Radial to axillary nerve and spinal accessory (XI) to suprascapular nerve (SSN) transfers are standard procedures to restore function after C5 brachial plexus dysfunction. The anterior approach to the SSN may miss concomitant pathology at the suprascapular notch and sacrifices lateral trapezius function, resulting in poor restoration of shoulder external rotation. A posterior approach allows decompression and visualisation of the SSN at the notch and distal coaptation of the medial XI branch. The medial triceps has a double fascicle structure that may be coapted to both the anterior and posterior division of the axillary nerve, whilst preserving the stabilising effect of the long head of triceps at the glenohumeral joint. Reinnervation of two shoulder abductors and two external rotators may confer advantages over previous approaches with improved external rotation range of motion and strength. Review of the clinical outcomes of 22 patients who underwent a double nerve transfer from XI and radial nerves. Motor strength was evaluated using the MRC scale and grade 4 was defined as the threshold for success.Abstract
Objective
Methods
Our study aimed to correlate Forgotten Joint Socre(FJS) preoperatively(Preop-FJS) and postoperatively(Postop-FJS), hypothesis being that patients with high Preop-FJS had more likelihood of poor Postop-FJS. We retrospectively identified 212 patients, having undergone uniform primary TKA by a single surgeon over 20 months, with complete data of FJS and New Knee Society Score (NKSS), recorded preoperatively and postoperatively(1year±1month). Mean age was 66.3 years, with 167 female and 45 males. We correlated Preop-FJS to Postop-FJS using Spearmans correlation test. For our hypothesis, we studied patients using two cutoffs for Preop-FJS, first set with median Preop-FJS cutoff of 35 and second set with median Preop-FJS cutoff of 40. We applied Mann Whitney U test to compare Postop-FJS. SPSS software V15.0 was used.Introduction
Material & Methods
Interestingly, recent studies have shown promising outcomes in elderly. To the best of our knowledge there are no reports available assessing sequential bone remodelling around DCPD (dicalcium phosphate dehydrate) coated short metaphyseal loading stem using serial radiography. Hence we report the unique patterns of bone remodelling in patients 70 years and older and whether these patterns were different from those seen in younger patients. A total of 41 consecutive primary hip arthroplasties were performed in patients with averaged age of 78.3 years using short stem. The presence and patterns of radiolucent lines, radio-opaque lines, calcar rounding, proximal bone resorption, spot welds, cortical hypertrophy, and intramedullary bone formation around the distal tip were assessed at serial radiography up to averaged follow up of 24.5 months. In early stage of stability, the radio-opaque line appeared in lateral aspect of stem which might means the tension force of stem. On the contrary to this findings, the medial side of stem mainly showed the spot welds due to compression on calcar support. The sequential radiographic bone remodelling in 70 years and older showed the different pattern from those of 30 to 50 year-old. Formation of new endosteal trabeculation (spot welds) were seen only in 55.6% of stems among the elderly study group where as all patients showed spot welds in the younger group. Calcar resorption was often observed in younger group but the degree of calcar resorption was less. The other findings in elderly patients was not different compared to those of younger patients.
