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Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_9 | Pages 35 - 35
1 May 2017
Han F Lim J Lim C Tan B Shen L Kumar V
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Background

The traditional Kocher approach for lateral elbow exposure is often complicated by injury to the posterior interosseous nerve (PIN) and the lateral ulnar collateral ligamentous (LUCL). Kaplan approach is less commonly used, due to its known proximity to the PIN. Extensor Digitorum Communis (EDC) splitting approach allows possible wide surgical exposure and low risk of LUCL damage. The comparison of PIN injury during surgical dissection among these 3 common lateral approaches was not previously evaluated. We aim to determine the anatomical proximity of the PIN in these 3 common lateral elbow approaches and to define a safe zone of dissection for the surgical exposure.

Methods

Cadaveric dissections of 9 pairs of fresh frozen adult upper extremities were performed using EDC splitting, Kaplan and Kocher approach to the radial head sequentially in a randomised order. The radial head and PIN were exposed. A mark was made on the radial head upon the initial exposure during dissection. Measurements from the marked point of the radial head to the PIN were made. Study has been approved by the ethics committee.


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_III | Pages 442 - 443
1 Oct 2006
Phillips A Walker M Sharp R Lim C Farrington W
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Introduction: We present our early results using the Stryker navigated knee system, since March 2003. There have been several papers showing an improvement in alignment of prostheses using navigation but few series have mentioned the problems of introducing this new technology.

Method: 214 consecutive operations were audited retrospectively from operation notes, discharge summaries and clinic notes.

Results: 11 surgeons performed 214 operations on 196 patients. 205 operations were primary knee joint replacements and 9 revisions. Average operation time was 149 minutes. 96% had an excellent outcome (pain free with a good range of motion), 2.6% had a moderate outcome and 1.4% had a poor outcome. 17 patients had superficial wound infections; 4 patients required an MUA for stiffness (with a good outcome); 3 DVTs (all below knee); 1 acute and 3 delayed haemarthroses; 1 temporarily unstable knee; 5 suffered prolonged pain, 1 peri-prosthetic fracture due to anterior notching of the femur requiring revision and there was 1 quads tendon rupture. There were 4 procedures abandoned, 2 because the femoral pin was unstable in osteoporotic bone and because of 2 software errors. Average range of motion was 0–110°. There was one deep infection following pyelonephritis. Average follow up has so far been 20.6 (2–104) weeks.

Conclusion: We have found that our results compare favourably with conventional techniques. We found it particularly useful for revision surgery and those patients who had intramedullary devices for previous fractures of the femur where conventional jigs could not be used.