ABSTRACT
Cases of fibrofatty replacement of the quadriceps muscles following repeated intramuscular injections into the thighs of infants and young children are being reported with increasing frequency. In such cases, the knee shows progressive painless limitation of flexion, habitual dislocation of the patella, or both. The recommended treatment is surgical release, done early before secondary adaptive changes occur in the soft tissues, cartilage, and bones comprising the joint. Full flexion should be obtained at the time of surgery. In children, the lag in extension that follows extensive release will usually disappear spontaneously.
Subject(s)
Injections, Intramuscular/adverse effects , Knee Joint , Muscular Diseases/etiology , Patella/injuries , Child, Preschool , Female , Humans , Infant , Joint Diseases/etiology , Joint Diseases/surgery , Joint Dislocations/etiology , Joint Dislocations/surgery , Male , Muscular Diseases/surgery , Muscular Diseases/therapyABSTRACT
A new method of reduction of shoulder dislocation has been employed in 35 elderly patients with excellent results. The surgeon stands behind the seated patient and inserts his flexed forearm into the axilla of the affected shoulder. His free hand applies traction on the flexed forearm of the patient. The surgeon's forearm pulls in a proximal and lateral direction and levers the head of the humerus into the socket. The method is relatively atraumatic, provides more direct control of the limb and applies more effective forces than the Kocher, Stimson, or hippocratic maneuvers.
Subject(s)
Shoulder Dislocation/therapy , Age Factors , Aged , Humans , Methods , Middle AgedABSTRACT
The clinical experience with silicone rubber arthroplasties has been unremarkable except for sporadic reports of reactive synovitis in the form of a foreign body giant cell inflammation. A 21-year-old man is the first known instance of a large lytic lesion in a bone articulating with a silicone implant.
Subject(s)
Bone Diseases/etiology , Foreign Bodies/etiology , Granuloma/etiology , Joint Prosthesis/adverse effects , Adult , Humans , Male , Radius , Silicone Elastomers/therapeutic use , Wrist Joint/surgeryABSTRACT
Osteonecrosis of the talus secondary to adrenal corticosteroids is rare. The pathophysiology of the disorder is controversial. This is a report of bilateral talar necrosis secondary to steroid medications in a 23-year-old male. Conservative methods of management of the condition are not altogether satisfactory. Bilateral ankle replacement in this case resulted in alleviation of pain and improvement of function.