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The Bone & Joint Journal
Vol. 102-B, Issue 2 | Pages 246 - 253
1 Feb 2020
Alluri RK Lightdale-Miric N Meisel E Kim G Kaplan J Bougioukli S Stevanovic M

Aims

To describe and analyze the mid-term functional outcomes of a large series of patients who underwent the Hoffer procedure for brachial plexus birth palsy (BPBP).

Methods

All patients who underwent the Hoffer procedure with minimum two-year follow-up were retrospectively reviewed. Active shoulder range of movement (ROM), aggregate modified Mallet classification scores, Hospital for Sick Children Active Movement Scale (AMS) scores, and/or Toronto Test Scores were used to assess functional outcomes. Subgroup analysis based on age and level of injury was performed. Risk factors for subsequent humeral derotational osteotomy and other complications were also assessed. A total of 107 patients, average age 3.9 years (1.6 to 13) and 59% female, were included in the study with mean 68 months (24 to 194) follow-up.


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_III | Pages 289 - 289
1 Mar 2004
Roidis N Stevanovic M Martirosian A Itamura J
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Aims: The purpose of our study was to determine the radiographic anatomy of the proximal radius in three different views in order to identify that position, which has the smallest value for the angle between the axis of forearm rotation (AFR) and the radial neck axis (RNA). It is our hypothesis that such a position should offer the optimal situation for the radial neck cut in radial head replacement, as it will approximate the normal biomechanical axis of forearm rotation. Methods: Anteroposterior (AP) and lateral radiographs of 20 healthy volunteersñ forearms were taken in three views (full supination, neutral, full pronation). Radial head maximum diameter and angular measurements between the axis of forearm rotation (AFR) and the radial neck axis (RNA) were made utilizing digital calipers. Results: Repeated-measures analysis of variance (ANOVA) revealed a statistically signiþcant difference between the three AP groups, with supination having the smallest values (p< 0.0001), but not for the lateral groups (p=0.128). Comparison of the AFR-RNA angle between the AP supinated position and the three lateral views revealed a statistically signiþcant difference among all the pairs with the AP supinated position having the smallest values. Conclusions: The RNA most closely approximates the AFR with the forearm in the supinated position. To best approximate the native AFR during radial head replacement, the cut should be made perpendicular to the neck axis with the elbow extended and the forearm in the supinated position.


The Journal of Bone & Joint Surgery British Volume
Vol. 78-B, Issue 5 | Pages 793 - 795
1 Sep 1996
Schnall SB Vu-Rose T Holtom PD Doyle B Stevanovic M

We investigated 14 patients with pyogenic flexor tenosynovitis for increased tissue pressures in involved digits. All showed raised pressures, in eight to 30 mmHg or more. These levels are consistent with a compartment syndrome.

We describe the results of a modified operative technique which includes irrigation of the sheath and the leaving open of a lateral incision. This also allows early active mobilisation of the finger and has given satisfactory early results.