[Dynamic correction of scapholunate instability using an ECRL tendon strip and a free PL interponat]. / Dynamische Stabilisierung des Skaphoids mit Extensor carpi radialis longus-Sehnenstreifen und freiem Palmaris longus-Sehneninterponat bei skapholunärer Instabilität.

The present article describes our technique of correction of static reduceable scapholunate instability.

Septic arthritis due to Legionella cincinnatiensis: case report and review of the literature.

Legionella spp. are an important cause of pulmonary and rarely extrapulmonary infections. L. cincinnatiensis has only been implicated in five cases to date. We herein report the first case of L. cincinnatiensis septic arthritis in a 90-year old lady with a past medical history of chronic kidney disease. She developed septic arthritis of her left wrist after having received intraarticular corticosteroid injections and oral corticosteroids administered for presumed chondrocalcinosis. Appropriate antimicrobial treatment of L. cincinnatiensis septic arthritis was delayed until identification of this organism in joint biopsies by broad-range bacterial PCR targeting the 16S rRNA gene with subsequent rDNA sequence analysis and by culture on special media. Reviewing all reported cases of septic arthritis caused by Legionella spp. other than L. cincinnatiensis it is notable that diagnosis was established by PCR in the majority of cases and only subsequently confirmed by special culture. Although most patients were immunosuppressed, outcome was favourable. Treatment consisted of a fluoroquinolone alone or in combination with rifampicin or a macrolide. Our case highlights the need for a high index of suspicion for infections with unusual/fastidious organisms when symptoms are suggestive of septic arthritis but conventional methods fail to identify a causative organism.

Quality of life and outcome after treatment of ruptured cerebral aneurysms: results of a single center in Switzerland.

OBJECT: To evaluate the subjective outcome and quality of life (QoL) of patients who suffered from aneurysmal subarachnoid hemorrhage and underwent endovascular coiling or microsurgical clipping in a single center. METHODS: For this retrospective single-center study, we included patients who underwent aneurysm occlusion at the Cantonal Hospital of Aarau between January 2000 and December 2006. The QoL, the functional status, and the level of independence were assessed by means of the Short Form (SF)-12 Health Survey, the modified Rankin Scale (mRS), and the Barthel Index. The questionnaires were sent to and completed by the patients. A total of 104 patients with a mean age of 53.14 years (range, 18-80 years) were included in the study. In 63 (60.6 %) of the cases, the aneurysm was clipped; in 41 (39.4 %) of the cases, endovascular coiling was performed. RESULTS: The SF-12 scores for the PCS (Physical Component Summary) and MCS (Mental Component Summary) were similar for both clipped (PCS 45.35; MCS 46.55) and coiled (PCS 46.31; MCS 47.87) patients. The mean values were, on average, 4.17 points lower for the PCS and 2.79 points lower for the MCS when compared with the mean of the US population, with a mean of 50 (standard deviation (SD) 10). The mean Barthel Index for the entire group was 92.26 (SD 16.8) and was almost identical for both the clipped (92.54; SD 16.21) and coiled (91.83; SD 17.9) patients (p = 0.56). The mean mRS did not differ between the coiled and clipped patients (coiled 1.63; clipped 1.56; p = 0.97) CONCLUSIONS: There were no significant differences in the functional and mental health scores between the two groups of clipped and coiled patients who were treated at our center, but both groups were lower than population-based scores. Although the neurologic condition and the imaging results on admission were worse in the coiled group, the long-term results did not differ significantly.