Controversies in Orthopedic Surgery of The Upper Limb

Preface
Contents
1: Displaced Proximal Humeral Fractures in the Elderly: Conservative Treatment Versus Open Reduction and Internal Fixation Versus Hemiarthroplasty Versus Reverse Shoulder Arthroplasty
1.1 Introduction
1.2 Epidemiology, Pathoanatomy, and Fracture Classification
1.2.1 Epidemiology
1.2.2 Pathoanatomy
1.2.3 Classification
1.3 Diagnosis: Clinical Presentation and Imaging
1.3.1 Clinical Presentation
1.3.2 Imaging
1.4 Treatment
1.4.1 Nonoperative Treatment
1.4.2 Operative Treatment
1.4.2.1 Open Reduction and Internal Fixation (ORIF)
Technique
1.4.2.2 Intramedullary Nailing (IMN)
1.4.2.3 Arthroplasty
Hemiarthroplasty (HA)
Reverse Shoulder Arthroplasty (RSA)
Outcomes
1.5 Postoperative Rehabilitation
1.6 Outcomes Evaluation
1.6.1 Health Questionnaires
1.6.2 Functional Scales
1.7 Overall Complications
1.8 Mortality
1.9 Conclusions
References
2: Surgical Versus Conservative Interventions for Treating Acromioclavicular Dislocation of the Shoulder in Adults
2.1 Introduction
2.2 Epidemiology and Classification
2.3 Diagnosis
2.4 Treatment and Results
2.5 Surgical Treatment
2.6 Acute Injuries
2.7 Chronic Injuries
2.8 Conclusions
References
3: Calcific Tendinopathy of the Rotator Cuff in Adults: Operative Versus Nonoperative Management
3.1 Introduction
3.2 Pathogenesis
3.3 Imaging
3.4 Treatment
3.4.1 Ultrasound-Guided Percutaneous Irrigation of Rotator Cuff Calcific Tendinopathy (US-PICT)
3.4.1.1 US-Guided Percutaneous Irrigation of Calcific Tendinopathy of the Rotator Cuff in Patients with or Without Previous External Shockwave Therapy
3.4.1.2 Efficacy of Ultrasound-Guided Percutaneous Treatment of the Rotator Cuff Calcific Tendinopathy with Double Needle Technique
3.4.1.3 US-PICT: Redefining Predictors of Treatment Outcome
3.4.2 External Shock Wave Therapy (ESWT)
3.4.2.1 Focused, Radial, and Combined ESWT
3.4.2.2 Effectiveness of Focused Shockwave Therapy Versus Radial Shockwave Therapy for Noncalcific Rotator Cuff Tendinopathies: A Randomized Clinical Trial
3.4.3 Platelet-Rich Plasma (PRP)
3.4.4 Needle Aspiration
3.4.5 Dextrose Prolotherapy
3.4.6 Sodium Thiosulfate
3.4.7 Surgical Treatment
3.5 Comparative Studies
3.5.1 Operative Versus Nonoperative Management
3.5.2 Radial ESWT Versus Ultrasound Therapy
3.5.3 Comparing Ultrasound-Guided Needling Combined with a Subacromial Corticosteroid Versus High-Energy ESWT
3.5.4 Comparison of Radial Extracorporeal Shockwave Therapy and Traditional Rehabilitation Medicine
3.6 Conclusions
References
4: Recurrent Anterior Shoulder Instability in Adults: Bankart or Latarjet?
4.1 Introduction
4.2 Bankart Procedure
4.2.1 Open Bankart Repair
4.2.2 Arthroscopic Bankart Repair
4.3 Latarjet Procedure
4.3.1 Modified Open Latarjet
4.3.2 Arthroscopic Latarjet
4.3.3 Open Latarjet Vs. Arthroscopic Latarjet
4.3.4 Latarjet vs. Anterior Glenoid Reconstruction Using Fresh Distal Tibia Allograft (DTA)
4.3.5 Latarjet After Failed Arthroscopic Bankart Repair
4.4 Comparative Studies: Bankart Vs. Latarjet
4.4.1 Arthroscopic Bankart vs. Open Bristow-Latarjet
4.4.2 Arthroscopic Bankart vs. Open Bristow-Latarjet in Patients Older than 40
4.4.3 Arthroscopic Bankart Repair with Remplissage vs. Open Latarjet
4.4.4 Arthroscopic Bankart Repair vs. Open Latarjet vs. Capsular Shift
4.5 Conclusions
Appendix 1: WOSI Score
References
5: Controversies in Shoulder Arthroplasty
5.1 Introduction
5.2 Rotator Cuff Arthropathy
5.2.1 Young Patients
5.2.2 Humeral Cut Neck-Shaft Angle of Less than 155 Degrees
5.2.3 Studies that Compare the RSA with or Without Lateralization with Bone Graft
5.2.4 Degree of Lowering of the Center of Rotation
5.2.5 Size of the Glenosphere
5.3 Glenohumeral Osteoarthritis
5.3.1 Comparison Between HA and TSA
5.3.2 Thinned Supraspinatus Tendon with a Partial Tear
5.3.3 Young Patients with Glenohumeral Osteoarthritis
5.3.4 Resurfacing Arthroplasty (Stemless Shoulder Arthroplasty)
5.3.5 Primary Osteoarthritis Patients with Joint Impingement, Posterior Erosion, and Posterior Subluxation of the Humeral Head
5.3.6 Reverse Prosthesis in Young Patients
5.4 Failed Anatomic Shoulder Arthroplasties
5.5 Proximal Humeral Fractures
5.6 Glenoid Bone Defects
5.6.1 Reverse Shoulder Arthroplasty
5.6.2 Total Shoulder Arthroplasty
5.7 Short-Stem Shoulder Arthroplasty
5.8 Complications of Shoulder Arthroplasties
5.8.1 Complications of RSA
5.8.1.1 Acromion and Scapula Spine Fractures
5.8.1.2 Instability
5.8.2 Complications of Total Anatomic Arthroplasty
5.9 Conclusions
References
6: Clavicle Fractures: To Operate or Not?
6.1 Introduction
6.2 Fractures of the Middle Third of the Clavicle
6.3 Fractures of the Distal Third of the Clavicle
6.4 Fractures of the Proximal Third of the Clavicle
6.5 Conclusions
References
7: Massive Rotator Cuff Tears: When and How to Repair
7.1 Introduction
7.2 Epidemiology
7.3 Anatomy and Biomechanics
7.4 Natural History of Rotator Cuff Disease
7.5 Rotator Cuff Tears Classification: Definition of Massive Rotator Cuff Tear
7.6 Massive Rotator Cuff Tears: When to Repair
7.6.1 Clinical Factors
7.6.2 Imaging Factors
7.6.3 Intraoperative Factors
7.7 Massive Rotator Cuff Tears: How to Repair
7.8 Conclusions
References
8: Humeral Shaft Fixation in Adults: Plate Fixation, Intramedullary Nail, or Nonoperative?
8.1 Introduction
8.2 Anatomy
8.3 Classification of Diaphyseal Humeral Fractures
8.4 Initial Patient Assessment
8.5 Treatment
8.5.1 Conservative Treatment
8.5.2 Intramedullary Nailing
8.5.2.1 Results
8.5.3 Internal Fixation with Plate
8.5.3.1 Surgical Approaches
8.5.3.2 Type and Placement of Plates
8.5.3.3 Results
8.5.3.4 MIPO (Minimally Invasive Plate Osteosynthesis) Technique
8.5.4 External Fixator
8.6 Comparison of Treatment Options
8.7 Conclusions
References
9: Controversies in the Management of Intra-Articular Distal Humerus Fractures in Adults
9.1 Introduction
9.2 Clinical Assessment
9.3 Anatomy and Classification
9.4 Imaging
9.5 Treatment
9.5.1 Nonoperative Management
9.5.2 Surgical Management
9.5.3 Surgical Approaches
9.5.3.1 Universal Posterior Incision
9.5.3.2 Bilaterotricipital Approach (Alonso-Llames)
9.5.3.3 Triceps-Reflecting Approach (Bryan-Morrey)
9.5.3.4 Triceps-Reflecting Anconeus Pedicle Flap (TRAP)
9.5.3.5 Triceps-Splitting Approach (Campbell Approach)
9.5.3.6 Olecranon Osteotomy
9.5.4 Implants
9.5.5 Fixation Methods
9.5.5.1 Reduction and Temporary Fixation
9.5.5.2 Definitive Fixation
9.5.6 Management of Ulnar Nerve
9.6 Postoperative Management
9.7 Complications of Surgical Management
9.7.1 Stiffness
9.7.2 Nonunion
9.7.3 Heterotopic Ossification
9.7.4 Ulnar Neuropathy
9.7.5 Other Complications [33]
9.8 Outcomes
9.9 Elbow Arthroplasty
9.10 Conclusions
References
10: Controversies in the Management of Radial Head Fractures in Adults
10.1 Introduction
10.1.1 Epidemiology
10.1.2 Anatomy and Biomechanics
10.1.3 Classification
10.2 Diagnosis
10.2.1 Clinical Examination
10.2.2 Radiological Tests
10.2.3 Associated Injuries
10.3 Management and Treatment
10.3.1 Nonsurgical Treatment
10.3.2 Surgical Treatment
10.3.2.1 Surgical Approach and Arthroscopic Techniques
10.3.2.2 Open Reduction and Internal Fixation (ORIF)
10.3.2.3 Excision of Radial Head
10.3.2.4 Radial Head Arthroplasty (RHA)
10.4 Conclusions
References
11: Controversies in the Surgical Treatment of Distal Biceps Tendon Ruptures in Adults: To Fix or Not to Fix? Single Versus Double Incision?
11.1 Introduction
11.2 Anatomy and Pathophysiology
11.3 Types of Injuries
11.4 Diagnosis
11.4.1 Clinical Diagnosis
11.4.2 Imaging Tests
11.5 Treatment
11.5.1 Partial Ruptures
11.5.1.1 Partial Rupture of the Short Head of the Biceps
11.5.2 Acute Complete Rupture
11.5.2.1 Surgical Technique
Anesthesia and Positioning
Single-Incision Technique (Author’s Preferred Method)
Approach
Tuberosity Preparation
Tendon Preparation
Fixation and Wound Closure
Double-Incision Technique
Postoperative Protocol
11.5.3 Chronic Rupture
11.6 Conclusions
References
12: Controversies in Tennis Elbow in Adults: Should We Ever Operate?
12.1 Introduction
12.2 Epidemiology
12.3 Etiology and Pathogenesis
12.4 Clinical Symptoms
12.4.1 Posterolateral Instability
12.4.2 Posterolateral Plica
12.4.3 Posterior Interosseous Nerve (PIN) Compression
12.4.4 Other Pathologies
12.5 Diagnosis
12.6 Conservative Treatment
12.6.1 Rest and Postural Reeducation
12.6.2 Exercises
12.6.3 Orthoses
12.6.4 Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
12.6.5 Shock Waves
12.6.6 Injections
12.6.6.1 Corticosteroid (CS) Injections
12.6.6.2 Autologous Blood Injections
12.6.6.3 Platelet-Rich Plasma (PRP) Injections
12.6.6.4 Stem Cell Injections
12.6.6.5 Botulinum Toxin A Injections
12.6.6.6 Prolotherapy
12.6.6.7 Percutaneous Radiofrequency
12.7 Surgical Treatment
12.7.1 Open Techniques
12.7.2 Percutaneous Release
12.7.3 Arthroscopic Technique
12.8 Results
12.8.1 Surgical Versus Nonsurgical
12.8.2 Open Versus Arthroscopic
12.8.3 Open Versus Arthroscopic Versus Percutaneous
12.9 Conclusions
References
13: Total Elbow Arthroplasty
13.1 Introduction
13.2 Primary TEA
13.2.1 Biomechanics
13.2.2 Patient Selection
13.2.3 Preoperative Planning
13.2.4 Surgical Approaches for TEA
13.2.5 Outcomes of TEA
13.2.5.1 Thirty-Day Readmissions and Reoperations After TEA
13.2.5.2 Long-Term Outcomes of TEA
13.2.5.3 Risk Factors for Reoperation After TEA
13.2.5.4 Mid- to Long-Term Survivorship of Cemented Semiconstrained “Discovery” TEA
13.2.6 Complications After TEA
13.2.6.1 Periprosthetic Infection: Resection Arthroplasty
13.2.6.2 Heterotopic Ossification Following TEA
13.2.6.3 Component Fracture After TEA
13.2.6.4 Humeral Amputation Following TEA
13.2.7 Inpatient Versus Outpatient TEA
13.2.8 Elective TEA Versus TEA for Fracture in Elderly Patients
13.2.9 TEA in Rheumatoid Arthritis Patients
13.2.10 TEA in Juvenile Idiopathic Arthritis (Juvenile Rheumatoid Arthritis) Patients
13.2.11 TEA in Osteoarthritis Patients
13.2.12 TEA in Posttraumatic Arthritis
13.2.13 Outcomes Following TEA for Rheumatoid Arthritis Versus Posttraumatic Conditions
13.2.14 Primary Versus Secondary TEA for Distal Humerus Fractures
13.3 Revision TEA
13.3.1 Outcomes After Revision TEA
13.3.2 Revision TEA: Comparison of Infected and Noninfected TEA
13.3.3 Outcomes Following Revision of the Revision TEA
13.4 Conversion of a Surgical Elbow Arthrodesis to TEA
13.5 The Future for TEA
13.6 Conclusions
References
14: Distal Radius Fractures in the Elderly: Current Controversies
14.1 Introduction
14.2 Conservative Treatment
14.2.1 Objective Outcome Measures Continue to Improve from 6 to 12 Months
14.3 Surgical Treatment
14.3.1 Preoperative Planning
14.3.2 Percutaneous Pinning Fixation
14.3.3 Dorsal Bridge Plate
14.3.4 IlluminOss System
14.3.5 Volar Locking Plate Preserving Pronator Quadratus Through the Minimally Invasive Approach
14.3.6 Bridge Plating with Bone Graft Substitutes in Combination with Systemic Romosozumab Administration
14.3.7 Combined Palmar and Dorsal Plating of Four-Part Distal Radius Fracture
14.3.8 Cobra Prosthesis in Complex Distal Radius Fractures
14.4 Do We Need to Restore Anatomy to Have Satisfactory Clinical Result?
14.5 Treatment of Malunited Distal Radius Fracture
14.5.1 Corrective Osteotomy: 2D Imaging Techniques for Preoperative Alignment Planning Versus a Novel Patient-Specific Plate Which Features Navigation and Fixation of Bone Segments As Preoperatively Planned in 3D
14.5.2 Corrective Osteotomy Through Planning with Prototyping in 3D Printing
14.6 Comparative Studies
14.6.1 Comparison of Surgical Effects Between Extension and Flexion Type of Distal Radius Fracture
14.6.2 A Comparison of Six Outcome Measures Across the Recovery Period After Distal Radius Fixation: Which to Use and When?
14.6.3 Surgical Plating Versus Closed Reduction
14.6.4 Plaster Immobilization Versus Anterior Plating for Dorsally Displaced Distal Radius Fractures
14.6.5 5 Cast Immobilization Versus Volar Locking Plate
14.6.6 Open Reduction and Volar Locking Plate Versus External Fixation with or Without Supplementary Pinning Versus Percutaneous Pinning
14.6.7 Variable-Angle Volar Plate Versus Bridging External Fixator with K-Wire Augmentation in Comminuted Distal Radius Fractures
14.6.8 Bilateral Distal Radius Fractures: External Fixation Versus Plate-Screw Treatment
14.7 Predictors of Management of Distal Radius Fractures in Patients Aged >65 Years
14.8 Conclusions
References
15: Scapholunate Dissociation
15.1 Introduction: Anatomy and Histology
15.2 Pathomechanics
15.3 Diagnosis
15.3.1 Physical Exams
15.3.2 Radiological Examination
15.3.2.1 Advance Imaging
15.3.2.2 Arthroscopic Examination
15.4 Principles of Treatment
15.4.1 Stage I: Partial SLIL Injury
15.4.1.1 Arthroscopic Debridement and Electrothermal Ligament Shrinkage
15.4.1.2 Reeducation of Wrist Proprioception
15.4.2 Stage II: Complete SLIL Injury, Repairable
15.4.2.1 Open Reduction and Dorsal SL Ligament Repair
15.4.2.2 Arthroscopic Repair and Capsular Reinforcement
15.4.3 Stage III: Complete SLIL Lesion, Non-Repairable, No Malalignment
15.4.4 Stage IV: Complete, Irreparable SLIL Injury, Reducible Malalignment
15.4.4.1 SLIL Ligamentoplasty Using a Tendon Graft
15.4.4.2 Arthroscopic Scapholunate Ligamentoplasty
15.4.4.3 Arthroscopically Assisted Ligament Reconstruction
15.4.4.4 Reduction-Association of the SL Joint (RASL) Procedure
15.4.5 Stage V: Chronic SL Injury with Irreducible Malalignment and Normal Joint Cartilage
15.4.5.1 Scapholunate Arthrodesis
15.4.5.2 Scaphoid-Trapezium-Trapezoid Arthrodesis
15.4.5.3 Radioscaphoid-Lunate Arthrodesis
15.4.6 Stage VI: Chronic SL Injury with Irreducible Malalignment and Cartilage Damage
15.4.6.1 SLAC 1 Treatment
15.4.6.2 SLAC 2 Treatment
15.4.6.3 Stage III SLAC Treatment
15.4.6.4 Stage IV SLAC Treatment
15.5 Authors’ Preferred Treatment
15.6 Conclusions
References
16: Wrist Arthritis: Total Versus Limited Fusion Versus Arthroplasty
16.1 Introduction
16.2 Treatment Algorithm for the Surgical Management of Wrist Arthritis
16.3 Normal Wrist Motion and Biomechanics and Its Importance in the Surgical Management of Wrist Arthritis
16.4 Partial/Limited Wrist Fusion
16.4.1 Radiolunate Fusion (Chamay Fusion)
16.4.2 Radioscapholunate (RSL) Fusion
16.4.3 Four-Corner Fusion
16.5 Total Wrist Arthroplasty
16.6 Total Wrist Fusion
16.7 TWA Versus TWF
16.7.1 Indications and Patient Selection
16.7.2 Quality Assessment of Studies and Outcomes Reporting Tools
16.7.3 Motion, Function and Satisfaction After TWA and TWF
16.7.4 Financial Factors Influencing the Choice Between TWA and TWF
16.7.5 Changing Complication Rates Between TWA and TWF
16.8 Conclusions
References
17: Controversies in Carpal Tunnel Syndrome in Adults: Endoscopic Versus Open Carpal Tunnel Release
17.1 Introduction
17.2 Clinical Results
17.3 Recurrence/Reoperation
17.4 Major Complications
17.4.1 Transient Neurapraxias
17.4.2 Major Nerve Injuries
17.4.3 Tendon and Artery Injuries
17.5 Minor Complications
17.6 Return to Work
17.7 Reporting Bias/Learning Curve
17.8 Costs
17.9 Conclusions
References
18: Distal Radioulnar Joint: Resection Arthroplasty or Prosthetic Arthroplasty
18.1 Introduction
18.2 Distal Radioulnar Joint (DRUJ) Anatomy
18.3 DRUJ Biomechanics
18.4 Management of Distal Radioulnar Joint Arthritis
18.4.1 Resection Arthroplasty
18.4.1.1 Darrach Procedure
Description and History
Intended Benefits
Potential Complications
Outcomes
Tips
Summary
Similar Procedures
18.4.1.2 Sauvé-Kapandji Procedure
Description and History
Intended Benefits
Potential Complications
Outcomes
Tips
Summary
18.4.1.3 Comparison of the Darrach Versus Sauvé-Kapandji Procedure
18.4.2 Prosthetic Arthroplasty
18.4.2.1 Partial or Complete Ulnar Head Replacement
Description and History
Intended Benefits
Potential Complications
Outcomes
Tips
Summary
18.4.2.2 Total DRUJ Arthroplasty
Description and History
Intended Benefits
Potential Complications
Outcomes
Tips
Summary
18.4.3 Authors’ Preferred Treatment Methods
18.4.4 Conclusions
References
19: Controversies in the Treatment of Fingertip Amputations in Adults: Conservative Versus Surgical Reconstruction
19.1 Introduction
19.2 Nonoperative Management
19.2.1 Occlusive Dressing
19.2.2 Semiocclusive Dressing and Splint Caps
19.3 Surgical Treatment
19.3.1 Primary Closure
19.3.2 Grafts
19.3.2.1 Composite Grafting
19.3.2.2 Skin Grafts
19.3.3 Flap Reconstruction
19.3.3.1 Volar V-Y Plasty
19.3.3.2 Advancement Flap
19.3.3.3 Cross-Finger Flap and Thenar Flap
19.3.3.4 Vascular and Neurovascular Island Flap
19.3.3.5 Reverse Homodigital Artery Flap Coverage
19.3.4 Purse-String Suture as a Complementary Technique with Conventional Flaps in Repairing Fingertip Amputation
19.3.5 The Palmar Pocket Method
19.3.6 Fingertip Replantation
19.4 Do We Need to Repair the Nerves When Replanting Distal Finger Amputations?
19.5 Digit Tip Regeneration
19.6 Conclusions
References
20: Metacarpophalangeal (MCP) and Proximal Interphalangeal (PIP) Joint Arthroplasty
20.1 Introduction
20.2 Metacarpophalangeal (MCP) Joint Arthroplasty
20.2.1 Primary MCP Joint Arthroplasty
20.2.1.1 Unconstrained MCP Joint Arthroplasties
Pyrocarbon MCP Joint Arthroplasty in Noninflammatory Arthritis
20.2.1.2 Silicone MCP Arthroplasty
20.2.1.3 Surface Replacement Arthroplasty (SRA)
20.2.1.4 Dorsal Capsule Interpositional Arthroplasty of the MCP Joint
20.2.2 Revision MCP Arthroplasty
20.3 PIP Joint Arthroplasty
20.3.1 Emergency Arthroplasty of the PIP Joint for Complex Fractures with Silicone Implant
20.3.2 Surface-Replacing Implant Arthroplasty
20.3.3 Complications After Surface-Replacing and Silicone PIP Arthroplasty
20.3.4 Lateral Stability in Healthy PIP Joints Versus Surface Replacement and Silicone Arthroplasty
20.3.5 Pyrolytic Carbon PIP Arthroplasty
20.4 Autologous Tissue for Small Joint Arthroplasty
20.5 Prevalence of Complications and Cost of Small Joint Arthroplasty for Hand Osteoarthritis and Posttraumatic Arthritis
20.6 Conclusions
References