The Internet Journal of Orthopedic Surgery最新文献

{"title":"Complex upper cervical spine injury associated with vertebral artery injury and sensory deficit: A case report.","authors":"N. BomelaL., N. S. Motsitsi","doi":"10.5580/1b4e","DOIUrl":"https://doi.org/10.5580/1b4e","url":null,"abstract":"Introduction. Multiple levels cervical spine injuries constitute less than half of all cervical spine injuries. They occur following severe trauma. There is a high risk of associated cranio-cervical vascular injury.Case presentation. We present a young adult patient who sustained complex multiple contiguous upper cervical spine ( C2-C3) fractures associated with asymptomatic vertebral artery thrombosis and sensory deficits involving C2 � C4 dermatomes. She underwent successful anterior cervical arthrodesis. She was followed up for fifteen months. Clinically she showed improvement, but the neck disability index was 46% at the last visit.Conclusion. Complex cervical spine injury may have significant morbidity despite successful surgical intervention","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"116 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124631068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone grafting and internal fixation of intracapsular femoral neck fracture. Two years follow up in five patients with a novel fixation device.","authors":"M. Waisman, J. Mizrahi, D. Waisman, Yosef Strulovich","doi":"10.5580/209d","DOIUrl":"https://doi.org/10.5580/209d","url":null,"abstract":"Objectives: To test the safety and effectiveness of a novel procedure and device for fixation of displaced or non-displaced intracapsular femoral neck fractures, in order to preserve the natural femoral head and prevent the need for partial or total hip replacement. Design: Singlearm, prospective clinical investigation. Setting: Patients admitted to the Orthopedic Department. Participants: Male and female patients between the ages of 50 and 75 with a Garden I-III type intracapsular femoral fracture.Intervention: Internal fixation with the WaisFix 100i device, and bone graft with bone substitute. Measurements: Experimental and computer simulator testing prior to clinical evaluation by mechanical and numerical modeling, and clinical and radiological follow-up. Results: Five women with Garden I-III type intracapsular femoral fracture underwent internal fixation and bone graft with the WaisFix 100i device. The operations were performed 8 to 26 hours following the traumatic event. There were no peri-operative complications or infections, and bleeding was negligible. The average hospitalization following surgery was 4 days, and hospital rehabilitation time was two weeks. Clinical and radiological bone union (eight to ten weeks) and optimal alignment were achieved in all cases. No cases of avascular necrosis, mechanical device failure or indication for hip replacement were observed after >2 years. Conclusion: At >2-years follow-up, the WaisFix100i internal fixation device and bone graft for intracapsular femoral neck fractures demonstrated safety, assessed by lack of complications; and effectiveness, assessed by rigid and stable fixation and short healing time.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127500843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pattern Of Injuries Due To Rubber Bullets In A Conflict Zone","authors":"Mohd Iqbal Wani, A. Sultan, M. Wani, Mudasir Malik, M. Baba, Nazia Masrat","doi":"10.5580/1c92","DOIUrl":"https://doi.org/10.5580/1c92","url":null,"abstract":"Background: The low velocity rubber bullets were used in Indian Administered Kashmir by Indian police since May 2008 to control anti India protests. Our hospital received all kinds of injuries be they due to conventional bullets or tear gas shells or rubber bullets. We included injuries only due to rubber bullets and specifically studied pattern of injuries caused by them.Methods: We analysed 100 patients who had sustained rubber bullets from May 2008 -july2010 and were received by our hospital. We assessed severity of injury in relation to range from which the bullet was hit, anatomical region of the injury and final outcome. Severity of injury was established by injury severity score (ISS). Findings: 100 patients 95 males and 5 females were included in the study who were proven to have sustained rubber bullet injuries. Average age ranged 12-60 years. Injuries were distributed randomly all along the body , the majority 80 patients (80%) had injuries in the limbs but those to head and neck 5 patients (5%), chest 8 patients (8%), abdomen 4 patients (4%) , back 3 patients (3%). 7 patients sustained injuries in multiple anatomic regions. 65 Patients (65%) had blunt injuries and 35 patients(35%) had penetration. Severity of injury was defined by the ballistic features of bullet, firing range and anatomic site of impact.Interpretation: The severity of injury whether blunt or penetrating caused by these rubber bullets is determined by resistance of body at the anatomic site of impact. Improper ranging with inaccuracy of rubber bullets with improper aiming can result in severe injuries sometimes ending in death. So this type of ammunition should never be considered safe in mob control.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114361539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fractures Of The Neck Of The Femur- Treated With Multiple Cannulated Screws In Younger Patients –A Study Of 40 Cases","authors":"Sanjay Kumar, D. Bagchi","doi":"10.5580/f98","DOIUrl":"https://doi.org/10.5580/f98","url":null,"abstract":"Intracapsular fractures of the neck of the femur are an enigma (4, 6, and 7) to orthopedic surgeons and it is a curse for an individual. Still it remains an unsolved problem in modern day’s orthopedics. The treatment in younger patients lacks any consensus among us. Review of literature gives strong and clear mandate for three things.No. 1 Osteosynthesis in extra capsular fractures of the neck of the femur (1, 4) , irrespective of the age. No 2 Osteosynthesis in case of intracapsular fractures of the neck of the femur in younger (1, 4) individuals.No 3 Replacement surgeries in intracapsular fractures of the neck of the femur in elderly greater than 60 years (1,4). The aim of this study was to see the efficacy of closed reduction and stabilization of intracapsular fractures of the neck of the femur in young adults <50 years of age with percutaneous multiple cannulated hip screw fixation. This study comprised of 40 patients over 5 years. Among 40 patients, 8 patients were either of Garden classification I or II type and rest of the patients were of type III & IV. The average age was 40 years ranging from 34 to 56 years. The average timing of surgery after trauma was 7 days. The results in all the 8 patients in Garden I & II were very good. They progressed to solid union with nearly normal hip. In the rest of the 32 patients of Garden III & IV they had variable results. 9 out of 32 patients (Garden III & IV) required some kind of revision surgery. In these 9 patients 7 had non-union and 2 patients had AVN.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126886388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thalo Navicular Arthrodesis Of Steinhaeuser In Senegal","authors":"E. S. Camara, A. Bousso, M. Tall","doi":"10.5580/4e5","DOIUrl":"https://doi.org/10.5580/4e5","url":null,"abstract":"INTRODUCTION An isolated arthrodesis from the line space of Chopart results from experimental study carried out by Steinhaeuser and its implementation/practice as described in the book he wrote in 1978. It has proven the significance of the line space of Chopart in the restoration from foot malformations/deformities. When Chellius (1), repeated the cadaveric experimentation of Steinhaeuser, he could draw the conclusion that blockade of talo navicular articulation /joint is sufficient to lock the back of the foot /back foot, and that calcaneo cuboidian blockade does not have any additional effect. These conclusions are confirmed by a clinical study carried out by . (ASENCIO and all.?) (2) Chopart arthrodesis has two major indications in Africa: In Africa the arthrodese/artthrodesis of Chopart finds two principal indications: the painful post-traumatic foot and the distorted poliomyelitic paralytic foot. MATERIAL From 1997 through 2003, 55 navicular tolo arthrodesis also called Chopart arthrodesis were performed. The age range of patients is 16 to 40 years and the average, 18 years. At total of 40 males and 15 female patients underwent the procedure. Characteristics of two categories of patients: 35 post traumatic arthrodesis; 20 neurological feet Only the talo navicular arthrodesis is performed in case of traumatic lesions while athrodesis of all the line space of Chopart is performed in case of neurological feet, in/within/on the sequelae of former acute poliomyelitic. METHOD The technique is simple and is performed under a locoregional anaesthesia with rachis anaesthesia in case of adhering iliac graft or with a poplite bloc, pneumatic garrotes on the calf. A dorso-median longitudinal incision in made between the anterior tibial tendon and extensors. A second latero-longitudinal incision is necessary for the calcaneo cuboidienne arthrodesis Figure 1 Photo I : chopart’s internal acess Thalo Navicular Arthrodesis Of Steinhaeuser In Senegal 2 of 4 Figure 2 Photo II : chopart’s double Extension by internal and external access with fixing of location The radiographic location by pin/ on the line space of Chopart is necessary because of the local modifications of the talo navicular articulation/joint. In fact, the naviculo cuneiforme joint/articulation is the only one that possesses most common features with the talo navicular joint. It is better to make a cut with an/the oscillating saw, rather than only a joint revivement the fusion of which is appears doubtful . Figure 3 Photo III : chopart’s osteotomy of correction In the talo naviculaires arthrodesis, we filled the resection space 18 times with a graft in order to maintain the length of the first ray Figure 4 Photos IV and V : External and internal view after with oscillating saw reducing the deformity by fixing an iliac graft In the large/great majority of cases (of arthrodese cases) concerning all the line space of Chopart, we do not use any graft. In fact, the corrective cuneiform (wedge-shape","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"124 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122084135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Results of different treatment modalities in the management of diaphyseal fractures of the humerus","authors":"Vipin Sharma, B. Awasthi, S. M. Mehta, S. Babhulkar","doi":"10.5580/1a3a","DOIUrl":"https://doi.org/10.5580/1a3a","url":null,"abstract":"Introduction This paper presents evaluation of103 patients of diaphyseal fractures of humerus treated by different modalities with a mean follow up of 2 yearsMaterials and Methods This is a prospective and retrospective study conducted at Dr. Rajendra Prasad Govt. Medical College and Hospital, Kangra (Tanda), HP, India during yr 2005-2006.It aimed at finding out comparison of the results obtained by different modes of treatment in fractures of humeral diaphysis. We studied a total of 103 patients out of which prospective study involved 72 patients and retrospective study ( 2003-2004) involved 31 patients( whose records were available) . All the cases were examined clinically and radiologically and were managed with an appropriate method of treatment. The closed fractures were classified by Muller�s classification while Gustillo Anderson was used for open fractures. The non-operative methods included Cooptation or U shaped Brachial splint or U-slab, Hanging arm cast ,Velpeau dressing, Shoulder spica cast, Functional brace . The patients with failure of closed reduction , with complex fracture geometry or open fractures were treated by operative methods. The patients were followed up weekly for the first 3 weeks and than at six weekly intervals to a maximum of 2 year (range 16-26 months) or till the union was achieved. From prospective study 3 patients were lost to follow up and hence excluded from the study. Functional outcome was assessed by Modified Stewart and Hundley (1955) criteria. Results Out of 100 patients there were [44 A fractures (A1-13, A2-9, A3-22), 36 B fracture (B1 26, B2 9, B3 1), and 20 C fractures (C1-15, C2-4, C3-1 ) ] .Out of these 14 fractures were associated with open injury (2 grade I , 4 grade II , 4 grade IIIA , 3 grade IIIB ,1 grade IIIC) . 46 cases treated conservatively united at 24 weeks(15.65 weeks) and 54 patients which were treated by different modalities united at 36 weeks( Ex fixator), 22 weeks(Nail), 20.3 weeks(Plate and screws ). Good results were obtained in 100% by velpeau dressing in children, 85% by U slab, 50% by plate and screws and 33.3% with nailing. There were postoperative complications like infection (6%),radial nerve palsy (2%) and non-delayed union(5-6%) . Conclusion Conservative management is method of choice in management of closed diaphyseal fractures of humerus as it gives early union, better limb function and is devoid of any of the routine postoperative complications. Patients with failed conservative treatment, open fractures and fractures with complex geomatry are better managed operatively. ORIF with plate and screws has proven to be better than nailing procedures in present series in terms of giving better functional outcome. Patients treated with external fixator had mostly fair and poor outcome as injuries dealt by them were open type III injuries.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"160 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133000503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unusual segmental fracture of the clavicle associated with rib fractures and pneumothorax","authors":"N. Osman, C. Sinopidis, L. Gibson","doi":"10.5580/897","DOIUrl":"https://doi.org/10.5580/897","url":null,"abstract":"Segmental fracture of the clavicle is an extremely rare injury with only 4 cases being previously published in the English literature. We report an unusual case of a segmental clavicle fracture associated with ipsilateral rib fractures and pneumothorax. The available literature is also reviewed and the management of these injuries is discussed.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129727635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Posterior Shoulder Fracture-Dislocation – A Diagnostic Challenge.","authors":"A. M. Trollegaard, M. Nygaard, B. L. Madsen","doi":"10.5580/14b6","DOIUrl":"https://doi.org/10.5580/14b6","url":null,"abstract":"A case of bilateral posterior shoulder fracture-dislocations following an epileptic seizure due to chronic alcohol abuse is described. The fracture-dislocations were missed primarily and were interpreted clinically as hemiparesis of the right arm with no damage to the left shoulder before they were diagnosed and treated firstly with closed reduction and later by open reduction and internal fixation. Treatment was operative with bilateral interlocking plates followed by bandaging with loose slings for four weeks with subsequent active physiotherapy. Results at follow-up after 38 weeks were excellent with Constant Shoulder Scores of 51/47 and no redislocations occurring.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"103 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115670431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Limited Dynamic Compression Plate Fixation In Acute Diaphyseal Fractures Of The Radius And Ulna – A Prospective Study","authors":"Sukhjeet Singh, Shabir Hassan Rawa, N. Muzaffar, M. Musa, M. Wani, Sudesh Sharma","doi":"10.5580/109a","DOIUrl":"https://doi.org/10.5580/109a","url":null,"abstract":"Aim: The aim of the present study is to evaluate the results of diaphyseal fractures of forearm bones treated by limited contact dynamic compression plating. Materials and methods: Twenty five patients with displaced diaphyseal fractures (closed and type1 compound) of forearm bones, both radius and ulna were managed by open reduction and internal fixation with limited contact dynamic compression plating (LC-DCP) from June 2003 to December 2005 with an average follow up of 18 months. There were 20 males and 5 females with a mean age of 32.9 years. The average interval from injury to surgery in our series was 5.8 days (3-16days). Road traffic accident was the most common mode of injury (64%). Pathological fractures were excluded. Average time of union was 13.6 weeks, 1 fracture united at the end of 28 weeks. Results: Complete radiological and","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"4 6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128915609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postherpetic Neuralgia: A Review","authors":"B. Jericho","doi":"10.5580/2684","DOIUrl":"https://doi.org/10.5580/2684","url":null,"abstract":"Postherpetic neuralgia, a complication of herpes zoster, is a neuropathic pain syndrome which results from a combination of inflammatory and viral damage to primary afferent fibers of sensory nerves. Postherpetic neuralgia is often diagnosed when pain persists in a dermatomal pattern weeks after the herpes zoster vesicular eruption has healed. The pain of postherpetic neuralgia can be debilitating, severely affecting patients’ quality of life. Unfortunately, no treatment has been shown to completely prevent postherpetic neuralgia, yet some treatments may shorten the duration or lessen the severity of symptoms. The pathophysiology, incidence, epidemiology, and treatment options for postherpetic neuralgia are presented.","PeriodicalId":322846,"journal":{"name":"The Internet Journal of Orthopedic Surgery","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133722285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}