ABSTRACT
Plain cervical spine radiographs are the first line investigation in trauma patients to exclude cervical spine fractures and dislocations. Adequate views are essential to reduce the risk of missing diagnoses. Injuries may however not be visible on plain cervical spine radiographs despite adequate views. Additional imaging such as computer tomography scanning is indicated in the event of a normal plain radiograph if there is any clinical suspicion of injury.
Subject(s)
Cervical Vertebrae/injuries , Joint Dislocations/diagnostic imaging , Spinal Fractures/diagnostic imaging , Adult , Cervical Vertebrae/anatomy & histology , Cervical Vertebrae/diagnostic imaging , Humans , Male , Radiography/methods , Tomography, X-Ray ComputedABSTRACT
The distal radius and its articulations clearly have a vital role in the functional abilities of the hand and wrist. The treatment of tumours of the radius, therefore, needs to achieve satisfactory clearance of the lesions while also preserving as much wrist function as possible. We have employed osteoarticular autologous fibula grafts to reconstitute the distal radius after tumour excision. Since 1992, 13 patients have been treated by this technique for tumours of the distal radius. The group comprised patients with primary and recurrent giant cell tumours of bone, osteosarcoma, chondrosarcoma and Ewing's tumour. This technique achieves a satisfactory functional result without compromise of the prognosis for the tumour.
Subject(s)
Bone Neoplasms/surgery , Fibula/transplantation , Radius , Wrist Joint/physiopathology , Adult , Aged , Bone Neoplasms/diagnostic imaging , Bone Neoplasms/physiopathology , Chondrosarcoma/surgery , Female , Giant Cell Tumors/surgery , Humans , Internal Fixators , Male , Middle Aged , Osteosarcoma/surgery , Radiography , Sarcoma, Ewing/surgery , Treatment OutcomeABSTRACT
We have retrospectively reviewed the results of 40 consecutive patients with nonunion of the scaphoid treated by the senior author (PG) between 1993 and 1996. These comprised two groups of patients. Group 1 comprised 20 patients treated between 1993 and 1994, with a Herbert screw and autograft, and Group 2, which also comprised 20 patients treated with the precision bone grafting technique which we describe. The precision bone grafting technique employs simple instrumentation to harvest bone percutaneously from the iliac crest and then insert it at the scaphoid nonunion site. The evaluation consisted of a clinical and radiological assessment of union and wrist function. Our review demonstrates a higher rate of union with the precision bone grafting technique than by the Herbert screw fixation with bone grafting.