[Final results after operative treatment of shoulder joint infections]. / Endergebnis nach operativer Behandlung von Schultergelenksinfekten.

PURPOSE: In a consecutive case series the results of operative treatment of patients with shoulder joint infections following rotator cuff surgery, endoscopic subacromial decompression or subacromial injection were studied. PATIENTS AND METHODS: Between 1990 and 2001 26 patients developed a postoperative infection. 24 patients were available for a mean follow-up of 4.3 (1-12) years. The mean age of the study group was 59.8 (28-84) years. Patients were divided into three groups. Group I consisted of 9 patients with infection after rotator cuff repair, group II consisted of 4 patients with infection after endoscopic subacromial decompression and there were 11 patients in group III with an infection that developed following subacromial injection. Patient evaluation was done according to the Constant and ASES Scores, the SF-36 and a visual analogue scale (VAS) for postoperative pain and satisfaction. RESULTS: The mean postoperative Constant Score was 68.6 pts (SD 25.1) in group I, 84.6 pts (SD 10.4) in group II and 75.6 pts (SD 25.1) in group III. The mean ASES-Score was 65.6 pts (SD 30.0) in group I, 69.8 pts (23.6) in group II and 78.5 pts (SD 25.7) in group III. The SF-36 showed for the summarized physical scale 37.3 pts (SD 12.6) in the first, 39.8 pts (SD 5.8) in the second and 37.7 pts (SD 12.4) in the third group and for the summarized psychometric scale 40.4 pts (SD 2.7) in the first, 44.3 pts. (SD 10.8) in the second and 45.7 pts. (SD 10.1) in the third group. For the VAS for pain, group I had 4.3, group II 4.0 and group III 2.5 pts Patient satisfaction showed similar results with 6.4 pts in the first, 6.5 pts in the second and 6.8 pts in the third group. CONCLUSION: Considering the functional results of operative revision, infection of the shoulder joint following rotator cuff surgery, endoscopic subacromial decompression or subacromial injection is a rare but severe complication.

Artificial spine fractures: detection with helical and conventional CT.

PURPOSE: To compare the accuracy of detection of artificial spine fractures with helical computed tomography (CT) versus conventional CT. MATERIALS AND METHODS: Twenty-six motion segments from 15 human cadaver thoracolumbar spines were imaged with helical and conventional CT both before and after fractures were artificially induced. The vertebrae were scanned with different collimations, reconstruction indexes, and exposure doses. A total of 900 images were analyzed by four radiologists, and a receiver operating characteristic (ROC) analysis was performed. RESULTS: ROC analysis showed a large area under the curve for conventional CT (0.913) than for helical CT (0.844) when 3-mm collimation was used. The ability to detect fractures with helical CT increased when collimation was decreased and exposure dose was increased. CONCLUSION: Conventional CT allows more accurate detection of artificial spine fractures than does helical CT. Helical CT requires thinner collimation for fracture detection comparable with that of conventional CT.