Orthopedics
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Sixty-six patients underwent posterior lumbar interpositional arthroplasty using a combination of calcium sulfate pellets, decompression bone, and autologous growth factors. Patients who underwent this modification of the soft posterior lumbar interbody fusion (PLIF) (Jones technique) were evaluated using clinical and radiographic ratings. ⋯ Furthermore, 93% of patients achieved at least 50% opacity of the disk space area. The Jones technique for the soft PLIF provided reduction of pain and stabilized the disk space height in addition to decreasing morbidity and cost.
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This study assessed patient experiences with interscalene block anesthesia for elective shoulder surgery. Routine use of interscalene anesthesia was introduced at our institution in 1997. All patients who underwent interscalene anesthesia during the first 3 years of our experience with this regional anesthetic technique were asked to respond to an anesthesia-related questionnaire. ⋯ The duration of pain relief postoperatively was 10.5 hours for patients with a successful block. Patients consistently reported that having an interscalene block was less painful than anticipated; 90% said they would have interscalene anesthesia again for shoulder surgery. This study demonstrates that interscalene anesthesia for elective shoulder surgery is safe and well accepted in this patient population.
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This article presents a retrospective review of the treatment of coccygodynia. The past 5 years of conservative treatment for coccygodynia were reviewed, including local injection. The results were evaluated. ⋯ The results of conservative treatment with local injection for coccygodynia appear to be successful. However, no other historical literature exists to compare these results. The results of coccygectomy for coccygodynia were also highly successful, and the success rate compares favorably to previous historical data in the literature.
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The medical records and radiographs of 63 patients, who were admitted between 1989-1997, with a combined femur fracture, were reviewed. Associated injuries were present in 38 (60%) patients. The combined fractures were classified into four major types depending on their anatomical position: type I, femoral shaft fracture combined with hip neck fracture; type II, femoral shaft fracture combined with a trochanteric fracture; type III, femoral shaft fracture combined with a distal femur fracture; and type IV, femoral shaft fracture combined with a proximal or distal femur fracture. ⋯ Fifty-six fractures healed without further operations. Of the remaining 6 fractures, 2 were material failures, 1 malunion with 3-cm shortening and external rotation of the femoral diaphysis, 2 early infections of the surgical wound, and 1 pseudarthrosis of the femoral shaft. All fractures were healed between 16 and 32 weeks (average: 20 weeks).