Nylon Tape Research Articles

Self locking zip ties temporary displaced mandibular fracture reduction

The article addresses mandibular fractures, which are common today, often resulting from traffic accidents, violence and falls. Surgical management is crucial to avoid future complications. The work describes a specific case in which Nylon tape (clip) was used to reduce a mandibular fracture in a male patient who was a victim of physical aggression. The patient, a homeless individual involved with narcotic substances, was treated by neurosurgery and trauma surgery teams. The fracture was initially reduced with nylon tape during primary care. The patient was subsequently transferred to the oral and maxillofacial surgery (BMF) team for definitive treatment. The treatment involved several steps, including nasotracheal intubation, antisepsis, local anesthesia, submandibular surgical access, removal of nylon tape, tooth extraction, cleaning of the fracture, manual reduction, plate fixation and occlusion review. The patient received conventional clinical support and was released on the second postoperative day for outpatient follow-up. The choice of fixation with replaced load of the 2.4 mm system (load bearing) stands out due to the need for high rigidity in contaminated fractures. The extraction of teeth 43 and 44 was carried out to avoid risks of contamination. The article concludes by highlighting the effectiveness and accessibility of using nylon tape for the temporary stabilization of mandibular fractures, providing local pain relief and reducing the distress associated with bone movement.

Self-traction Method for Uncinate Process Dissection During Laparoscopic Pancreaticoduodenectomy

BackgroundDissection of the uncinate process is one of the most challenging procedures in laparoscopic pancreaticoduodenectomy and is also oncologically important to secure the retroperitoneal resection margin. In this study, we introduced a traction method that could provide stable lateral traction of the uncinate process to elevate it to allow better visualization of the retroperitoneal resection margin between the uncinate process and the superior mesenteric artery. MethodsThe pancreatic head and duodenal unit were encircled using a 25-cm-long nylon tape and an elastic rubber band was used to tract it. The elastic power of the rubber band induces gradual automatic self-traction that allows the surgeon to proceed with the dissection without any other manipulation. With the help of this traction method, both of the operator’s hands were free from the traction. ResultsThis video demonstrated the setting for the application of our self-traction method and how it can be used to achieve a proper operative field during uncinate process dissection. ConclusionThis simple traction method could allow better exposure of the operative field and provide a stable operative environment.

Treatment of Acute Ankle Syndesmodic Injury by Elastic Fixation

Anatomic decrease of the syndesmosis of intense lower leg syndesmodic injury is fundamental for improving useful results and maintaining a strategic distance from posttraumatic osteoarthritis. The point of the examination was to assess the clinical, useful and radiological result of flexible obsession (Nylon Tape stitches Ethibond sutures) in treatment of intense lower leg syndesmodic injury. Patient and strategies : The investigation included 20 patients with intense syndesmodic injury; which was finished by Elastic obsession (Nylon Tape stitches Ethibond stitches). All patients were followed up at about fourteen days, 6 weeks,6 months postoperatively. Evaluation will be done through Radiographic and useful results, AOFAS lower leg hindfoot scores and intricacy identified with a medical procedure. Results: The mean subsequent period was 9.4±2.2 months, the interim of WB was 6.65±0.9 weeks. All Patients had association before the finish of the investigation. The mean AOFAS score was 94.5±7.1. 6 patients (30%) had gentle agony, while 14 patients (70%) had no torment. 16 patients (80%) had no limit of development, while 4 patients (40%) had restrictions of every day action. 18 patients (90%) could walk >6, while 2 patients (10%) strolled 4-6 in particular. 18 patients (90%) had no troublesome in strolling, while 2 patients (10%) had some trouble in strolling. 19 patients (95%) had no step anomaly, while 1 patient (5%) had clear stride variation from the norm. Decision: Elastic obsession is a substantial alternative for syndesmodic wounds. The inclusion procedure is straightforward and gives syndesmosis adjustment without taking out ordinary tibiofibular movement and furthermore deters the requirement for schedule second activity for equipment expulsion, making it possibly financially savvy. The astounding AOFAS score proposing high patient fulfillment.

The recovery of touch DNA from RDX-C4 evidences

RDX (Royal Demolition Explosive) is the organic compound with the formula (O2NNCH2)3. It is a white solid material without smell or taste, widely used as an explosive. It is more energetic explosive than TNT, and it was used widely in World War II. The estimated number of RDX-C4 cases in Bahrain ranged between the years 2015–2018 (May) with a total quantity of 370.72 KG in a total number of 38 cases. The effect of explosive RDX-C4 is very massive and can cause many causalities and fatalities among civilians and policemen. These cases consisted of adhesive film with tapes wrapped around RDX-C4 substance (Demolition Charge M112), black batteries, pipes, black bag contained RDX-C4, and in magnetic improvised explosive device (IED). Touch DNA recovery utilized different collection methods, such as nylon swabbing, tape lifting, and direct cutting of certain parts of the samples that were positive of RDX-C4 through DXR Raman Spectrometer. Samples were extracted and purified with magnetic beads chemistry and quantified. Low copy DNA extracts were subjected to a concentration step. DNA extracts were amplified and processed for detection to obtain reliable results using GlobalFiler Amplification PCR kit and run through ABI 3500xL Genetic Analyzer for fragment length determination. We have discovered that RDX-C4 cannot bind to the DNA nor to the solutions used in DNA typing. Thus, it does not cause DNA inhibition or degradation. From this point of view, we were successful in obtaining acceptable and fit results using advanced techniques. This study will be very useful and informative to assist the forensic community in terrorism case applications worldwide as terrorists do not respect geographical boundaries nor ethnicities of the victims, and the use of DNA profiling technology is the most suitable way to identify the terrorists and keep an end to their violence.

Bilateral horizontal salter osteotomies with anterior symphyseal closure using a nylon tape in the treatment of exstrophy of the bladder.

The aim of this case series study is to describe the orthopedic management of bladder exstrophy and to report on the intermediate-term outcomes following bilateral horizontal Salter osteotomies with anterior symphyseal closure using a nylon tape. This retrospective study included seven patients (five boys and two girls) who underwent bilateral horizontal osteotomies after reconstruction of the urogenital deformity using the Cantwell-Ransley technique and symphyseal closure by nylon tape number 2-5. the age range was between 7 months and 8 years (median age = 17 months). Three patients had recurrent bladder exstrophy after they underwent "ramotomy" early in their life, whereas four were operated primarily. All patients were followed up over 2 years, with a mean follow-up duration of 3.27 years (2-5 years). Petrie cast was applied, with both legs abducted and internally rotated till bony union had been achieved. This allowed free handling of the wounds and catheters. Removal of k-wires was performed in an outpatient clinic after the complete union of bony osteotomies had been achieved (6-8 weeks). Satisfactory bladder closure was achieved in all patients. None of the patients had a bone infection or nonunion at the osteotomy sites. No postoperative wound dehiscence has occurred for up to 5 years. The foot progression angle improved from 37°-70° (median = 45°) preoperatively to 0°-15° (median = 5°) postoperatively. Symphyseal diastasis was closed well in all of our patients in postoperative plain radiography compared with 5.8-11 cm (median = 8.2 cm) diastasis preoperatively. One patient had a superficial wound infection. Another patient had a sutured bladder neck by a nylon tape during the symphyseal closure. Bilateral horizontal Salter osteotomies with anterior symphyseal closure using nylon tape are safe and effective in the management of bladder exstrophy, especially in older children and in extreme diastasis (> 6 cm); with improvement in the gait as it corrects the acetabular external rotation.

ACROMIOCLAVICULAR AND CORACOCLAVICULAR RECONSTRUCTIONBY NYLON TAPE VERSUS CORACOCLAVICULAR SCREW IN MANAGEMENT OF ACUTE ACROMIOCLAVICULAR DISLOCATION

Background & Purpose: A number of different surgical techniques were described to treat acute acromioclavicular (AC) joint dislocations which aim to restore joint congruity and mechanical stability. The purpose of this study was to compare functional, radiological outcomes and fixation related complications of acromioclavicular and coracoclavicular (CC) reconstruction by nylon tape versus coracoclavicular screw in management of acute acromioclavicular dislocation.Patients &Methods: In the periodfrom September 2017 to December 2019, a prospectiverandomized controlled clinical trial was conducted in Ain Shams University hospitals including 30 cases with types III and V AC injuries. They were divided into two groups, 15 patients underwent AC and C Creconstruction by nylon tape (Group A) and the other 15 patients underwent coracoclavicular screw (Group B).The patients were evaluated forpain, range of motion (ROM), radiologic findings (CC distance difference between both sides was measured), American Shoulder and Elbow Surgeons(ASES), and Constant scores. Postoperative complications were recorded and assessment of time of returning to the work was done. The evaluation was done preoperatively and each time of follow up with a minimum period of one year.Results: After a mean follow up period of 15±2.7 months for group A and 14.37±4.74 months for group B, patients of both groups showed highly significant improvement between mean preoperative and postoperative pain, ROM, Constant, ASES scores and CC distance difference. Group A showed better results as regard mean postoperative ROM, Constant score and ASES score than group B, while group B showed better results as regard mean postoperative pain score and CC distance difference. However, there was no statistically significant difference between the 2 groups. In group A the mean post-operative pain and ROM scores (both as a part of constant score) was 12.67 (±3.2) and 33.53 (±2.9) respectively while in group B was 12.92 (±3.34) and 32.83 (±2.98) respectively. The mean post-operative Constant and ASES scores was 86.93 (±7.22) and 89.93 (±7.5) respectively for group A and 86.17 (±8.33) and 87.58 (±6.08) respectively for group B. Radiographic CC distance difference (mm) between both shoulders at one year postoperatively was 2.27 in group A and 2.13 in group B. There was a statistically significant difference between the mean time to return to work for patients in group A (3.2 months) and patients in group B (4.2 months). Complete loss of reduction occurred in three patients in group B, two cases of subluxation (50 % of the preoperative CC distance difference) in group A, one case of wound infection in each group and one case of fracture clavicle in group B. Conclusion: Both AC and CC reconstruction by nylon tape and CC screw procedures are valid surgical options and have adequate outcome in treatment of patients with acute AC dislocation. However there are some concerns about the failure rate and the need of another operation for screw removal that was present in CC screw group which affects patient satisfaction in that group.

Experimental study of the patellar tendon fixation strength after its reconstruction

Modular replacement is an adequate method of treatment after removal of proximal tibia tumors. However, there are problems with the restoration of the knee joint function, its extensor mechanism. Objective: to determine the strength of patellar ligament fixation under modeling on the knee joint of a pig. The reconstruction of the extensor mechanism was made with a nylon tape or attachment tube to fix the patellar ligament to the proximal tibia tuberosity. Methods: on the preparations of the pigs knee joints, the reconstruction of the extensor mechanism was simu­lated in two series of the experiment: I — grafting of the patellar ligament using a nylon tape; II — grafting with attachment tube, previously fixed to the proximal part of the tibia. The samples were tested for strength under the influence of a tension loading, the value of which was gradually increased until the patellar ligament was torn off from the tibia. The obtained results were processed statistically. Results: samples of the I series withstood the load before failure on average 1.4 times less than in the II series (t = –4.820; p = 0.001). The average values of the load that caused the tearing of the patellar ligament were significantly different, however, the maximum value of the series of breaking load of series I did not intersect with the minimum value of the series of data of series II. Detachment of the ligament from the patella occurred due to the eruption, and not the destruction of the suture material. Conclusions: the attachment tube is 1.4 times stronger (p < 0.01) than nylon tape. Due to this, the knee joint movements, and operated limb weight bearing can be started in the early postoperative period, thereby reducing the number of complications and improving the functional outcomes of surgeries in patients with proximal tibia tumors.

26. Posterior ligamentous reinforcement does not prevent proximal junctional kyphosis in adult spinal deformity

BACKGROUND CONTEXT Violation of the posterior soft tissues is believed to contribute to the development of proximal junctional kyphosis (PJK). Clinical and biomechanical studies have suggested that augmentation of the posterior ligamentous structures (PLS) may help prevent PJK. PURPOSE To determine whether augmentation of the PLS from the UIV-1 to UIV+1 prevents PJK. STUDY DESIGN/SETTING Single-surgeon retrospective cohort study. PATIENT SAMPLE One hundred fifty adult spinal deformity patients. OUTCOME MEASURES PJK (defined as a proximal junctional angle ≥20°) at final follow-up. METHODS We conducted a retrospective cohort study of 150 adult spinal deformity patients who underwent ≥5 level fusions to the pelvis by a single surgeon between 2014 and 2017. Exclusion criteria included neuromuscular or congenital scoliosis (18 patients), or follow-up less than 1 year (24 patients), leaving 108 patients available for final analysis. Patients were divided into two groups: PLS+ patients had reconstruction of the PLS between UIV+1 and UIV-1 with a surgical nylon tape while PLS- patients did not. Demographics, surgical data, and sagittal alignment parameters were compared between the cohorts. The primary outcome of interest was the development of PJK at final follow-up (1 or 2 years). A subgroup propensity match and backward stepwise logistic regression model were utilized to control for surgical and radiographic differences in the cohorts. RESULTS Thirty-one patients (28.7%) were PLS+. There were no differences with regard to preoperative or final sagittal alignment parameters, number of levels fused (10.7±3.8 vs 9.7±3.8, p=0.331), and BMI (24.9±5.2 vs 27.0±6.9 kg/m2, p=0.143), though the PLS+ cohort was older (64.1±10.4 vs 51.3±21.4 years, p=0.002) and had greater 6-week corrections in sacral slope (SS), pelvic tilt (PT), pelvic incidence-lumbar lordosis (PI-LL), C7-S1 sagittal vertical axis (C7 SVA), and T1 pelvic angle (T1PA), p 0.05 for 6-week changes in SS, PT, LL, PI-LL, C7 SVA, T1PA, thoracic kyphosis, thoracolumbar kyphosis, and cervical lordosis), PLS augmentation was still not associated with a lower rate of PJK (29% PLS+ vs 38.7% PLS-, p=0.367). In our multivariate analysis, only increased sagittal malalignment and failure to restore sagittal balance were retained as having independent associations with PJK, while PLS+ was not retained in the model. CONCLUSIONS Even after controlling for relevant variables such as age, preoperative alignment, and degree of correction, PLS reinforcement at the UIV+1 did not reduce the incidence of PJK at 1 year. Our findings emphasize the multifactorial nature of PJK and the difficulty of preventing PJK with a single surgical technique FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.

Posterior Ligamentous Reinforcement of the Upper Instrumented Vertebrae +1 Does Not Decrease Proximal Junctional Kyphosis in Adult Spinal Deformity.

Study Design:Retrospective cohort study.Objectives:Violation of the posterior soft tissues is believed to contribute to the development of proximal junctional kyphosis (PJK). Biomechanical and clinical studies suggest that augmentation of the posterior ligamentous structures (PLS) may help prevent PJK. The purpose of this study was to evaluate the effect of PLS augmentation on the rate of PJK at 1 year.Methods:A retrospective single-surgeon cohort study was performed of 108 adult spinal deformity patients who underwent 5 level fusions to the pelvis. Patients were divided into 2 groups: PLS+ patients had reconstruction of the PLS between upper instrumented vertebrae +1 (UIV+1) and UIV−1 with a surgical nylon tape while PLS− patients did not. Demographics, surgical data, and sagittal alignment parameters were compared between the cohorts. The primary outcome of interest was the development of PJK at final follow-up. A subgroup propensity match and logistic regression model were utilized to control for differences in the cohorts.Results:A total of 108 patients met final criteria, 31 patients (28.7%) were PLS+. There were no differences with regard to preoperative or final sagittal alignment parameters, number of levels fused, rates of 3-column osteotomies, and body mass index (P > .05), though the PLS+ cohort was older and had larger initial sagittal corrections (P < .05). The rates of PJK for PLS+ (27.3%) and PLS− (28.6%) were similar (P = .827). After controlling for sagittal correction via propensity matching, PLS+ had no impact on PJK (29% vs 38.7%, P = .367). In our multivariate analysis, only increased sagittal malalignment and failure to restore sagittal balance were retained as significant predictors of PJK.Conclusion:Even after controlling for extent of correction and preoperative sagittal alignment, PLS reinforcement at UIV+1 using a hand-tensioned nylon tape does not reduce the incidence of PJK at 1 year.

Using nylon tape to aid the formation of loop stomas.

Using nylon tape to aid the formation of loop stomas.

Distal radioulnar joint instability: trans-osseous flexible stabilization using nylon tape

Introduction Distal radioulnar joint (DRUJ) instability causes pain, dysfunction, and weak grip. Casting may cause joint stiffness and osteopenia and cannot guarantee stability. Surgery includes a direct or indirect radioulnar tether and radioulnar ligament reconstruction. We hypothesized that nylon tape provides a direct intrinsic tether, restores joint stability and forearm function, and avoids tendon harvest.

An alternative method of transperitoneal graft introduction in aortobifemoral bypass surgery.

SummaryIntroductionIntestinal injury and bleeding, which usually occurs while taking the graft through the transperitoneal tunnel, is one of the most important complications of aortobifemoral bypass surgery. In this study, case reports were examined where, for some reason, the tunneller instrument could not be used to create the transperitoneal tunnel and the tunnelling forceps was used. In some of these cases, the grafts were taken through conventionally and in others an alternative method was used.MethodsBetween 2002 and 2013, the records of 81 patients treated surgically by aortobifemoral bypass for peripheral arterial disease, were investigated retrospectively. In the conventional method, after creating a tunnel with tunnelling forceps, the forceps was re-introduced into the tunnel and the graft was clasped and brought through the tunnel. In the alternative method, a nylon tape was left as a guide in the tunnel while creating the tunnel, and the forceps was not introduced again. The graft was taken through the tunnel with the help of the nylon tape. Patients treated with the conventional method were included in group 1 (n = 49) and patients in which the graft was guided with nylon tape were included in group 2 (n = 32). The groups were compared peri-operatively.ResultsThere were no significant differences between the groups in terms of co-morbidity factors. Extubation time, intensive care length of stay, revision for bleeding, other postoperative complications, and infection and late-term infection rates were similar in the two groups (p > 0.05). Hospital length of stay and blood usage were significantly higher in group 1 (p < 0.05). Drainage amounts were higher in group 1 but not statistically significant.ConclusionUsing nylon tape to introduce the graft into the femoral area during aortobifemoral bypass operations was found to be more effective than using the tunnelling forceps.

A modified technique of laparoscopic mobilisation and transfer of intra-abdominal testis via inguinal canal.

Several techniques have been described for mobilising intra-abdominal testis (IAT) into the scrotum. Many are associated with significant morbidity. We hereby introduce our modification of the technique that is safe and reproducible. Surgical technique using a nylon tape to railroad instruments into the peritoneal cavity to minimise false passage and trauma is described in detail. Once the testis is delivered out of the scrotal wound, further division of restrictive bands to mobilise the testis is carried out laparoscopically. These steps are not previously described in the literature. A retrospective study of consecutive patients with IAT undergoing surgical intervention by a single surgeon over a period of 15 years has been included to demonstrate outcome. Twenty-five patients with unilateral IAT (10R, 15L) and 2 patients with bilateral IAT, a total of 29 IAT, underwent laparoscopic orchidopexy over the period 1997-2012. Median age of the patients was 3.0 years. One-stage testicular vessel preserving (VP) orchidopexy was performed in 20 testes, Fowler-Stephen (FS), vessel sacrificing orchidopexy (3 one-stage and 6 two-stage) was required in 9 testes. At follow-up, atrophy was detected in 1 (5.0 %) and 2 (22.2 %) patients of the VP and FS groups respectively. The railroading technique of transferring IAT into the scrotum via the inguinal canal under laparoscopic guidance minimises tissue trauma. It negates the need to create new tissue opening. It is reproducible with a testicular atrophy rate comparable to published literature.

A modified laparoscopic ureterolithotomy by pulling ureter with Carter–Thomason fascial closure and ureter incision by broken 15th blade

To evaluate the efficacy and safety of a modified laparoscopic ureterolithotomy for the treatment of upper ureteral stones; this method involved the use of a Carter-Thomason fascial closure device, a broken 15th blade. From February 2009 to December 2012, 38 patients with unilateral upper ureteral stones were examined and classified into 2 groups: one group underwent conventional laparoscopic ureterolithotomy (n = 21) and the other group underwent modified laparoscopic ureterolithotomy (n = 17). The modified laparoscopic ureterolithotomy consisted of the use of a Carter-Thomason fascial closure to extract the black silk along with the nylon tape. The ureter incision was made with a modified instrument consisting of a needle holder with a broken 15th blade tip. Patient demographics were similar in both groups. No significant differences were detected between the conventional laparoscopic ureterolithotomy and modified laparoscopic ureterolithotomy groups with respect to operating time, estimated blood loss, and stone clearance rates. Drain-indwelling times were significantly shorter in modified laparoscopic ureterolithotomy patients than in conventional laparoscopic ureterolithotomy patients (3.2 ± 1.3 vs 4.7 ± 1.5 days). Hospital stay was significantly lesser in modified laparoscopic ureterolithotomy patients than in conventional laparoscopic ureterolithotomy patients (4.3 ± 1.2 vs 5.2 ± 1.2 days). No differences were detected in the ureteral stent indwelling time for the two groups. The use of the Carter-Thomason fascial closure facilitated ureter handling, and the use of a needle holder with a broken 15th blade tip enabled a sharp and precise ureteral incision. Our method allows early removal of the drain and thus earlier patient discharge.

An alternative management option for infected non-union of long bone fractures.

Management of infected non-union following fracture of a long bone is a challenge to the orthopaedic surgeon. Several methods of treating these cases have been described.(1-7) Although reports of single stage or multiple stage procedures exist in the literature, general consensus appears to favour a two-stage approach with initial debridement followed by the use of local antibiotic cement in the first stage.(2,5,8) This antibiotic-impregnated cement has been reported in previous papers as placed around an intramedullary nail or via antibiotic cement beads,(4-6,9) Cement beads offer no mechanical stability to the fracture site. Placing cement around an intramedullary device provides added concerns, such as cement nail debonding and the continued presence of metal, which could cause persistence of infection when in contact with endosteal sequestrate. We describe the use of an antibiotic cement nail fashioned by hand intra-operatively around a length of nylon tape. This eliminates the need for further metalwork during the infected stage, thereby reducing the chance of persistent non-union as well as providing some stability across the fracture site.

Individual variation related to testicular biometry and semen characteristics in collared peccaries (Tayassu Tajacu Linnaeus, 1758)

The aim of this research was to study the individual variation with regard to the morphometry of the testes evaluated by ultrasonography and semen characteristics and to verify the existence of relationship between these variables in collared peccaries. In addition, the testes of the animals were evaluated by histology in order to determine the proportion occupied by the seminiferous tubules. A total of 52 ejaculates were obtained from ten adult specimens that had been restrained by anesthesia. The testicular measurements (length, height, and width) were performed by ultrasonography, and the testicular volume was calculated according to Lambert's formula. The scrotal circumference was measured by encircling the thickest portion of the testicle with a graduated nylon tape. The semen was collected by electroejaculation. Testicular fragments were analyzed through classic histology for the determination of the area occupied by the seminiferous tubules. The results show a great amount of individual variation with regard to testicular morphometry and semen characteristics. No significant correlations were obtained between testicular measurements and semen characteristics. The histometric analysis revealed that 67.8% of the testes are occupied by seminiferous tubules. Results show that the measurement of testicular dimensions does not serve as an indicator of the quality of semen obtained by electroejaculation in collared peccaries, as there is no correlation between testicular morphometry and semen characteristics in this species that presents large variations among individuals.

Midterm Results of Combined Acromioclavicular and Coracoclavicular Reconstruction Using Nylon Tape

The purpose of this study was to evaluate the radiologic and functional outcomes of an anatomic reconstruction of both acromioclavicular (AC) and coracoclavicular (CC) ligaments in types III to V AC injuries using nylon tape and no metal hardware. A prospective case-series study was performed on 17 cases with types III to V AC injuries treated by anatomic reconstruction of the AC ligaments (anterior and superior) and CC ligaments (conoid and trapezoid) using nylon tape and no metal hardware. Clinical assessments, radiologic findings, and visual analog scale, American Shoulder and Elbow Surgeons, and Constant scores were recorded for all patients. After a minimum postoperative period of 2 years, all cases were re-evaluated and rescored. The case-series study comprised 17 cases with types III to V AC injuries. After a mean follow-up period of 28 months (minimum, 24 months), the patients had a significantly improved mean visual analog scale score (from 6.4 to 2.4 points), American Shoulder and Elbow Surgeons score (from 25 to 81.7 points), and Constant score (from 21 to 85 points), with overall 88.2% satisfaction. Radiographic superior displacement showed reduction from 13 to 2 mm whereas posterior displacement showed reduction from 5 to 2 mm, and both were statistically significant (P < .05). The rate of return to the patients' preinjury jobs was 82.4%, and there was 1 case of recurrent subluxation. Combined anatomic reconstruction of both AC and CC ligaments using nylon tape by the described technique provides overall 88.2% satisfaction, 94% radiologic reduction, and a low complication rate. Level IV, therapeutic case series.

Laparoscopic Ureterolithotomy for Upper Ureter Stone with Some Modified Surgical Tips

Introduction and Objective: To report large upper ureter stone removal by laparoscopic approach with some surgical tips using Carter–Thomason fascial closure and various modified instruments. Methods: A 45-year-old man underwent laparoscopic ureterolithotomy via transperitoneal approach. In semilateral position, skin and fascial incision (1.2 cm) was made lateral to rectus muscle at umbilicus level, and 10-mm balloon trocar was used for scope. Two 5-mm trocars for working channel were inserted consecutively. After periureter tissue dissection, ureter with stone was pulled with nylon tape and black silk. Carter–Thomason fascial closure was used to extract the black silk outside of body and the proper traction tension and level; the angle was adjusted by the black silk extracorporeally to make next procedure more easily. Then, the ureter incision was made by modified instrument: needle holder with broken 15th blade tip, so we can sharply and precisely incise ureter at stone level. Next, the stone was removed, and a modified, both-end-closed ureteral catheter was inserted by bidirectional way using two guide wires. The ureter traction tension and level were readjusted to insert the ureteral catheter more easily. Ureteral incision was closed with an absorbable suture material (vicryl 4-0) by interrupt method, and drain was indwelled. Results: We can finish the whole procedure with a 1.2-mm balloon trocar and two 5-mm working trocars. The removed stone was 1.6 cm. The operative time was 136 minutes and blood loss was minimal. There was no intraoperative or postoperative complication. The patient was discharged 3 days after the operation. Conclusions: Pulling ureter using Carter–Thomason fascial closure and black silk makes ureter handling easier. Needle holder with broken 15th blade tip and a modified, both-end-closed ureteral catheter by bidirectional way using two guide wires make laparoscopic ureterolithotomy more feasible, so we can sharply and precisely incise ureter and insert the ureteral catheter more easily. In our experience, these tiny surgical tips are useful and can be applied to laparoscopic ureterolithotomy. No competing financial interests exist. Runtime of video: 6 mins 3 secs

Combined intra-extra-articular technique for stabilisation of coxofemoral luxation

To report a new technique for repairing traumatic cranio-dorsal coxofemoral luxation in dogs. Stabilisation of hip luxation was carried out in two dogs: a one-year-old male Border Collie and an eight-year-old female American Staffordshire Bull Terrier. A caudal approach was performed to expose the hip joint. Following this, a 2.5 mm hole was drilled through the acetabular wall at the original attachment of the round ligament, followed by a tunnel between the fovea capitis and the proximal third of the femur. Nylon tape was tied in a clove hitch knot around the femoral neck. The tape was placed as a bridge over the ischial spine to create an acetabular roof in order to increase articular stabilisation. Follow-up examinations were performed at 10, 40 and 90 days after surgery.The dogs did not show any signs of lameness, pain or reoccurrence of the luxation during any of the follow-up examinations. This tape-technique enabled reinforcement of the acetabular roof which in turn increased the stability of the joint.

Arthroscopic Dorsal Capsular Release in the Wrist

Wrist stiffness is a multifactorial condition that is debilitating for those which it affects. Although good results have been achieved in the past with aggressive physiotherapy and splinting regimens, however, there are some cases that remain refractory to this treatment. In those cases that are caused primarily by arthrofibrosis, arthroscopic surgical release of the capsule is another treatment option. Arthroscopic release of the volar wrist capsule has been previously described. The authors describe this new technique for arthroscopic dorsal capsular release using an intracapsular nylon tape to afford protection to the extensor tendons. They believe that the procedure is relatively safe with a low complication rate as well as good patient outcomes. Although the cohort of patients in whom this procedure is indicated is likely to be small, we feel that it gives the upper-limb surgeon another option for managing this often difficult problem.