Michael D. Feldman

Arthroscopic excision of type II capitellar fractures

Type II capitellar fractures are uncommon. The current treatment recommendation for these fractures is open excision. The major complication of open excision is loss of motion. Two cases of the previously unreported technique of arthroscopic excision are presented with a review of the literature. Arthroscopic excision of displaced type II capitellar fractures is a safe, effective technique that causes minimal soft tissue trauma, allows thorough inspection of the joint for additional occult injuries, and optimizes postoperative range of motion.

Editorial Commentary: What's in a Name: Is There a Difference Between Incomplete and Partial Rotator Cuff Repairs?

For the treatment of large to massive rotator cuff repairs, not all partial repairs are equivalent. The technique of rotator cuff repair in large to massive rotator cuff tears matters. By using mobilization techniques to mobilize the rotator cuff to obtain anatomic or near anatomic coverage, double-row techniques to increase footprint coverage, and medial mobilization to decrease tension on the repair, exposure of the humeral head can be minimized, which can improve outcomes.

Editorial Commentary: Pitching a New Curve: Identifying the Etiology of Nontraumatic Throwing Injuries

Loss of shoulder motion, especially to flexion and external rotation, may increase the risk of nontraumatic shoulder and elbow injuries in elite pitchers. However, the etiology of these injuries is likely mulitifactorial, and before we direct our therapists to abandon sleeper stretches in favor of flexion and external rotation exercises, further research is needed to keep pitchers off the disabled list and on the mound.

Editorial Commentary: My Shoulder Feels Great, But Why Is My Thigh Numb? Lateral Femoral Cutaneous Nerve Injury After Shoulder Arthroscopy in the Beach Chair Position

Lateral femoral cutaneous nerve injury after shoulder arthroscopy in the beach chair position is an uncommon, but irritating complication for patients. Taking an extra minute to ensure a safe beach chair position will likely minimize the occurrence and prevent a disheartening conversation at the first postoperative visit.

Arthroscopic Training in the 21st Century: A Changing Paradigm

Although proficiency training will never completely replace the apprenticeship model, improvement in arthroscopic surgical-simulator technology permits students to spend less time observing and more time doing. The best models and simulators allow measurement and documentation of skill-based progression. Once basic skills have been satisfactorily demonstrated, trainees transitioning to actual operative arthroscopy should be expected to contribute to safer and more efficient patient care while continuing to learn and improve.

Editorial Commentary: Planting a Tree to Create the Shade—Performing Quality Long-term Studies Requires Forethought

Forecasting the future questions that need to be answered while collecting prospective data makes the design of long-term studies challenging. But, with the current focus in health care to report outcomes, more information will now be prospectively collected, likely providing the necessary data to more critically analyze our results with higher-level of evidence studies.

Editorial Commentary: Can It Really Be That Simple? Predicting Risk Factors for Failed Arthroscopic Rotator Cuff Repair

Failure after arthroscopic rotator cuff repair is multifactorial. Tear size and chronicity do matter but, until a case series with a large enough sample size can be performed, we must still continue to counsel patients that a wide variety of risk factors and comorbidities may affect healing.

Editorial Commentary: Does Early Arthroscopy of Subtle Instability in High Ankle Sprains Hasten Return to Play in Elite Athletes?

Anterior inferior tibial fibular ligament tenderness to palpation, a positive squeeze test, and a positive external rotation test correlate well with syndesmosis instability after high ankle sprain. However, it is still unknown whether subtle unstable high ankle sprains (grade IIB) could heal satisfactorily with nonoperative treatment and whether their recovery would be prolonged compared with operative treatment.