No abstract

Background: The largest rotator cuff tendon, the subscapularis, rotates the glenohumeral joint internally. This study's objective was to compare the arthroscopic versus the open technique outcomes in subscapularis tear repair. Methods: This prospective study comprised 30 patients who had a subscapularis tear and needed either arthroscopic or open surgery for repair. The study was done in Benha university hospitals and Ahrar teaching hospital from November 2020 to February 2023. Patients were split into 2 groups: Arthroscopic group: 15 were treated by arthroscopic surgery. Open surgery group: 15 were treated with open surgery. Results: The arthroscopic group had a higher percentage of combined tears and affected the right side more often, while the open surgery group had a higher percentage of isolated tears and affected the left side more often. The arthroscopic group had more postoperative pain, but fewer complications than the open surgery group. Preoperative and postoperative clinical assessments showed substantial changes among groups of the study concerning the constant score, UCLA score, and results of belly press test. The arthroscopic group had more positive results in belly press tests and lift off after operation. The two groups had similar outcomes in terms of post-surgical complications and duration of follow up. Conclusions: In terms of motion range and functional results, arthroscopic treatment may be preferable to open repair. While there are still rare cases when open repair surgery makes sense, particularly when arthroscopic options are restricted.

Background: Management of the distal tibiofibular syndesmosis remain controversial area in the treatment of ankle fractures. Objective was to evaluate reliability of intraoperative test for syndesmotic disruption including hook test and tap test and compare it with preoperative radiographs. Methods: The study include 20 patients. Results: The mean age of the studied patients was 36 years. Regarding gender, there was a male predominance; about two-thirds of the studied patients were males (60.0%). More than one-third of the studied patients were from rural areas (40.0%). Also, more than one-third (40.0%) were smokers. Syndesmotic disruption was detected in more than one-third of the patients (45.0%) by pre-operative radiographs. Hook test was positive in half of the patients (50.0%), while tap test was positive in all patients (100.0%). When comparing results of hook and tap tests to the reference pre-operative radiograph findings, hook test showed a sensitivity of 44.4%, specificity of 45.5%, PPV of 40.0%, NPV of 50.0%, and overall accuracy of 45%. Tap test showed a sensitivity of 100.0%, specificity of 0.0%, PPV of 45.0%, NPV of 0.0%, and overall accuracy of 45%. Conclusion: Tap test is better than hook test in detection of Syndesmotic disruption and matching with preoperative radiograph Tap test is a simple, accurate and reliable technique for detection of syndesmotic instability. Diagnostic indices of hook and tap tests demonstrated similar overall accuracy.

The posterior cruciate ligament (PCL) is critical to the stability of the knee and is sometimes referred to as the "pivot." Multiligamentous knee injuries are the most prevalent sort of pcl injuries, however they may also be PCL injuries on their own. Pcl injuries may result from a variety of causes, including a sports injury, a car accident, or a hyperextension injury. Pcl injury in non-athletes is treated with conservative treatment for a few weeks to allow for healing of the PCL, but in cases of multi-ligamentous knee injury or complete isolated pcl injury grade 3, surgical repair or reconstruction is required to restore knee mechanics and allow healing of the pcl in a proper length and position. Injuries to the anterior cruciate ligament (PCL) can be treated surgically in a variety of ways, including a single or double bundle reconstruction, anatomical transtibial or all-inside technique, tibial inlay reconstruction, or just repair of the PCL and augmentation with an internal brace, depending on the healing power of the pcl. Post-operative laxity after posterior cruciate ligament restoration with or without internal brace augmentation was compared in this research. Thirty patients who had PCL injuries and underwent PCL repair at Benha University Hospital or the Health Insurance Hospitals were included in a prospective research to evaluate postoperative laxity. Fifteen patients had PCL repair with an internal brace and fifteen underwent PCL reconstruction without an internal brace. Results: In the first group with an internal brace, outstanding in 7 instances, good in 7 cases, and average in one case. Without internal bracing, outstanding in two instances 13.3%, good in five cases (33.3%), and fair in eight cases (53.3%) are all that can be said. Structural integrity was improved by adding an independent ST to the PCL repair, regardless of the method utilised, resulting in decreased dynamic and total elongation and increased ultimate strength. During high loads, the ST seems to be a "safety belt" that becomes more prominent, demonstrating increased plastic deformation.