No abstract

No abstract

<p><strong>Background:</strong> Preoperative glenoid version measurement can guide base plate implantation and directing screws positioning. Glenoid vault depth affects guide-wire insertion with accurate inclinations towards maximum bone stock. No consensus exists regards the precise glenoid level for version assessment, whether at midaxial or coracoid tip level, and if those values are identical or not. Additionally, there is not much data in literature concerning the deepest point of glenoid vault and its proximity to anterior and inferior glenoid surfaces. Thus, we aimed in this study to report glenoid version values at all levels utilizing two different methodologies (Freidman method, vault version method). Additionally, detecting deepest vault point and how much distant from anterior and inferior glenoid aspects.</p><p><strong>Methods: </strong>Sixty dry, unpaired scapulae were scanned with 1.25mm-thick slices. Version was measured at all levels and compared. Axial and coronal slices with greatest vault depth was determined and distance from anterior and inferior glenoid rims were determined.</p><p><strong>Results:</strong> Version method showed significant difference in version at coracoid tip and midaxial levels (p&lt;0.001). Mean versions were 18.2±10.6º and 8.9±6.8º respectively. Also, significant difference was noted between version of upper, middle, and lower thirds, except between middle and lower thirds. A significant difference was evident between both methodologies on comparing version at coracoid tip level (p&lt;0.001).<strong></strong></p><p class="Default"><strong>Conclusions: </strong>Glenoid version at coracoid tip and midaxial levels are not the same. Correlation of preoperative version values with intraoperative situations might be studied in future studies.<strong></strong></p><p class="abstract"> </p><p> </p>

<p><strong>Background:</strong><strong> </strong>Appropriate distal tibiofibular syndesmotic reduction is crucial to restore ankle stability, guard against future arthrosis with worse functional outcome. Optimal technique for syndesmotic reduction has been a matter of debate. This study aimed at radiological evaluation of syndesmotic integrity following two methods of reduction (posterior malleolar fixation and trans-syndesmotic screw fixation), additionally, correlating the posterior malleolus size to the radiological results of both techniques.</p><p><strong>Methods: </strong>Syndesmotic integrity was compared after each technique as per translational and rotational fibular positions. Utilizing, preoperative and postoperative computed tomography scans of injured ankle, the fibular antero-posterior and Medio-lateral translation distances were measured. Additionally, the fibular rotation angle was calibrated. Incidence of inadequate reduction in each group was reported. Preoperative and postoperative radiological findings were compared and correlated to posterior malleolus size in relation to tibial articular distance.</p><p><strong>Results:</strong> A significant difference between both techniques was noted in term of fibular rotation. In patients with PM ˂ 10% of tibial articular surface, a significant difference was obvious in postoperative AP-translational and rotational findings between both techniques. Overall malreduction incidence rate of 68.9% was reported in this study, with 84.7% rate in patients managed with SS-fixation, whilst 51.2% rate in those managed via PM-fixation.</p><p><strong>Conclusions:</strong><strong> </strong>Posterior malleolar fixation could limit syndesmotic malreduction risk whatsoever it’s size. Approaching CT reference values for syndesmotic reduction might benefit preoperative planning and detect intraoperative malreduction. Further future clinical studies correlating these findings to clinical outcome would be more helpful.</p>

Introduction: Management of concomitant coracoid fracture with acute acromioclavicular joint disruption has been a matter of debate. The coracoid component is not always radiographically recognized; thus, this combined orthopedic injury is not often common. Management options varied from conservative to surgical management with single or dual fixation strategy. This study aimed at outcome evaluation of clavicular hook plate with coracoid screw fixation in athletics and patients with high-demand activities for at least one year follow-up. Material and methods: Included patients underwent fixation through clavicular hook plate and coracoid screw. The hook plate was removed after an average period of 16.1 weeks, rehabilitation program was followed. Patients were subjected at final follow-up visit to clinical assessment via ROMs, constant, and ASES scores. Besides, radiological judgement of acromioclavicular joint reduction as per CCD and CCD ratio. Results: The average ASES Scores were 39.1±14.6, 67.4±11.5, and 86.7±5.7 at 3, 6, and 12 months, respectively with a statistically significant improvement in between (P-value <0.001). The mean active shoulder abduction and forward elevation ROMs were 156.4°±12.8° and 171.4°±6.3°. The average CCD was 9.04±0.9 mm (7.6-10.2 mm), and the mean CCD ratio was 1.07±0.03% (1.01-1.11%). Conclusion: Dual fixation via hook plate and coracoid screw without CCL reconstruction provides a stable fixation construct with considerable functional and radiological outcome in high demand patients with acute traumatic ACJ disruption combined with coracoid fracture. Study Design: Case series study.