Search Results
Search for other papers by Pieter Caekebeke in
Google Scholar
PubMed
Search for other papers by Joris Duerinckx in
Google Scholar
PubMed
University Hospital Antwerp, Department of Orthopedic Surgery, Edegem, Belgium
Search for other papers by Roger van Riet in
Google Scholar
PubMed
-
Acute distal biceps tendon (DBT) pathology includes bicipitoradial bursitis, tendinosis, partial and complete tears.
-
Diagnosis of complete DBT tears is mainly clinical, whereas in partial tears medical imaging is a valuable addition to the clinical diagnosis.
-
New insights in clinical and medical imaging of partial tears may reduce time to diagnosis and may guide the treatment plan.
-
Most complete tears are best treated with primary repair using either a single-incision or double-incision approach with good clinical outcome.
-
The double-incision technique has a higher risk of heterotopic ossification, whereas a single-incision technique carries a higher risk of nerve-related complications.
-
Intramedullary fixation may be a viable solution to negate the risk of posterior interosseus nerve lesions in single-incision repairs.
-
DBT endoscopy can be used to treat low-grade partial tears and tendinosis.
Cite this article: EFORT Open Rev 2021;6:956-965. DOI: 10.1302/2058-5241.6.200145
Department of Orthopedics, AZ Monica, Deurne, Belgium
Department of Orthopedics, AZ Monica, Deurne, and University Hospital Antwerp, Edegem, Belgium
Search for other papers by Megan Conti Mica in
Google Scholar
PubMed
Department of Orthopedics, AZ Monica, Deurne, Belgium
Department of Orthopedics, AZ Monica, Deurne, and University Hospital Antwerp, Edegem, Belgium
Search for other papers by Pieter Caekebeke in
Google Scholar
PubMed
Department of Orthopedics, AZ Monica, Deurne, Belgium
Department of Orthopedics, AZ Monica, Deurne, and University Hospital Antwerp, Edegem, Belgium
Search for other papers by Roger van Riet in
Google Scholar
PubMed
-
Chronic posterolateral rotatory instability (PLRI) is the most common form of chronic elbow instability.
-
PLRI usually occurs from a fall on the outstretched hand. On impact, the radial head and ulna rotate externally coupled with valgus displacement of the forearm. This leads to posterior displacement of the radial head relative to the capitellum, thus causing disruption of some or all of the lateral-sided stabilisers.
-
PLRI is mainly a clinical diagnosis with a history of instability, clicking and lateral-sided pain, with a positive clinical examination including the pivot-shift test, push-up, chair and tabletop test.
-
MRI can often help guide diagnosis but more commonly assists in surgical planning.
-
Surgery is indicated in patients with persistent, symptomatic instability of the elbow causing pain or functional deficit. There are several surgical techniques to treat PLRI, often leading to good to excellent results.
-
An open or arthroscopic technique has been successfully used in patients with symptomatic PLRI following one or more episodes of dislocation or subluxation. At the pre-operative examination under general anaesthesia, all of our patients had a positive pivot-shift test but not a frank dislocation. We prefer to perform a lateral collateral ligament (LCL) reconstruction with an allograft tendon.
-
The outcomes after repair are good to excellent in the majority of patients. Results of acute repair are generally better compared with reconstruction. This is due to the fact that predictive factors for a poor outcome include the number of previous surgeries and the prevalence of degenerative changes at the elbow.
-
Recurrent instability is not uncommon following repair or reconstruction and has been reported in up to 25% of patients after medium- to longer-term follow-up.
Cite this article: EFORT Open Rev 2016;1:461-468. DOI: 10.1302/2058-5241.160033
Search for other papers by Maartje Michielsen in
Google Scholar
PubMed
Search for other papers by Annemieke Van Haver in
Google Scholar
PubMed
Department of Orthopaedic Surgery, University Hospital Antwerp, Antwerp, Belgium
Search for other papers by Matthias Vanhees in
Google Scholar
PubMed
Department of Orthopaedic Surgery, University Hospital Antwerp, Antwerp, Belgium
Search for other papers by Roger van Riet in
Google Scholar
PubMed
Department of Orthopaedic Surgery, University Hospital Antwerp, Antwerp, Belgium
Search for other papers by Frederik Verstreken in
Google Scholar
PubMed
-
In malunion cases, restoration of anatomy is a key factor in obtaining a good functional outcome, but this can be technically very challenging.
-
Three-dimensional printed bone models can further improve understanding of the malunion pattern.
-
The use of three-dimensional (3D) computer planning, and the assembly of patient-specific instruments and implants, especially in complex deformities of the upper limb, allow accurate correction while reducing operation time, blood loss volume and radiation exposure during surgery.
-
One of the major disadvantages of the 3D technique is the additional cost because it requires specific computer software, a dedicated clinical engineer, and a 3D printer.
-
Further technical developments and clinical investigations are necessary to better define the added value and cost/benefit relationship of 3D in the treatment of complex fractures, non-unions, and malunions.
Cite this article: EFORT Open Rev 2019;4 DOI: 10.1302/2058-5241.4.180074
Department of Orthopedic Surgery, St. Antonius Hospital, Utrecht, The Netherlands
Search for other papers by Izaäk F. Kodde in
Google Scholar
PubMed
Search for other papers by Jetske Viveen in
Google Scholar
PubMed
Search for other papers by Bertram The in
Google Scholar
PubMed
Search for other papers by Roger P. van Riet in
Google Scholar
PubMed
Department of Orthopedic Surgery, Amsterdam UMC, Amsterdam, The Netherlands
Search for other papers by Denise Eygendaal in
Google Scholar
PubMed
-
Primary radial head arthroplasty (RHA) produces good or excellent results in approximately 85% of patients. However, complications are not uncommon and have been described in up to 23% of cases.
-
The number of RHA is increasing, and consequently the absolute number of complications is expected to rise as well. The decision on whether to revise or remove the prosthesis seems more likely to depend on the preference of the surgeon or the hospital, rather than on objectifying problems with the prosthesis.
-
The current article presents an algorithm for the work-up and treatment of most complications that can occur following RHA.
-
Five subgroups of problems were identified: osteoarthritis, stiffness, instability, infection and implant-related issues.
-
In short, the preferred treatment depends mainly on the chondral condition and stability of the elbow joint.
Cite this article: EFORT Open Rev 2020;5:398-407. DOI: 10.1302/2058-5241.5.190055
