Clinical orthopaedics and related research
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Based on a follow-up study of 15 distal femoral epiphyseal fractures, the following conclusions are drawn: Closed reduction with cross pinning of the distal femoral epiphysis provided slightly better results and prevented loss of reduction; angulation deformity, requiring corrective surgery occurred in four patients, two of whom had initial anatomical reductions; significant leg length inequality was not seen; abduction injuries of the distal femoral epiphysis are not uncommon in teenage football players.
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Clin. Orthop. Relat. Res. · Mar 1976
Case ReportsGiant synovial cyst of the calf and thigh in a patient with granulomatous synovitis.
A giant synovial cyst with granulomatous synovitis was removed from the thigh and calf in an 80-year-old woman. The lesion included necrotizing, epitheloid cell granulomata with Langhans' type giant cells. ⋯ The treatment consisted of synovectomy and total knee arthroplasty with an uneventful recovery. A giant calf cyst, usually associated with rheumatoid arthritis, but in this situation, noted in granulomatous synovitis seems not to have been reported previously.
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Injection of irritant fluid precisely into the facet joint causes referred pain patterns indistinguishable from the pain complaints frequently associated with the "disk syndrome." Even straight leg raising and diminished reflex signs can be obliterated by precise local anesthetic injection into the facet joint. The use of radiographically localized injection of steroids and local anesthetic into the facet joint has been presented as a diagnostic-therapeutic procedure. Clinical experience with a group of 100 consecutive patients suggests that this treatment alone can achieve long-term relief in one-fifth of the patients with lumbago and sciatica and partial relief in another one-third of these patients. This information suggests that the structures related to the facet joint can be a persistent contributor to the chronic pain complaints of individuals with low back and leg pain.
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Sea urchin spine injury is usually a benign process that rarely comes to the attention of a physician. Aside from the transient episode of excruciating pain which responds dramatically to hot water soaks, there is usually no residual disability. As in any puncture wound, tetanus prophylaxis and observation for latent infection is advised. ⋯ Cases are reported herein of the latter two problems occurring in the hand. A case of a neuropathy associated with sea urchin injuries has not been previously reported in the literature. When such injuries necessitate exploration, aseptic surgical technique is required.
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Clin. Orthop. Relat. Res. · Jul 1975
Combined staged anterior and posterior correction and fusion of the spine in scoliosis following poliomyelitis.
The problems with severe forms of scoliosis following poliomyelitis include the associated muscle imbalance, soft tissue contractures and pelvic obliquity. Such deformities militate against optimal correction and maintenance of that correction and their treatment is often marred by pseudarthroses. Seventeen patients with an average curve of 93 degrees have been treated and followed for up to 38 months. ⋯ No pseudarthroses were seen when the Harrington rod was used. Great care must be taken if halo-pelvic traction is to be used for patients with pelvic obliquity, for preliminary correction halo-femoral traction will often be adequate. In the more severe forms of paralytic scoliosis a combined staged anterior and posterior correction and fusion should be considered if the aim is maximal correction of the scoliosis and avoidance of pseudarthroses.