Very rare aetiology of giant popliteal pseudoaneurysm: anterior cruciate ligament surgery.

There are various causes of the formation of arterial pseudoaneurysms, including trauma, surgical procedures, infection and iatrogenic injuries. A popliteal aneurysm was detected in a patient with pain and discomfort in his leg. The patient had a history of knee surgery. The aneurysm was treated surgically. Aneurysms following penetrating arterial injury resulting from surgical intervention requiring the use of surgical devices is one of the possible traumatic causes.

Prognosis of wrist ganglion operations.

A retrospective study was conducted to evaluate the results of treatment of 40 wrist ganglia operated under local anesthesia over four years. The mean follow-up period was 27 months (range 6-48 months). There were 24 dorsal and 16 volar ganglia. The mean complication rate was 56% for volar ganglia, 12.5% for dorsal ganglia, and the difference was significant (p < 0.05). The recurrence rates were 31.2% and 8.3%, respectively (mean 17.5%). There was evidence of nerve damage to the superficial branch of the radial nerve in one patient (dorsal cyst) and to the palmar cutaneous branch of the median nerve in two patients (volar cysts). The mean nerve injury rate was 7.5%. In two patients with volar ganglia, the palmar superficial branch of the radial artery was lace-rated and had to be ligated. The significantly higher complication rate after excision of volar ganglia in contrast to dorsal ones might indicate that the former should be approached more carefully in contrast to dorsal ones and preferably by a senior surgeon.

Effects of diclofenac and intra-articular morphine/bupivacaine on postarthroscopic pain control.

BACKGROUND: This study was undertaken to compare analgesic effects and requirements for supplemental analgesic therapy after knee arthroscopy in patients given intraarticular morphine/bupivacaine, diclofenac i.m., or both compared with placebo. METHOD: In a randomised, double-blind controlled trial 40 patients were divided into four groups. Patients received 25 ml of 0.25% bupivacaine and 2 mg of morphine intraarticularly in group I, 75 mg of diclofenac i.m. in group III, the combination of 75 mg of diclofenac i.m. and 25 ml of 0.25% bupivacaine and 2 mg of morphine intraarticularly in group II, and placebo in group IV. Postoperative analgesia was provided with fentanyl in the recovery room and acetaminophen was given for subsequent pain relief. RESULTS: In the postoperative period, VAS scores for pain were highest in the placebo group, whereas they were lowest in the combination group. VAS scores were significantly lower in group I and II than group IV at the postoperative 2nd hour (p < 0.05). VAS score was significantly lower in group II than groups III and IV at the postoperative 3rd hour (p < 0.01). VAS scores were significantly lower in group I, II and III than group IV at the postoperative 6th hour (p < 0.05). Fentanyl consumption was significantly lower in group II than group IV (p < 0.05). Acetaminophen consumption in groups II and III were significantly lower than group IV (p < 0.05). CONCLUSION: The combination of diclofenac i.m. and intraarticular morphine/bupivacaine appears to be the most beneficial analgesic combination due to its lower VAS scores and supplemental analgesic requirements in the postoperative period.

Visualization of bone pathologies and lung cancer with 99mTc-glucose phosphate: a comparative study.

Glucose phosphate (GP) labelled with 99mTc was used to obtain scintigraphic images of bone lesions in one group of patients (n = 28) and of lung tumors in another (n = 35). All bone lesions detected by 99mTc-MDP were also demonstrated by 99mTc-GP; all lung tumors except 4 were detected by 99mTc-GP, the failure rate being about the same as that for 67Ga. The use of 99mTc-GP is preferable to that of 99mTc-MDP because the former does not accumulate in normal bone; the advantage of 99mTc-GP over 67Ga lies in its better physical characteristics and in the fact that the result of the study is available within a few hours rather than three days.