RESUMO
Modern day fast bowling places immense strain on the spine. Stress fractures of the lumbar region are common. If a period of conservative treatment fails to return a fast bowler to professional sport, surgery is considered. Good results have been reported using a direct screw repair of the spondylolytic defect. A case is presented of a failed surgical intervention with an alternative technique.
Assuntos
Traumatismos em Atletas/cirurgia , Vértebras Lombares/cirurgia , Espondilólise/cirurgia , Adulto , Fraturas de Estresse/cirurgia , Humanos , Masculino , Fraturas da Coluna Vertebral/cirurgia , Fusão Vertebral , Falha de TratamentoRESUMO
The physical demand of the modern game of cricket on the fast bowler is known to cause stress fractures of the lumbar spine. Between 1983 and 2001, we diagnosed pars interarticularis defects in 18 professional cricketers contracted to a single English County Cricket Club. Eight of these players were treated conservatively, with rest, supervised rehabilitation, bowling action analysis and re-education where necessary. The remaining 10 were treated operatively, 9 by Buck's repair of the spondylolytic lesion. All 18 players returned to professional sport.We recommend treatment of this select group of sportsmen in a unit consisting of a specialist physiotherapist, a bowling coach and a spinal surgeon. Should conservative measures fail, we recommend Buck's repair as the operation of choice.
Assuntos
Traumatismos em Atletas/reabilitação , Fraturas de Estresse/etiologia , Vértebras Lombares/lesões , Doenças Profissionais/reabilitação , Fraturas da Coluna Vertebral/etiologia , Adolescente , Adulto , Traumatismos em Atletas/diagnóstico por imagem , Traumatismos em Atletas/cirurgia , Seguimentos , Fixação de Fratura/métodos , Fraturas de Estresse/diagnóstico por imagem , Fraturas de Estresse/reabilitação , Humanos , Vértebras Lombares/diagnóstico por imagem , Masculino , Doenças Profissionais/cirurgia , Modalidades de Fisioterapia , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas da Coluna Vertebral/reabilitação , Tomografia Computadorizada por Raios XRESUMO
A prospective, randomised and independently assessed trial of the Ring UPM total hip replacement showed that the quality of the early result was better if the femoral prosthesis was cemented than if it was not. More patients with cemented prostheses were painfree at four months (58% cemented:42% uncemented) and at one year (63% cemented:50% uncemented), but at two years pain relief was equal in both groups. At two years significantly more patients with cemented prostheses could walk without support (96% cemented:62% uncemented, p = 0.01 to 0.05). There is a need for more similar trials to compare the results of contemporary designs of cemented and uncemented total hip prostheses.
Assuntos
Prótese de Quadril , Metilmetacrilatos , Osteoartrite do Quadril/cirurgia , Atividades Cotidianas , Idoso , Artroplastia/métodos , Feminino , Humanos , Locomoção , Masculino , Pessoa de Meia-Idade , Dor , Estudos Prospectivos , Desenho de PróteseRESUMO
We report the clinical and operative details of seven cases of fracture of the femoral stem of the Ring TiMESH cementless hip prosthesis (two were cemented and five uncemented). Six fractures occurred in the proximal one-third of the stem and one at mid-stem. The failures are attributed mainly to two defects in stem design, the narrowness of the anteroposterior dimensions and the depth of the recess for the titanium mesh pads. Great difficulty was experienced in removing the osseo-integrated distal fragments of the broken stems.
Assuntos
Prótese de Quadril , Fenômenos Biomecânicos , Cimentos Ósseos/uso terapêutico , Articulação do Quadril/diagnóstico por imagem , Prótese de Quadril/estatística & dados numéricos , Humanos , Incidência , Teste de Materiais , Desenho de Prótese , Falha de Prótese , Radiografia , Fatores de Tempo , TitânioRESUMO
In a five-year period, 153 feet in 101 patients were treated by a Wilson's osteotomy of the first metatarsal for hallux valgus. Postoperative support was provided by either a below-knee or a forefoot plaster, and was continued for either three weeks or six weeks. The results showed overall success in 91% with no significant difference between the four groups. We suggest that a forefoot plaster for three weeks is adequate support after a Wilson's osteotomy.
