ABSTRACT
We report the case of a 93-year-old patient with bilateral Mac Kee-Farrar hip arthroplasties implanted 34 years ago. The patient was seen in 2005 for a type B1 periprosthetic fracture on the right prosthesis implanted in 1973. There was no loosening and the fracture was treated by plate fixation. Before the fracture, the Postel-Merle d'Aubigné (PMA) score was 16 on both sides, with a Devane activity score grade 2. At last follow-up, the PMA score was 13 for both hips, with a Devane activity score grade 1. Serum cobalt level was 1.36 microg/L (normal <1 microg/L). This exceptional case is to our knowledge the longest observed with this implant without clinical or radiographic signs of loosening. The serum cobalt level, rarely assayed after more than 30 years, was within the limits accepted for a metal-on-metal hip bilateral arthroplasty. We discuss the causes of failure and success of the Mac Kee-Farrar implant as reported in the literature and remark that long survival of the metal-on-metal bearing can occasionally be observed without signs of wear. Recent works on the metal-on-metal bearing merit attention.
Subject(s)
Arthroplasty, Replacement, Hip/methods , Hip Prosthesis , Aged, 80 and over , Female , Follow-Up Studies , Humans , Prosthesis Design , Time FactorsABSTRACT
For 3 months, we carried out studies of 65 patients with chronic low back pain due to accidents at work. The financial compensation is often low for these patients. The reasons are: they will only compensate for spinal stiffness (without any neurological complications) and minus any previous pathology. Therefore, it would appear that the management of these patients must be particular and specific.
Subject(s)
Accidents, Occupational , Low Back Pain , Workers' Compensation , Adult , Disability Evaluation , Female , Fractures, Bone , France , Humans , Male , Middle Aged , Orthopedics , Wrist InjuriesABSTRACT
The operative management by coracoid graft transfers in the recurrent dislocations of the shoulder and the frequent shoulder arthroscopies could be the source of lesions to the musculocutaneous nerve. Although rarely mentioned in articles, these complications certainly exist. The precise topography of this nerve does not seem to be well known by surgeons. Consequently, we returned to the anatomic study of the nerve with its variations and their relationship to the external terminal anomalies of the brachial plexus.
Subject(s)
Musculocutaneous Nerve/injuries , Shoulder/surgery , Arthroscopy/adverse effects , Humans , Intraoperative Complications , Musculocutaneous Nerve/anatomy & histologySubject(s)
Accidents, Occupational , Insurance, Health , Rehabilitation, Vocational/economics , Social Security , France , HumansSubject(s)
Arm/abnormalities , Abnormalities, Multiple/epidemiology , Adolescent , Adult , Arm/surgery , Artificial Limbs , Child , Child, Preschool , Ectromelia/epidemiology , Female , Humans , Infant , Infant, Newborn , Male , ParisABSTRACT
A case of jaundice is reported, which was eventually ascribed to TAO alone, once infectious, viral, neoplastic . . . causes were outruled. For specific reasons, high doses of this antibiotic had been required. The physiopathology is discussed; allergy is dismissed. The product's hepatotoxicity in high doses is considered. Although pathological evidence is lacking, this hypothesis is supported by the occurrence of rapid and complete resolution once therapy was discontinued. Specific characteristics of the jaundice are also pointed out: mildness and occurrence after a long interval. This brief paper is by no means designed to disparage TAO, but is meant to monitor, as far as possible, its dosage.
Subject(s)
Jaundice/chemically induced , Troleandomycin/adverse effects , Adult , Dose-Response Relationship, Drug , Humans , Jaundice/diagnosis , Liver/drug effects , Liver Function Tests , Male , Troleandomycin/administration & dosage , Wound Infection/drug therapyABSTRACT
Radiographs taken at an interval of one week showed collapse of the twelfth dorsal vertebra, very suggestive of an eosinophilic granuloma. A biopsy performed during surgery, because of the rapid progression of the lesion, was able to confirm the diagnosis.
Subject(s)
Eosinophilic Granuloma/diagnosis , Thoracic Vertebrae/diagnostic imaging , Child , Eosinophilic Granuloma/complications , Eosinophilic Granuloma/surgery , Female , Humans , Osteolysis/etiology , Radiography , Spinal Diseases/complications , Spinal Diseases/diagnosis , Spinal Diseases/surgery , Thoracic Vertebrae/pathology , Time FactorsSubject(s)
Hip Dislocation/etiology , Hip Prosthesis , Adult , Aged , Female , Hip Dislocation/therapy , Humans , Male , Postoperative Complications/etiologySubject(s)
Femur Head/injuries , Hip Fractures/mortality , Age Factors , Aged , Hip Fractures/surgery , Humans , Intraoperative Complications , Middle Aged , Posture , PrognosisABSTRACT
A case of osteomyelitis due to Salmonella Dublin is reported by the authors who underline the features which distinguish this affection from typhous osteomyelitis, which is completely different.
