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Introduction: Various techniques have been described for restoring leg length and offset during total hip arthroplasty (THA). We herein describe a novel "Quartered Head Technique" (QHT) involving a series of femoral osteotomies., Methods: 124 hips were included in the analysis. An anterolateral approach was used in all cases. Leg length, and offset were assessed intraoperatively and reproduced using the QHT. A leg-length discrepancy (LLD) of <6 mm was chosen as acceptable based on previously published literature. Postoperative pelvic radiographs were assessed by two independent observers to ensure inter-observer reliability., Results: The mean absolute postoperative difference in leg length from the contralateral leg was +3.58 mm. 84% of patients had LLD within ±6 mm of the contralateral limb. Mean absolute postoperative difference in offset from the contralateral leg was +3.88 mm. 90% of patients were within ±6 mm offset of the contralateral limb. There was no statistical difference noted between observer measurement., Conclusions: The QHT provides a simple, inexpensive, yet effective method of maintaining femoral leg length and offset during total hip arthroplasty., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The authors describe a technique for bilateral simultaneous measuring of forearm compartments pressure for assessment of suspected chronic exertional compartment syndrome of the forearm. Under ultrasound guidance, 18-G cannulae were inserted bilaterally into the superficial flexor and dorsal extensor forearm compartments. The imaging was used to confirm safe subfascial placement, and ensured no kinking or catching on the muscle bellies during dynamic movements. An arterial pressure transducer with 4 portals allowed simultaneous measurements from 4 compartments. Intracompartmental pressure (ICP) was measured in 2 ways, (1) hand in a relaxed position and (2) power grip with Jamar Dynamometer. After baseline measurements were taken, the patient undertook a period of rowing sufficient to generate symptoms. ICPs were then recorded at 1, 2, and 5 minutes by which time symptoms had resolved. Using this method ICPs in 4 myofascial compartments was measured in the same limb, simultaneously, pre- and postexercise., Competing Interests: Conflicts of Interest and Source of Funding: The authors report no conflicts of interest and no source of funding., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

Introduction: A technique of reconstructing the inguinal ligament using a pedicled fascia lata flap is described., Presentation of Case: A 62-year-old man was referred with massive bilateral abdominal wall hernias, following numerous attempts at repair and subsequent recurrences. There was complete absence of the right inguinal ligament. The inguinal ligament was reconstructed using a strip of fascia lata, pedicled on the anterior superior iliac spine. This was transposed to cover the external iliac vessels, and sutured to the pubic tubercle. The musculoaponeurotic abdominal wall was reconstructed with two 20cm×20cm sheets of porcine acellular dermal matrix and an overlying sheet of polypropylene mesh, sutured to the remaining abdominal wall muscles laterally, and to both inguinal ligaments. The cutaneous abdominal wall was closed with an abdominoplasty technique. The reconstruction has remained intact nine months following surgery., Discussion: Complete destruction of the inguinal ligament is rare but can occur following multiple operative procedures or trauma. To date, the only published reports of inguinal ligament reconstruction have been performed using synthetic mesh. The use of autologous tissue should reduce the risk of erosion into the neurovascular bundle, seroma formation, and enhance integration into surrounding tissues., Conclusion: This new technique for autologous reconstruction of the inguinal ligament provides a safe alternative to the use of synthetic mesh in the operative armamentarium of plastic and hernia surgeons., (Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.)