Implant-Related Complications Do Not Interfere with Corrections with the Shilla Technique in Early Onset Scoliosis: Preliminary Results.

Growth-preservation techniques are utilized in early onset scoliosis (EOS) cases requiring surgical intervention. The Shilla technique corrects the deformity by reducing additional surgeries with its growth-guidance effect. As with other techniques, various problems can be encountered following the administration of the Shilla technique. The aim of this study was to examine the effect of complications encountered with the Shilla treatment on correction and growth. Sixteen patients with a follow-up period of at least one year after receiving Shilla growth guidance for EOS were included in this retrospective study. No complications occurred, and no unplanned surgery was required in 50% of the cases. Of the remaining eight patients with postoperative implant-related complications (50%), six (37.5%) required unplanned surgery; this consequently caused implant failure in the proximal region in five cases (31.25%) and deep tissue infection around the implant in one case (6.25%). Deformity correction, spine length, and quality-of-life scores significantly improved in EOS through Shilla growth guidance. In terms of spinal growth and deformity correction, there were no significant differences between patients with implant-related problems and individuals without occurrences. Although implant-related problems were detected in our dataset and corresponding unexpected surgeries were necessary, these complications had no significant unfavorable influence on correction and spine growth.

Use of cryoablation beyond the prostate.

UNLABELLED: Cryoablation has been used for many years as a surgical ablation technique in the prostate and kidney. However, since the introduction of high-intensity focused ultrasound (HIFU) and robotic surgery for prostate tumours, its popularity in the urologic community has declined. In the early 2000s, innovations in cryoablation technology allowed the use of thinner probes, which were suitable for percutaneous application. As a result, radiologists began using cryoablation, first in the liver, and then in other organs or tissues such as the kidney, lung, breast, pancreas, bone, and soft tissue. In most of these locations, cryoablation has great potential given its inherent advantages, including the use of local anaesthesia, little or no pain during and after the procedure, real-time monitoring of the ablation area on US, CT or MRI, the potential for ablation of large tumours with multiple probes, and the ability to change the shape of the ablation in non-spherical tumours. Yet despite these advantages, the use of percutaneous cryoablation among radiologists appears to be far lower than that of heat-based ablation techniques. The aim of this article is to outline specific aspects of cryoablation and to illustrate its potential clinical applications with case presentations. KEY POINTS: • Recent advances have made cryoablation suitable for percutaneous use by radiologists with image guidance. • Cryoablation has distinct advantages over heat-based ablation techniques. • Cryoablation is becoming increasingly popular for lung, breast, kidney, bone, and soft tissue tumours.

Multiple simultaneous metatarsal stress fractures in the same foot.

Metatarsal stress fractures are common overuse injuries in athletes, military recruits, and ballet dancers, usually occurring in the second, third, and fourth metatarsals, respectively. Such fractures may also occur in a variety of other individuals, regardless of demographic characteristics, sex, or profession, and they are highly associated with excessive activity. Moreover, these types of fractures are usually diagnosed late and have poor outcomes. To our knowledge, there has been only one case report of an individual with stress fractures of all three central metatarsals in the same foot. We describe herein a racehorse training jockey who presented with multiple simultaneous metatarsal stress fractures in the same foot. We also discuss the possible mechanisms by which this entity occurred, as well as its management and outcome.

[Treatment results of pseudarthrosis of the humeral shaft by open reduction and internal fixation with dynamic compression plating]. / Humerus diyafiz psödoartrozlu olgularda dinamik kompresyon plagi ile açik redüksiyon ve internal fiksasyon uygulamasinin sonuçlari.

OBJECTIVES: We evaluated the results of open reduction and internal fixation with the use of dynamic compression plating in patients with pseudarthrosis of the humeral shaft. METHODS: Eighteen patients (12 males, 6 females; mean age 41 years; range 22 to 68 years) with aseptic pseudarthrosis of the humeral shaft were treated by open reduction and internal fixation with the use of a dynamic compression plate following unsuccessful treatment with conservative (n=7) or surgical (n=11) methods. The mean interval between the initial and final treatments was 12.2 months (range 5 t 46 months). Exploration of the radial nerve and autogenous corticocancellous grafting were simultaneously performed in all the cases. Functional results were evaluated according to the Stewart-Hundley's criteria. The mean follow-up was 38.8 months (range 12 to 78 months). RESULTS: Union was achieved in all (94.4%) but one patient within a mean duration of 5.5 months (range 3 to 8 months). Functional results were good in fourteen patients (77.8%), fair in three patients (16.7%), and poor in one patient (5.6%). Radial nerve palsy that occurred in two patients during the early postoperative period underwent spontaneous recovery within three and five months, respectively. Mild reflex sympathetic dystrophy developed in two patients. CONCLUSION: In selected patients with pseudarthrosis of the humeral shaft, the results of open reduction and internal fixation with the use of dynamic compression plating are excellent, provided that an appropriate surgical technique is employed.