Open reduction is inevitable in cases of comminuted fractures, interposition of the capsule or anular ligament between the head and the neck, totally displaced, and fracture dislocation [26].
In cases of doubt, arthroscopy could be of assistance to determine interposition when the medial clear space remains wide after proper reduction.
There is no evidence found for suturing but exploration is thought to be beneficial in case of interposition of medial structures.
Moreover, sonographic examination may be limited in case of obese patients and bowel gas interposition.
Briefly, sera (approximately 60 nL) had been arrayed in triplicate through multiple depositions as 350 µm diameter spots onto Nitrocellulose FAST slides (Whatman, Florham Park, NJ), in such a fashion to obtain even interposition of cases and controls throughout the slide, using a 2470 Arrayer (Aushon BioSystems, Burlington, MA).
The ideal glue should not induce fibrosis that can lead to nerve compression and in the case of substance interposition between nerves, it should not act as a barrier to nerve regeneration.
Garras et al. (Garras et al. 2008) described a series of 21 cases using fresh-frozen allografts for interposition in the subtalar arthrodesis with 90.5% union rate, although, in seven cases, grafts were used in association with platelet-rich plasma.
The revision procedures included excision of both the implant and the trapezium, followed by prosthesis surgery in 1 case, and conversion to a tendon interposition arthroplasty in 4 cases.
Other cases of knee irreducibility determined by interposition of various capsulo-ligamentous structures have been previously described.
