Paul W Grutter | PubMed Health

PubMed2005

Anatomical acromioclavicular ligament reconstruction: a biomechanical comparison of reconstructive techniques of the acromioclavicular joint.

BACKGROUND: Current surgical treatments for acromioclavicular separations do not re-create the anatomy of the acromioclavicular joint. HYPOTHESIS: Anatomical acromioclavicular reconstruction re-creates the strength of the native acromioclavicular joint and is stronger than a modified Weaver-Dunn repair. STUDY DESIGN: Controlled laboratory study. METHODS: The native acromioclavicular joint in 6 fresh-frozen cadaveric upper extremities was stressed to failure under uniaxial tension in the coronal plane. A modified Weaver-Dunn procedure, anatomical acromioclavicular reconstruction using a palmaris longus graft, and anatomical acromioclavicular reconstruction using a flexor carpi radialis graft were then performed sequentially. Each repair was stressed to failure. Load-displacement curves and mechanism of failure were recorded for each. RESULTS: Loads at failure for the native acromioclavicular joint complex, modified Weaver-Dunn procedure, anatomical acromioclavicular reconstruction using a palmaris longus tendon graft, and anatomical acromioclavicular reconstruction using a flexor carpi radialis tendon graft were 815 N, 483 N, 326 N, and 774 N, respectively. The strength of the native acromioclavicular joint complex was significantly different from the modified Weaver-Dunn repair (P < .001) and the anatomical acromioclavicular reconstruction using a palmaris longus tendon graft (P < .001) but not from the anatomical acromioclavicular reconstruction using a flexor carpi radialis tendon graft (P = .607). CONCLUSION: The strength of the described anatomical acromioclavicular reconstruction is limited by the tendon graft used. Anatomical acromioclavicular reconstruction with a flexor carpi radialis tendon graft re-creates the tensile strength of the native acromioclavicular joint complex and is superior to a modified Weaver-Dunn repair.

Acromioclavicular Joint↗

PubMed2005

Simple techniques for passing suture through bone.

Sutures often must be passed through bone tunnels to repair soft tissue or bone. Three easy, inexpensive, and time-saving suture-passing techniques are described in this article. These techniques, which involve using 1 of 3 readily available instruments (Angiocath, Hewson suture retriever, Keith needle), can be applied in many different orthopedic surgical procedures and may save much time and aggravation in the operating room.

Bone and Bones↗

PubMed2004

The accuracy of distal posterior interosseous and anterior interosseous nerve injection.

PURPOSE: To standardize a technique of delivering a local anesthetic to the posterior interosseous nerve (PIN) and anterior interosseous nerve (AIN) by using the anatomic landmarks of the wrist and to evaluate the accuracy of the technique in a cadaver model. METHODS: Techniques for PIN and AIN injection and for PIN injection alone are described. Techniques were tested in a fresh frozen cadaver model by using methylene blue injections. Stained nerves were dissected under loupe magnification. Digital photographic images were taken of each nerve. Staining was quantified by calculating the mean density and area stained. RESULTS: For both techniques methylene blue was delivered accurately to the PIN in 100% of the samples. Methylene blue was delivered accurately to the AIN in 100% of samples in which it was injected. CONCLUSIONS: These techniques saturated successfully the PIN and AIN and may be useful as diagnostic and therapeutic tools for chronic wrist pain and in evaluating presurgically the effectiveness of partial wrist denervation.

Anesthetics, Local↗