Journal of Orthopedic Surgery and Techniques

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Table of Content: Volume 6, Issue 2

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Case Report Pages 547-550

Pathological Humeral Fracture from Bone Metastasis of a Gastrointestinal Stromal Tumour: First Reported Case

Authors: Johnson Pok-Him Tam, Anderson Siu-Ming Leung, Raymond Chi-Hin Yau, Kenneth Wai-Yip Ho and Albert Ying-Lee Lam

Abstract: Gastrointestinal stromal tumour (GIST) is the most prevalent mesenchymal tumour of the GI tract. Metastases commonly occur in the liver and peritoneum, with very rare reported cases of bone metastases, hence no therapeutic standard has been established for the management of bone metastases. Modern targeted therapy has improved patient survival, and although there are only a small number of reported GIST bone metastases, the incidence will likely continue to increase. Further understanding of GIST bone metastases is required for implementation of an accurate and effective treatment plan.

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Case Report Pages 561-563

Reconstruction of the Tibialis Posterior Flexor Retinaculum: Description of Surgical Technique

Authors: Matthew H Adsit, MD, Dallas Hampton, BS, Conor N. O'Neill, MD, James Satalich, MD and Alexander Vap, MD

Abstract: Dislocation of the tibialis posterior tendon is a rare traumatic injury often with a delayed diagnosis. The surgical management of the majority of these injuries is reconstruction of the flexor retinaculum. Non-operative management or missed diagnosis of these injuries leads to chronic pain, posterior tibialis tendon insufficiency, and acquired flat foot deformity. Reconstruction of the flexor retinaculum is not well characterized in the orthopedic literature. The technique described here was used to reconstruct the flexor retinaculum in the setting of an acute tibialis posterior dislocation.

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Review Article Pages 551-560

The Use of Preoperative CRP and ESR as Predictive Markers of Prosthetic Joint Infection in Primary Total Hip and Knee Arthroplasty

Authors: Andrew Hester, MD, Keenan Gibson, DO, Noah Embry, BS, Josiah Snowden, BS, Blake Campbell, BS and Russell Wagner, MD

Abstract: C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are inflammatory markers commonly used during the diagnosis and treatment of periprosthetic joint infection (PJI) in arthroplasty patients. The purpose of this study was to assess for a correlation between pre-operative CRP/ESR and post-operative development of PJI in patients undergoing primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) and to assess modifiable and non-modifiable risk factors in patients with elevated preoperative inflammatory markers.

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Case Report Pages 542-546

An Atypical Iatrogenic Fracture Pattern: A New Modification of Mallory Classification for Intraoperative Femoral Fracture

Authors: Johnson Pok Him Tam and Marvin Man Ting Chung

Abstract: This case illustrates an atypical intra-operative femoral fracture pattern during femoral stem insertion, that was not previously reported in the literature. We propose a new modification of the current modified Mallory classification, adding a type V indicating extension to lateral cortex of femoral shaft. Surgeons should be aware of the exact fracture pattern, especially atypical ones, to ensure adequate fixation and implant stability. Imaging or further exploration should be utilized when in doubt.

Clinical Technique Pages 539-541

The Hyper Wag Fluoroscopic View for Cephallomedullary Screw Placement in Hip Fracture Treatment

Authors: Matthew Weber, DO, Bryon Thompson, DO and Cris Sherman, DO

Abstract: Intraoperative fluoroscopy is routinely used to guide appropriate guide wire placement and eventual lag screw placement during internal fixation of a proximal femoral fracture. The femoral head and neck are evaluated in at least two planes to avoid articular screw penetration but also ensure adequate lag screw purchase within the femoral head. The importance of this concept was originally highlighted by Baumgaertner describing the tip to apex distance, which is routinely evaluated on AP and lateral views.

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