Rotation Correction Research Articles

Clinical Tips for Rotation Correction in Self-ligating Brackets

The use of self-ligating brackets is becoming increasingly popular in modern orthodontic practice. However, one of the major downsides of self-ligating brackets is the lack of rotational control, which is typically achieved using rotation wedges in conventional brackets but is not possible with self-ligating brackets. The paper highlights two techniques for achieving rotational control with self-ligating brackets. The first technique involves using a flowable composite to create a wedge effect within the bracket, while the second method utilizes a Chewie to correct rotation. The paper describes effective and time-saving techniques for achieving rotational control with self-ligating brackets, which can make them more appealing to orthodontists.

A stabilized finite volume method based on the rotational pressure correction projection for the time-dependent incompressible MHD equations

This paper presents an efficient numerical scheme for solving the time-dependent incompressible Magnetohydrodynamics (MHD) equations based on the rotational pressure correction projection method within the finite volume framework. Utilizing the lowest equal-order mixed finite element pair (P1−P1−P1) to approximate the velocity, magnetic and pressure fields, our numerical scheme satisfies the discrete inf-sup condition by the pressure projection stabilization. To tackle the coupling inherent in the time-dependent incompressible MHD equations,the rotational pressure correction projection method is introduced to split the original problem into several linear subproblems. The unconditional stability of numerical schemes are provided,optimal error estimates in both L2 and H1-norms of numerical solutions are also presented.Finally, some numerical results are given to verify the established theoretical findings and show the performances of the considered numerical schemes.

Rotation Correction Algorithm Based on Polar Harmonic Fourier Moments and Optimization of Color Image Security Quantization Watermarking Scheme

Rotation Correction Algorithm Based on Polar Harmonic Fourier Moments and Optimization of Color Image Security Quantization Watermarking Scheme

One-bone forearm for the treatment of supination contractures secondary to neonatal brachial plexus injury.

The one-bone forearm procedure has been considered as a potential treatment for severe forearm deformities. However, its primary limitation lies in the elevated risks of nonunion and infection. In order to enhance union rates, a technical modification was introduced, aiming not only to establish end-to-end radio-ulnar fixation but also to incorporate an additional overlay and fixation between the proximal and distal radius osteotomy stumps. This technique, initially applied in a heterogeneous patient population including individuals with neurological, tumoral, and congenital conditions, yielded promising results, achieving a consolidation rate of 100% and enabling supination corrections of up to 120°. In this study, we present a retrospective cohort of 28 patients, with an average age of 9 years, all afflicted by forearm supination contracture exceeding 90° secondary to neonatal brachial plexus injury. These patients underwent treatment with the modified technique. The mean correction achieved in forearm rotation was 116°, and the average follow-up period extended to 43 months. Remarkably, all patients exhibited bone union within an average period of 6.6 weeks, without any complications. Our findings underscore the efficacy of this modified technique, which enables substantial rotational corrections, boasts a high union rate, and maintains a low incidence of complications. This approach is particularly valuable for young patients suffering from neonatal brachial plexus injury with severe fixed supination deformities. IV.

Three-dimensional acetabular reorientation during periacetabular osteotomy: an intraoperative navigation method using an external fixator for periacetabular osteotomy.

Bernese periacetabular osteotomy (PAO) is an effective procedure for treating acetabular dysplasia. However, limited visual control of the acetabular position during surgery may result in under- or overcorrection or changes in acetabular version resulting in residual dysplasia or femoroacetabular impingement. Thus, we wanted to develop a simple and straightforward navigation method that provides information about acetabular correction in all three planes during surgery. Intraoperatively, acetabular coordinates are shown in coronal, sagittal, and transverse plane by two perpendicular tubes of an external fixator mounted onto a third tube that is fixed to the mobilized acetabular fragment with two Schanz screws. The application and fixation of the external fixator on the pelvis are demonstrated in this article. We used this analog navigation method on 27 PAOs, where we mainly performed a lateral rotational correction. The pre- and postoperative radiographs of these 27 hips were analyzed regarding the radiological hip parameters, taking into account the pelvic tilt. The mean preoperative lateral center edge angle (LCEA) of the 27 PAOs improved from 16° (+-6) to a mean of 34° (+-6°) and the mean acetabular index (AI) was corrected from 15° (+-4) to 2° (+-4). This implements highly physiologic postoperative values for lateral coverage in this population. In this case series, no postoperative acetabular retroversion was measured in any of the 27 PAOs. Three-dimensional control of the acetabular orientation during periacetabular osteotomy is important to avoid over- and undercorrection. Using a fixateur externe as an analog navigation method this three-dimensional control can be implemented intraoperatively for PAOs.

New findings on clinical experience on surface-guided radiotherapy for frameless non-coplanar stereotactic radiosurgery treatments.

The aim of this study was to assess the accuracy of a surface-guided radiotherapy (SGRT) system for setup and intra-fraction motion control in frameless non-coplanar stereotactic radiosurgery (fSRS) using actual patient data immobilized with two different types of open-faced masks and employing a novel SGRT systems settings. Forty-four SRS patients were immobilized with two types of open-faced masks. Sixty lesions were treated, involving the analysis of 68 cone-beam scans (CBCT), 157 megavoltage (MV) images, and 521 SGRT monitoring sessions. The average SGRT translations/rotations and 3D vectors (MAG-Trasl and MAG-Rot) were compared with CBCT or antero-posterior MV images for 0° table or non-coplanar beams, respectively. The intrafraction control was evaluated based on the average shifts obtained from each monitoring session. To assess the association between the SGRT system and the CBCT, the two types of masks and the 3D vectors, a generalized estimating equations (GEE) regression analysis was performed. The Wilcoxon singed-rank test for paired samples was performed to detect differences in couch rotation with longitudinal (LNG) and lateral (LAT) translations and/or yaw. The average SGRT corrections were smaller than those detected by CBCT (≤0.5mm and 0.1°), with largest differences in LNG and yaw. The GEE analysis indicated that the average MAG-Trasl, obtained by the SGRT system, was not statistically different (p=0.09) for both mask types, while, the MAG-Rot was different (p=0.01). For non-coplanar beams, the Wilcoxon singed-rank test demonstrated no significantly differences for the corrections (LNG, LAT, and yaw) for any table rotation except for LNG corrections at 65° (p=0.04) and 75° (p=0.03) table angle position; LAT shifts at 65° (p=0.03) and 270° (p<0.001) table angle position, and yaw rotation at 30° (p=0.02) table angle position. The average intrafraction motion was<0.1mm and 0.1° for any table angle. The SGRT system used, along with the novel workflow performed, can achieve the setup and intra-fraction motion control accuracy required to perform non-coplanar fSRS treatments. Both masks ensure the accuracy required for fSRS while providing a suitable surface for monitoring.

TROPIC: Transfascial Oblique Posterior Interbody Correction: Technical Note

Adult spinal deformity is a common problem in today's aging adult population, particularly in the thoracolumbar spine. This can lead to severe pain and disability, leading to a poorer quality of life. Traditionally, open deformity correction has been the mainstay of treatment for these patients as it provides an excellent operative corridor; however, this comes with severe risk and high complication rates. There has been a trend toward more minimally invasive approaches to correct the deformity while preserving the muscle and soft tissue surrounding the bony spine across the fusion. We describe a minimally invasive surgical technique through a Wiltse approach without invading the paraspinal musculature to gain access to the bony spine to perform lumbar interbody fusions and osteotomies. A total of 3 patients were identified for this technical note who underwent the transfascial oblique posterior interbody correction procedure for adult spinal deformity. The patients had severe coronal and rotational imbalances. We were able to achieve adequate correction through an approach without disturbing the spinal musculature and soft tissues. This technique provides benefits of spinal rotational and coronal plane correction and restores lordosis with current advancements of today's technologies without the downsides of an open surgical approach.

A Novel End-to-End Deep Learning Framework for Chip Packaging Defect Detection.

As semiconductor chip manufacturing technology advances, chip structures are becoming more complex, leading to an increased likelihood of void defects in the solder layer during packaging. However, identifying void defects in packaged chips remains a significant challenge due to the complex chip background, varying defect sizes and shapes, and blurred boundaries between voids and their surroundings. To address these challenges, we present a deep-learning-based framework for void defect segmentation in chip packaging. The framework consists of two main components: a solder region extraction method and a void defect segmentation network. The solder region extraction method includes a lightweight segmentation network and a rotation correction algorithm that eliminates background noise and accurately captures the solder region of the chip. The void defect segmentation network is designed for efficient and accurate defect segmentation. To cope with the variability of void defect shapes and sizes, we propose a Mamba model-based encoder that uses a visual state space module for multi-scale information extraction. In addition, we propose an interactive dual-stream decoder that uses a feature correlation cross gate module to fuse the streams' features to improve their correlation and produce more accurate void defect segmentation maps. The effectiveness of the framework is evaluated through quantitative and qualitative experiments on our custom X-ray chip dataset. Furthermore, the proposed void defect segmentation framework for chip packaging has been applied to a real factory inspection line, achieving an accuracy of 93.3% in chip qualification.

Automated External Bone Fixation Robot Design and Orthopedic Analysis

Background: Bone external fixation technology is an important therapeutic approach for limb correction, primarily involving a class of external fixation correction mechanisms. It has achieved good results in limb lengthening and correcting deformities to restore limb function. In clinical practice, existing correction mechanisms face challenges such as high resistance between components, complex installation procedures, and high precision requirements for installation, requiring manual adjustment by physicians, which limits precise control and quantification of correction parameters. Objective: To address these issues, an automated correction bone external fixation robot was designed based on traditional Ilizarov external fixation devices(TIEFD). Methods: By increasing the number of unidirectional hinge connections, the robot can effectively reduce motion resistance. Subsequently, the robot was combined with the tibia for correction motion simulation, obtaining the motion parameters θ of the deformed bones during the correction process based on the trajectory of the tibia's point mass. Finally, correction motion experiments and finite element analysis(FEA) were conducted on the robot combined with a control system. Results: The results showed that the robot could precisely control correction parameters, with the error range for rotational correction not exceeding 0.5 radians and the error range for traction correction not exceeding 0.2 mm. FAE, based on corrective force data, concluded that compared to (TIEFD), the robot could reduce bone stress by 16 MPa during the correction process. Conclusion: The robot effectively reduces patient discomfort, this provides a reliable theoretical basis for bone external fixation technology and holds positive significance for the treatment of skeletal deformities.

Three-dimensional deformity correction in adolescent idiopathic scoliosis patients: what are the benefits of hybrid apical sublaminar bands versus all-pedicle screws?

The amount of three-dimensional (3D) correction with apical sublaminar band (hybrid-SLB) technique has not been compared to all-pedicle screw instrumentation for adolescent idiopathic scoliosis (AIS) using detailed axial correction metrics or comparable rod types. Our purpose is to compare 3D improvement in AIS deformities following posterior spinal instrumentation and fusion (PSIF) with hybrid-SLB and segmental correction to all-pedicle screw correction. Patients ages 10-18 years with AIS who underwent PSIF between 2015 and 2022 and had preoperative and postoperative EOS imaging were included. Electronic medical records were reviewed for demographic, Lenke classification, operative technique, and 3D EOS data. Average changes in major and minor Cobb angle, axial rotation, thoracic kyphosis, and lumbar lordosis were compared. Ninety-five patients met inclusion criteria with 55 in the hybrid-SLB group (mean age 14.9 ± 1.9 years) and 40 in all-pedicle screw (mean age 14.7 ± 2.1 years). While all-pedicle screw demonstrated greater correction of major (45.7 ± 13.4 vs 37.9 ± 14.3 degrees; P = 0.008) and minor (28.7 ± 13.1 vs 17.8 ± 12.5 degrees; P = 0.001) Cobb angles, hybrid-SLB showed greater increase in T4-T12 kyphosis (13.3 ± 15.3 vs 5.6 ± 13.5 degrees; P = 0.01). Correction of T1-T12 kyphosis, axial rotation, and lumbar lordosis was similar between groups. 3D EOS analysis of AIS patients before and after PSIF revealed that all-pedicle screw constructs had greater overall coronal plane correction and hybrid-SLB had greater thoracic sagittal plane correction. Axial corrective abilities were similar. Hybrid-SLB may have advantages for correction of thoracic lordosis or hypokyphosis. Level of evidence: Level III, retrospective cohort study.

Pointer Meter Reading Method Based on YOLOv8 and Improved LinkNet.

In order to improve the reading efficiency of pointer meter, this paper proposes a reading method based on LinkNet. Firstly, the meter dial area is detected using YOLOv8. Subsequently, the detected images are fed into the improved LinkNet segmentation network. In this network, we replace traditional convolution with partial convolution, which reduces the number of model parameters while ensuring accuracy is not affected. Remove one pair of encoding and decoding modules to further compress the model size. In the feature fusion part of the model, the CBAM (Convolutional Block Attention Module) attention module is added and the direct summing operation is replaced by the AFF (Attention Feature Fusion) module, which enhances the feature extraction capability of the model for the segmented target. In the subsequent rotation correction section, this paper effectively addresses the issue of inaccurate prediction by CNN networks for axisymmetric images within the 0-360° range, by dividing the rotation angle prediction into classification and regression steps. It ensures that the final reading part receives the correct angle of image input, thereby improving the accuracy of the overall reading algorithm. The final experimental results indicate that our proposed reading method has a mean absolute error of 0.20 and a frame rate of 15.

Precision mass measurements in the zirconium region pin down the mass surface across the neutron midshell at N = 66

Precision mass measurements of 104Y, 106Zr, 104,104m,109Nb, and 111,112Mo have been performed with the JYFLTRAP double Penning trap mass spectrometer at the Ion Guide Isotope Separator On-Line facility. The order of the long-lived states in 104Nb was unambiguously established. The trend in two-neutron separation energies around the N=66 neutron midshell appeared to be steeper with respect to the Atomic Mass Evaluation 2020 extrapolations for the 39Y and 40Zr isotopic chains and less steep for the 41Nb chain, indicating a possible gap opening around Z=40. The experimental results were compared to the BSkG2 model calculations performed with and without vibrational and rotational corrections. All of them predict two low-lying minima for 106Zr. While the unaltered BSkG2 model fails to predict the trend in two-neutron separation energies, selecting the more deformed minima in calculations and removing the vibrational correction, the calculations are more in line with experimental data. The same is also true for the 21+ excitation energies and differences in charge radii in the Zr isotopes. The results stress the importance of improved treatment of collective corrections in large-scale models and further development of beyond-mean-field techniques.

Double-bar technique for the correction of asymmetric pectus excavatum.

Minimally invasive repair of pectus excavatum (MIRPE) improves clinical outcomes and chest wall morphology. However, asymmetry in patients with pectus excavatum (PE) remains as an important issue, even after surgery. Here, we evaluated the benefit of double-bar technique in achieving a symmetric chest wall. This retrospective study included 79 patients with PE who underwent MIRPE between 2017 and 2021. The patients were divided into the double- or non-double-bar groups. Asymmetric degree (AD) and sternal rotation angle (SRA) were used to assess the severity of asymmetry based on computed tomography (CT) images. The primary outcome was the change in radiologic parameters. Secondary outcomes were clinical results, including hospital stay, pain scores, and complication rates. Subgroup analysis of patients with preoperative asymmetric PE was performed. Patients in the double-bar group (n=23) were younger than those in the non-double-bar group (n=56). Additionally, the double-bar group exhibited lower pain scores and shorter hospital stay. Based on radiological assessments, the double-bar group demonstrated a greater decrease in AD without compromising improvement in the Haller index (HI). The benefit of the double-bar technique was more obvious among patients with asymmetry with a preoperative AD >5%, resulting in a significant reduction in AD. In this subgroup, a better correction of sternal rotation was observed. The double-bar technique may be a promising option for correcting asymmetry in patients with PE. Simplified AD and SRA radiologic assessments can be used to evaluate improvements in chest wall configuration.

Pelvic rotation correction combined with Schroth exercises for pelvic and spinal deformities in mild adolescent idiopathic scoliosis: A randomized controlled trial.

Individualized treatment of spinal deformity is needed for adolescent idiopathic scoliosis (AIS), and the integration of pelvic rotation correction based on proprioceptive neuromuscular facilitation (PNF) into regular physiotherapy may be a promising approach. However, few high-quality studies have investigated its effects. This study aimed to evaluate the efficacy of pelvic rotation correction combined with Schroth exercises in the treatment of mild AIS. This was a randomized controlled trial. Forty-two AIS patients were randomly divided into experimental and control groups. Both groups underwent 20 therapeutic sessions over 24 weeks. All patients (n = 42) performed Schroth exercises at each session. In addition, the experimental group (n = 21) also participated in a pelvic rotation correction program based on PNF at each session. The primary outcome was the concave/convex ratio of hipbone widths, and the secondary outcomes included the Cobb angle, trunk rotation angle, self-perception, apical vertebral translation, and apical vertebral rotation. Patients were evaluated before and after 24 weeks of intervention. There was a significant between-group difference in the change from baseline between the experimental and control groups for the following parameters: concave/convex ratio 2.89% (95% confidence interval [CI], 1.58 to 4.20, P<0.001), trunk rotation angle -1.26° (95% CI, -2.20 to -0.32; P = 0.01), and apical vertebral rotation improved by at least one class from baseline in 3 patients (14.3%) in the control group and 9 patients (42.9%) in the experimental group (P = 0.04). While Cobb angle -1.60° (95% CI, -7.75 to 0.54; P = 0.14), self-image 0.149 (95% CI, 0.001 to 0.297; P = 0.049), apical vertebral translation -0.58 mm (95% CI, -3.83 to 2.67; P = 0.72), and pelvic obliquity 0.10° (95% CI, -0.21 to 0.41; P = 0.52) did not differ significantly. Pelvic rotation correction combined with Schroth exercises more effectively improved pelvic axial rotation and other spinal deformities, including trunk rotation and apical vertebral rotation, than Schroth exercises alone in the treatment of mild AIS.

Direct Vertebral Rotation versus Simple Rod Derotation Techniques in Correction of Adolescent Idiopathic Scoliosis

Abstract Background One method for treating adolescent idiopathic scoliosis (AIS), which is characterised by abnormal spinal alignment in the coronal, sagittal, and rotational planes, is surgical correction. The two surgical techniques most typically used to correct spine alignment are simple rod derotation (SRD) and direct vertebral rotation (DVR). Aim The study's goal was to assess the effectiveness of two treatment methods for adolescent idiopathic scoliosis: simple rod derotation and direct vertebral rotation. Subjects and Methods A randomised controlled research involving 36 adolescents with idiopathic scoliosis was done. patients were randomly split into one of two groups: 18 patients in group A had DVR treatment, while 18 patients in group B received SRD with a 2-year follow-up. Results Apical Vertebral Rotation measured from CT scans in DVR group was 24.4° ±8.38° preoperatively and it decreased significantly postoperatively to 14.4°±4.61 °with (42.22%) correction rate while in SRD group it was 25.03°±7.99° preoperatively and it also decreased significantly postoperatively to a mean value of 21.41°±7.01° with (14.65%) correction rate. There were statistically significant differences between both groups postoperative (P &amp;lt; 0.001) Conclusion The most noticeable difference between DVR and SRD was clinical rib hump correction, which was explained by apical vertebral rotation correction determined on an axial CT scan. It also demonstrates that there is no significant difference in coronal curve correction, shoulder height difference, or patient satisfaction between the two techniques.

Unsupervised denoising of the non-invasive fetal electrocardiogram with sparse domain Kalman filtering and vectorcardiographic loop alignment

Objective. Even though the electrocardiogram (ECG) has potential to be used as a monitoring or diagnostic tool for fetuses, the use of non-invasive fetal ECG is complicated by relatively high amounts of noise and fetal movement during the measurement. Moreover, machine learning-based solutions to this problem struggle with the lack of clean reference data, which is difficult to obtain. To solve these problems, this work aims to incorporate fetal rotation correction with ECG denoising into a single unsupervised end-to-end trainable method. Approach. This method uses the vectorcardiogram (VCG), a three-dimensional representation of the ECG, as an input and extends the previously introduced Kalman-LISTA method with a Kalman filter for the estimation of fetal rotation, applying denoising to the rotation-corrected VCG. Main results. The resulting method was shown to outperform denoising auto-encoders by more than 3 dB while achieving a rotation tracking error of less than 33∘. Furthermore, the method was shown to be robust to a difference in signal to noise ratio between electrocardiographic leads and different rotational velocities. Significance. This work presents a novel method for the denoising of non-invasive abdominal fetal ECG, which may be trained unsupervised and simultaneously incorporates fetal rotation correction. This method might prove clinically valuable due the denoised fetal ECG, but also due to the method’s objective measure for fetal rotation, which in turn might have potential for early detection of fetal complications.

The Intermalleolar Method for Intraoperative Rotational Assessment of the Tibia-A Prospective Clinical Validation Study.

To determine the accuracy of the intermalleolar method, an intraoperative fluoroscopic method for assessing tibial rotation in patients undergoing intramedullary nail fixation for tibial shaft fractures, by comparing it with the gold standard computed tomography (CT). Prospective cohort study. Academic Level 1 trauma center. Consecutive patients, aged 18 years and older, with unilateral tibial shaft fractures who underwent intramedullary fixation from September 2021 to January 2023. Intraoperatively, tibial rotation measurements were obtained using the intermalleolar method on both the uninjured and injured limbs. Postoperatively, patients underwent bilateral low-dose lower extremity rotational CT scans. CT measurements were made by 4 blinded observers. Mean absolute rotational differences and standard errors were calculated to compare the injured and uninjured limbs. Subgroup analysis was performed assessing accuracy relating to injured versus uninjured limbs, body mass index, OTA/AO fracture pattern, tibial and fibular fracture location, and distal articular fracture extension requiring fixation. Of the 20 tibia fractures, the mean patient age was 43.4 years. The intermalleolar method had a mean absolute rotational difference of 5.1 degrees (standard error 0.6, range 0-13.7) compared with CT. Sixty percent (24/40) of the measurements were within 5 degrees, 90% (36/40) of the measurements were within 10 degrees, and 100% (40/40) were within 15 degrees of the CT. No patients were revised for malrotation postoperatively. The intermalleolar method is accurate and consistently provides intraoperative tibial rotation measurements within 10 degrees of the mean CT measurement for adult patients undergoing intramedullary nail fixation for unilateral tibial shaft fractures. This method may be employed in the operating room to accurately quantify tibial rotation and assist with intraoperative rotational corrections. Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Predictability of tooth rotations in patients treated with clear aligners

Clear aligners are employed daily for the treatment of several malocclusions. Previous clinical studies indicated low accuracy for the correction of tooth rotations. The aim of this study was to evaluate the predictability of tooth rotations with clear aligners. The sample comprised 390 teeth (190 mandibular; 200 maxillary), measured from the virtual models of 45 participants (21 men, 24 women; mean age: 29.2 ± 6.6 years old). For each patient, pre-treatment (T0) digital dental models (STL files), virtual plan (T1) and post-treatment digital dental models (T2) of both the mandibular and maxillary arches were imported onto Geomagic Control X, a 3D metrology software which allows angular measurements. Rotations were calculated by defining reproducible vectors for all teeth in each STL file and superimposing both T0 with T1 to determine the prescribed rotation, and T0 with T2 to determine the achieved rotation. Prescribed and achieved rotations were compared to assess movement’s accuracy. The Wilcoxon signed-rank test and paired t-test were used to assess differences between the prescribed and achieved movements (P < 0.05). The overall predictability of rotational movement was 78.6% for the mandibular arch and 75.0% for the maxillary arch. Second molar accuracy was the lowest in both arches. Clear aligners were not able to achieve 100% of the planned movements.

Transmalar Kirshner Wire Fixation Under Ultrasound Scanning is Useful for Unstable Zygomatic Arch Fracture Combined With Zygomatic Body Fracture.

Plate fixation to zygomatic arch fractures carries the risk of facial nerve palsy and scarring of the cheek; however, without plate fixation, bone deviation or displacement may reoccur after surgery. Furthermore, zygomatic arch fractures combined with zygomatic body fractures are more postoperatively unstable than single zygomatic arch fractures. Few reports have focused on this combined fracture type, and no consensus has been reached regarding treatment. Because plate fixation for slight deviation of the zygomatic body has little advantage for stabilization, the authors, usually opt for transmalar pinning alone instead of plate fixation at the hospital. This study is a retrospective case series of 7 patients, among 100 zygomatic fractures excluding isolated zygomatic arch fractures, treated using transmalar pinning under ultrasound scanning. The reduction was performed through the oral and temporal incision as a surgical procedure. Under ultrasound observation, a Kirshner wire was inserted into the zygomatic body from the unaffected side while maintaining the reduced position. The wire was removed at an outpatient visit 2 to 3 months following surgery. In all cases, the zygomatic body was of the laterally rotated type, and postoperative morphologic evaluation showed improvement without postoperative complications. Scores were higher in middle-aged and older than in young people. Correction of zygomatic rotation also scored higher than zygomatic arch morphology. Transmalar Kirshner wire fixation under ultrasound observation is a simple and minimally invasive method for zygomatic arch fractures, which avoids the possible complications related to plate fixation.

No significant change of tibiofemoral rotation after femoral rotational osteotomy in patients with patellofemoral instability.

An increased value of tibiofemoral rotation is frequently observed in patients with patellofemoral instability or maltracking. Nevertheless, the appropriate approach for addressing this parameter remains unclear so far. One potential approach for correcting tibiofemoral rotation is femoral rotational osteotomy. We hypothesized that femoral rotational osteotomy affects tibiofemoral rotation. All patients who underwent femoral rotational osteotomy between January 2018 and May 2022 were included in this study. Pre- and postoperative tibiofemoral rotation and the degree of femoral rotation were measured using two-dimensional (2D) and three-dimensional (3D) measurements. The effect of femoral rotation on tibiofemoral rotation was assessed. Forty knees (18 rightand 22 left) of 36 patients (28 femalesand 8 males) were included. Mean preoperative femoral torsion was 32.1 ± 10.1° in 2D and 30.8 ± 10.1° in 3D. Femoral rotation was performed by -14.1 ± 8.3° using 2D measurements and -15.0 ± 8.0° using 3D measurements. Tibiofemoral rotation changed from 9.9 ± 6.2° to 9.7 ± 6.0° (p = n.s.) in 2D, and from 10.2 ± 5.5° to 9.4 ± 5.4° (p = n.s.) in 3D. Tibiofemoral rotation showed no significant changes after femoral rotational osteotomy. Hence, femoral rotational osteotomy cannot be used to correct tibiofemoral rotation in addition to correcting the femoral version. Other surgical techniques need to be evaluated if correction of tibiofemoral rotation is required. Level III.