RESUMEN
Numerous techniques have been described for the arthrodesis of various forefoot and midfoot joints. These techniques include the use of plates, screws, wires, staples, and Steinman pins. The ease of the dorsal approach in instituting these techniques has persuaded most orthopaedic surgeons to instrument the dorsal, or compression, side of the arthrodesis. By instrumenting the compression side, the deforming forces of the arthrodesis may cause distraction on the plantar side. The use of the tension band technique in foot arthrodeses changes the plantar distraction forces to a compressive force without necessitating the exposure of the plantar surface.
Asunto(s)
Artrodesis/métodos , Articulaciones Tarsianas/cirugía , Fenómenos Biomecánicos , Hilos Ortopédicos , Antepié Humano/cirugía , HumanosRESUMEN
The authors study the literature and the surgical treatment in chronic nonrheumatoid cases. Their technique employs one-half of the extensor digitorum communis tendon as a tether on the central extensor tendon, recentralizing it over the metacarpophalangeal joint.
Asunto(s)
Luxaciones Articulares/cirugía , Articulación Metacarpofalángica , Tendones , Adulto , Anciano , Anciano de 80 o más Años , Artritis Reumatoide/complicaciones , Enfermedad Crónica , Femenino , Humanos , Artropatías/etiología , Artropatías/fisiopatología , Artropatías/cirugía , Luxaciones Articulares/etiología , Luxaciones Articulares/fisiopatología , Lupus Eritematoso Sistémico/complicaciones , Articulación Metacarpofalángica/fisiopatología , Persona de Mediana Edad , Rango del Movimiento Articular , Rotura EspontáneaRESUMEN
We measured femoral anteversion by the Kingsley-Olmsted method in 24 unpaired, dry femurs. When the head and neck of the same femurs were measured by computed tomography (CT) scan, measurement was 5 degrees less than the Kingsley-Olmsted method, whereas ultrasound of the head and neck was 5 degrees higher. An anterior flat plane was also defined to help measure anteversion in patients with a high neck shaft angle. Physical and ultrasound measurement correlated well with the previous measurement by the Kingsley-Olmsted method and CT scan of anteversion. Although measurement by CT scan and ultrasound are different their results are both reproducible and measure the same parameters; however, ultrasound measurement yields a number approximately 10 degrees higher.
Asunto(s)
Fémur/anatomía & histología , Antropometría , Fémur/diagnóstico por imagen , Cabeza Femoral/anatomía & histología , Cabeza Femoral/diagnóstico por imagen , Cuello Femoral/anatomía & histología , Cuello Femoral/diagnóstico por imagen , Humanos , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
Trigger thumb in children is an uncommon condition. We reviewed 41 patients with 53 trigger thumbs. Although the current accepted approach to the treatment of congenital trigger thumbs is a prolonged period of observation, our findings indicate that all of our patients eventually required surgical release of the flexor pollicis longus tendon. Waiting 3 years before a surgical release was done did not affect the surgical result.
Asunto(s)
Tenosinovitis/cirugía , Pulgar/cirugía , Niño , Preescolar , Diagnóstico Diferencial , Femenino , Humanos , Lactante , Masculino , Estudios Retrospectivos , Tenosinovitis/diagnóstico , Tenosinovitis/epidemiologíaRESUMEN
A review of the recent orthopaedic literature reveals little information on the endocrinopathic associations of polyostotic fibrous dysplasia. This article illustrates the need for endocrinologic evaluations at both initial diagnosis and at follow-up examinations. Two patients with polyostotic fibrous dysplasia and acromegaly are presented. In both cases, diagnosis was made by endocrinologic and radiographic evaluations, including computed tomography (CT) scan of the skull. One patient had pituitary macroadenoma, and the other had pituitary microadenoma. Irradiation therapy was performed successfully in both patients without any complications.
Asunto(s)
Acromegalia/complicaciones , Displasia Fibrosa Poliostótica/complicaciones , Acromegalia/diagnóstico , Adulto , Displasia Fibrosa Poliostótica/sangre , Displasia Fibrosa Poliostótica/diagnóstico , Hormonas/sangre , Humanos , Masculino , Pruebas de Función Adreno-HipofisariaRESUMEN
A simple and efficient method of achieving and maintaining reduction of a boxer's fracture (neck of the fifth metacarpal) is described. This method can be implemented during drying of the plaster splint, and adequate roentgenograms can be taken without the presence of redundant plaster over the fracture site found with the traditional ulnar gutter splint.
Asunto(s)
Fracturas Óseas/terapia , Metacarpo/lesiones , Férulas (Fijadores) , Moldes Quirúrgicos , HumanosRESUMEN
A retrospective review was performed on 28 patients with low-velocity gunshot wounds to the cervical spine. These composed 31% of all spinal gunshot wounds seen during the study period between 1979 and 1988. Surgical decompression did not seem to improve neurologic recovery in either the incomplete or complete patients. Neurologic recovery also appeared to be unaffected by the presence of retained intracanal bullet fragments. The authors found no advantage to routine neck exploration of this penetrating injury. Complications were seen in 93% of the patients. Most complications were thromboembolic, pulmonary, and urinary tract infections. No cases of instability occurred as a direct result of the gunshot wound. No deaths occurred in this series. Two cases of posttraumatic syrinxes were diagnosed. The authors' current treatment recommendations for these patients include selective wound management and observation of retained intracanal bullet fragments in patients with complete lesions. Surgical decompression after this injury is not recommended.