface-area interbody fusion with an indirect decompression for spinal stenosis. This retrospective chart review was done to determine the viability of performing stand-alone (SA) LLIF.
Forty-nine patients at least 18 years of age with minimum one-year follow-up at a single institution underwent SA-LLIF using minimally invasive surgery (MIS) approach without further posterior surgery between 2011 and 2015. One to five-level fusions were included. Retrospective review of surgical outcomes and radiographic parameters were examined preoperatively, acutely postoperatively and at 1 year postoperatively.
Forty-nine patients (102 spinal segments) underwent SA-LLIF. Fusion levels ranged from one to five with a mean of 2.1 ± 2.1. Mean blood loss was 68 ± 63.2cc and mean surgical time was 143.4 ± 66.5 minutes. Fifty-seven percent had undergone prior spine surgery unrelated to their index procedure. Complication rate was 38.9% and reoperation rate was 20.4%. No difference in complication rates was noted between constructs with three or more levels fused versus less than three levels fused. At one-year, significant improvement was noted with pelvic tilt, pelvic incidence, and lumbar lordosis.
SA-LLIF is an optional MIS treatment of stable degenerative disc disease and spinal stenosis, with good one-year correction and maintenance of radiographic parameters. With complication rate of 38.9% and reoperation rate of 20.4%, true benefit of forgoing posterior supplemental fixation may be questioned.

Recently, opening-wedge high tibial osteotomy (HTO) has attracted much interest due to its advantages over closing-wedge HTO. However, it has been reported to influence the posterior tibial slope (PTS), potentiating the knee for subsequent complications.
This study aimed at evaluating: 1. How open-wedge HTO changes the PTS, and 2. how the PTS evaluation method influences the extent of the PTS change.
Patients with genu varum deformity, who underwent HTO at the center of the current study were included. Tomofix plate or Podo plate with or without bone graft were used for fixation purposes. The pre- and post-operative assessment of the PTS was performed using three different evaluation methods, including tibial anatomical axis (TAA), fibular anatomical axis (FAA) and posterior tibial cortex (PTC).
A total of 119 knees from 83 patients, with mean age of 31.32 ± 10.1 years and mean follow-up of 3.1 ± 1.9 years, were included in this study. Medial compartmental osteoarthritis was the most frequent type of etiology. The pre-operative PTS was 13.16, 13.81 and 11.55 using the TAA, FAA and PTC method, respectively. The post-operative PTS was 12.59, 12.95 and 10.77 using the TAA, FAA and PTC method, respectively. The change of PTS was not statistically significant using either methods.
A negligible reduction of less than 1º was observed in the PTS of patients following opening-wedge HTO. The PTS assessment was not affected by the choice of evaluation method.

The scaphocapitate fracture syndrome is a rare injury and refers to concomitant fractures of the scaphoid and capitate carpal bones. It is a special type of perilunate fracture dislocation, accompanied with rotation of 90 or 180 degrees of the fractured proximal pole of the capitate bone.
A right-handed 23-year-old man was presented due to left wrist pain after falling down from great height. His wrist was swollen with severe pain, tenderness, and remarkable restriction of the range of motion. Plain X rays and CT scan revealed scaphoid waist fracture accompanied with capitate fracture and rotation of its proximal pole indicating scaphocapitate fracture syndrome. The scaphoid and head of the capitate were reduced and fixed with headless Herbert screws and the injured lunotriquetral ligament was repaired followed by immobilization of the wrist for 6 weeks. After removing the cast, the patient was referred to physical therapy and finally achieved a painless wrist with acceptable range of motion and grip strength.
Careful clinical examination and appropriate imaging are essential for diagnosis of this rare injury. Open reduction through posterior approach as well as anatomic reduction and fixation with headless compression screws and repairing the ligamentous injuries can result in acceptable clinical and radiological outcomes.

Despite its low prevalence, giant cell tumor of tendon sheath (GCTTS) is considered as one of the most common benign tumors in the hand. GCTTS mostly affects tendon sheaths and finger joints; however, its presence in the wrist and Guyon canal is scarcely reported.
In this report, we describe the case of a 32-year-old female with signs and symptoms of ulnar tunnel syndrome in her right hand while the MRI illustrated a soft tissue mass in the Guyon canal. Excisional biopsy was performed, confirming the diagnosis of GCTTS.
This report proposes the consideration of GCTTS as a differential diagnosis in patients suffering from ulnar tunnel syndrome. In addition, it could be concluded that an excisional biopsy might be considered as a therapeutic and diagnostic method in this disease.