Siemionow and Chou review the surgical management of atlantoaxial instability in the context of Down syndrome, using two interesting illustrative cases with different craniocervical abnormalities (atlantoaxial rotatory subluxation and os odontoideum). Both patients present with significant craniocervical spinal cord compression, and in this context, they highlight the specific case nuances that...

Study Design Retrospective case review. Objective Atlantoaxial instability with and without basilar invagination poses a considerable challenge in management regarding reduction, surgical approach, decompression, instrumentation choice, and extent of fusion. A variety of strategies have been described to reduce and stabilize cranial settling with basilar invagination. Modern instrumentation opt...

OBJECTIVES We performed in vitro validation of a non-invasive skin-mounted system that could allow quantification of anteroposterior (AP) laxity in the outpatient setting. METHODS A total of 12 cadaveric lower limbs were tested with a commercial image-free navigation system using trackers secured by bone screws. We then tested a non-invasive fabric-strap system. The lower limb was secured at ...

Lateral ankle sprain (LAS) is an extremely common athletic injury. Despite extensive clinical and basic science research, the recurrence rate remains high. Functional instability (FI) following LAS is hypothesised to predispose individuals to reinjury because of neuromuscular deficits which result following injury. This paper provides an overview of the potential causes of FI which may manifest...

Logical correction of aging contour changes of the face is based on understanding its structure and the processes involved in the aging appearance. Aging changes are seen at all tissue levels between the skin and bone although the relative contribution of each component to the overall change of facial appearance has yet to be satisfactorily determined. Significantly, the facial skeleton changes...

Down syndrome, the result of trisomy of chromosome 21, is one of the most common chromosomal abnormalities. Patients have a characteristic facial appearance, variable levels of intelligence and self-care skills, and a variety of associated medical conditions. Orthopaedic manifestations occur frequently; most are related to hypotonia, joint hypermobility, and ligamentous laxity. Atlanto-occipita...

The incidence of atlantoaxial rotatory subluxation is fairly uncommon; however it is more common to be encountered in the pediatric population. It is usually seen in children after a retropharyngeal inflammation or after a minor trauma. Children have unique anatomical features such as inherent ligamentous laxity and shallower and more horizontally oriented facet joints that allow greater freedo...

Acetabular labral tears are usually seen in individuals in whom the hip is exposed to elevated axial and torsional forces. In our experience we have encountered a series of female patients in whom symptom onset was during pregnancy or obstetric labour. We reviewed our patient database to identify all patients who had undergone hip arthroscopy in our hospital. The records of female patients who ...

Many surgical procedures have been described in the literature for the correction of hallux valgus,6 but a special knowledge of the etiologic factors, pathomechanics, and patient factors is needed to achieve a permanent solution for this deformity. There are two categories of recurrence: operative factors and patient factors. The main cause of recurrence associated with operative factors is imp...