- Email: [email protected]
Acromial fracture complicating arthroscopic subacromial decompression
ABSTRACTS tant factor in determining the strength of the bovine FATC. The finding that reconstructed bovine FATC is significantly weaker than the intact bovine ACL is also similar to previous studies of in vitro testing on human FATC and intact ACL. However, unlike human cadaver specimens, bovine knees are readily available and have little specimen variance in regards to bone density. This makes them an ideal model for mechanical testing of graft fixation. We did not find any significant correlation between input torque and fixation strength, contrary to previous reports. Screw divergence did not have an adverse effect on fixation strength. There was no significant difference between 7- and 9-ram screws with respect to peak load and energy to failure. Both 7- and 9-mm screws were superior to the 5.5mm screws for the same parameters in this paradigm. Altering screw length did not effect the load deformation properties for the larger size screws. Based on these findings, the 7-ram interference screw can be used with equal confidence as the 9-mm screw, and the 20-ram screw be exchanged for the 30-mm screw.
The Effect of Intraarticular Steroid Injection on Arthroscopy Infection Rates. Brian J. Jolley, Howard D. Martin, Gerald Miley, and Jo-Ann E. Lee. Cincinnati, Ohio, and Boston, Massachusetts, U.S.A. The objective of this study was to ascertain the effect of intraarticular injection of Depo-Medrol at the conclusion of arthroscopy on infection rates. All of the arthroscopies performed at The New England Baptist Hospital over a 10-month period in 1990 were reviewed. A total of 1,115 were done. Two hundred five of these were accompanied by an injection of Depo-Medrol. Six of these patients subsequently developed an infection. This is a rate of 2%, compared with an infection rate of 0.1% in arthroscopies without steroid injection. This is statistically significant, with p < 0.005. Other variables that might predispose the patient to developing an infection, such as infection elsewhere at the time of surgery, increased age, history of diabetes mellitus, previous surgery on the joint, obesity, and prolonged operative or tourniquet times, were found not to be significantly different between the two groups. The injection of steroids significantly increased the risk of infection after arthroscopy. This increase in morbidity must be weighed against the benefits of their use.
351
Acromial Fracture Complicating Arthroscopic Subacromial Decompression. Leslie S. Matthews, W.Z. Burkhead, Stuart Gordon, John Racanelli, and Louis J. Ruland. Baltimore, Maryland; Dallas, Texas; and Haverford, Pennsylvania, U.S.A. Arthroscopic subacromial decompression (ASAD) is being performed with increasing frequency, and for many surgeons has replaced open surgery for the treatment of refractory impingement syndrome. A newly recognized complication of this procedure is fracture of the acromion process. We report six cases of fracture of the acromion after ASAD. All patients were diagnosed after developing increasing shoulder pain in the postoperative period after ASAD. Commonly the pain was sudden in onsdt and developed during the course of postoperative therapy. Identifiable risk factors included osteopenia and overzealous bone resection. Diagnosis was frequently delayed, and three of six fractures were only identifiable on axillary radiographs, which were not initially obtained in the evaluation of the patient's postoperative pain. Pain was a consistent symptom after fracture. The degree of disability varied depending on the size and location of the fracture. Treatment varied from benign neglect to total acromionectomy, but results were consistently poor. Given the poor results seen after acromial fracture, emphasis must be placed on proper preoperative planning and meticulous surgical technique so as to avoid over abundant bony resection, which may lead to this potentially serious complication.
Review of 270 Endoscopic Carpal Tunnel Releases Using the Chow Technique. Daniel J. Nagle and Gerald D. Harris. Chicago, Illinois, U.S.A. Purpose: To prospectively analyze the results of endoscopic carpal tunnel release using the Chow technique. Materials and Methods: A database was created to provide a means of collecting uniform preoperative, operative, and postoperative data. A detailed medical history was taken from each patient. Electrodiagnostic test results were recorded. Perioperative complications were tracked. Postoperative data were collected at designated intervals by the occupational therapists in our office. The postoperative data included clinical tests specific for carpal tunnel syndrome, pinch and grip measurements, postoperArthroscopy, Vol. 9, No. 3, 1993
The Effect of Intraarticular Steroid Injection on Arthroscopy Infection Rates. Brian J. Jolley, Howard D. Martin, Gerald Miley, and Jo-Ann E. Lee. Cincinnati, Ohio, and Boston, Massachusetts, U.S.A. The objective of this study was to ascertain the effect of intraarticular injection of Depo-Medrol at the conclusion of arthroscopy on infection rates. All of the arthroscopies performed at The New England Baptist Hospital over a 10-month period in 1990 were reviewed. A total of 1,115 were done. Two hundred five of these were accompanied by an injection of Depo-Medrol. Six of these patients subsequently developed an infection. This is a rate of 2%, compared with an infection rate of 0.1% in arthroscopies without steroid injection. This is statistically significant, with p < 0.005. Other variables that might predispose the patient to developing an infection, such as infection elsewhere at the time of surgery, increased age, history of diabetes mellitus, previous surgery on the joint, obesity, and prolonged operative or tourniquet times, were found not to be significantly different between the two groups. The injection of steroids significantly increased the risk of infection after arthroscopy. This increase in morbidity must be weighed against the benefits of their use.
351
Acromial Fracture Complicating Arthroscopic Subacromial Decompression. Leslie S. Matthews, W.Z. Burkhead, Stuart Gordon, John Racanelli, and Louis J. Ruland. Baltimore, Maryland; Dallas, Texas; and Haverford, Pennsylvania, U.S.A. Arthroscopic subacromial decompression (ASAD) is being performed with increasing frequency, and for many surgeons has replaced open surgery for the treatment of refractory impingement syndrome. A newly recognized complication of this procedure is fracture of the acromion process. We report six cases of fracture of the acromion after ASAD. All patients were diagnosed after developing increasing shoulder pain in the postoperative period after ASAD. Commonly the pain was sudden in onsdt and developed during the course of postoperative therapy. Identifiable risk factors included osteopenia and overzealous bone resection. Diagnosis was frequently delayed, and three of six fractures were only identifiable on axillary radiographs, which were not initially obtained in the evaluation of the patient's postoperative pain. Pain was a consistent symptom after fracture. The degree of disability varied depending on the size and location of the fracture. Treatment varied from benign neglect to total acromionectomy, but results were consistently poor. Given the poor results seen after acromial fracture, emphasis must be placed on proper preoperative planning and meticulous surgical technique so as to avoid over abundant bony resection, which may lead to this potentially serious complication.
Review of 270 Endoscopic Carpal Tunnel Releases Using the Chow Technique. Daniel J. Nagle and Gerald D. Harris. Chicago, Illinois, U.S.A. Purpose: To prospectively analyze the results of endoscopic carpal tunnel release using the Chow technique. Materials and Methods: A database was created to provide a means of collecting uniform preoperative, operative, and postoperative data. A detailed medical history was taken from each patient. Electrodiagnostic test results were recorded. Perioperative complications were tracked. Postoperative data were collected at designated intervals by the occupational therapists in our office. The postoperative data included clinical tests specific for carpal tunnel syndrome, pinch and grip measurements, postoperArthroscopy, Vol. 9, No. 3, 1993