RESUMEN
INTRODUCTION: The purpose of the study was to assess the efficacy of the dorsal closing wedge osteotomy for the treatment of Freiburg's infraction. MATERIAL AND METHODS: Twenty patients with Freiburg's infraction were admitted at our hospital over a period of six years. Patients with a normal plantar contour of the metatarsal head were included. All patients underwent a dorsal closing wedge osteotomy of the metatarsal. RESULTS: The mean Leeds Movement Performance Index (LMPI) score was 84 (range 70-86). The mean metatarsal shortening was 2mm. the passive flexion restriction was 16° and extension restriction was 10°. Also, a strong negative correlation was found between Smillie classification and American Orthopaedic Foot and Ankle Score (AOFAS) final score (r's = -0.85, P < .001). CONCLUSION: The dorsal closing wedge osteotomy is an efficient and reproducible method for the management of Freiburg's infraction.
RESUMEN
Ipsilateral fractures of the femoral neck and trochanter are uncommon. We report a 30-year-old man with a T-shaped fracture separating the trochanter and neck from the head. He underwent osteosynthesis using a dynamic compression plate, screws, and pins. Bone union occurred 4 months postoperatively. At the one-year follow-up, the patient was free of pain and had no evidence of avascular necrosis. It is important to preserve the femoral head in young patients by preventing further compromise of the tenuous blood supply.
Asunto(s)
Fracturas del Cuello Femoral/cirugía , Fijación Interna de Fracturas/métodos , Fracturas de Cadera/cirugía , Accidentes de Tránsito , Adulto , Fracturas del Cuello Femoral/diagnóstico por imagen , Fijación Interna de Fracturas/instrumentación , Fracturas de Cadera/diagnóstico por imagen , Humanos , Masculino , Dispositivos de Fijación Ortopédica , RadiografíaRESUMEN
PURPOSE: To assess the efficacy of acute invaginating docking for infected non-unions of the humerus. METHODS: Eight men and 3 women aged 17 to 59 years with infected non-unions of the humerus underwent acute invaginating docking with shortening and Ilizarov fixation. RESULTS: The mean shortening was 2.9 cm owing to additional debridement. The mean time to external fixator removal was 14.9 (range, 8-28) weeks. The final bone result was excellent in 1, good in 8, and fair in 2. The functional result was excellent in 7 and good in 4. CONCLUSION: This modality enables simultaneous treatment of infected non-unions, axial alignment, vascularity, stability, and function.
Asunto(s)
Enfermedades Óseas Infecciosas/terapia , Fracturas no Consolidadas/cirugía , Fracturas del Húmero/cirugía , Técnica de Ilizarov , Adolescente , Adulto , Enfermedades Óseas Infecciosas/diagnóstico por imagen , Enfermedades Óseas Infecciosas/etiología , Estudios de Cohortes , Desbridamiento , Femenino , Fracturas no Consolidadas/diagnóstico por imagen , Fracturas no Consolidadas/microbiología , Infecciones por Bacterias Gramnegativas/diagnóstico , Infecciones por Bacterias Gramnegativas/etiología , Infecciones por Bacterias Gramnegativas/terapia , Infecciones por Bacterias Grampositivas/diagnóstico , Infecciones por Bacterias Grampositivas/etiología , Infecciones por Bacterias Grampositivas/terapia , Humanos , Fracturas del Húmero/diagnóstico por imagen , Fracturas del Húmero/microbiología , Masculino , Persona de Mediana Edad , Radiografía , Recuperación de la Función , Resultado del Tratamiento , Adulto JovenRESUMEN
Ulnar lengthening is an accepted modality of treatment to achieve joint levelling in Kienbock's disease. The conventional method of ulnar lengthening with a plate and bone graft is fraught with complications including graft site morbidity, non-union, hardware removal and difficulty in the achievement of a proper length. We used a Umex distractor to achieve distraction osteogenesis in a group of 12 patients and assessed them over an average follow-up period of 29.5 months. We had one excellent, ten good and one fair result. We conclude that distraction osteogenesis addresses all the complications of coventional lengthening in addition to providing an increase in the local blood supply, which might be beneficial in a disease that is primarily an avascular necrosis. This procedure addresses both the biomechanical and the biological aspects of this disease.