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Background: We surgically treated comminuted radial head and neck fractures using headless compression screws, including multiple screws for the radial head and a single oblique screw for the radial neck. This study aimed to compare the clinical and radiological results for comminuted radial head and neck fractures between surgery using headless compression screws with a single oblique screw for the radial neck, our new procedure, and a plate system precontoured to the proximal radius. Methods: This retrospective study included 23 patients (11 and 12 in the screw and plate groups, respectively). The fractures were type 3 according to the Mason-Johnston classification modified by Broberg and Morrey. Clinical outcomes analyzed included the motion range of the elbow and forearm, Mayo Elbow Performance Score, and radiological assessments. In addition, postoperative complications were also investigated. The average follow-up was 18 months. Results: The bone union was achieved in all the patients, and there were no significant differences in clinical outcomes and radiological assessments except forearm supination (p = 0.02). Furthermore, additional surgical procedures were performed in one and five patients in the screw and plate groups, respectively (p = 0.16). Posterior nerve palsy was observed in two patients in the plate group. Complications were observed in one and six patients in the screw and plate groups, respectively (p = 0.07). Conclusion: Both surgical procedures achieved good clinical and radiological outcomes with bone and ligament injury repair. The screw group had a greater range of forearm supination than the plate group.
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Calcaneal osteomyelitis (CO) is considered to be difficult to cure when it turned into a chronic phase. We report one case of calcaneal osteomyelitis which arises after the operation of calcaneal fracture. Remission was obtained by performing curettage of the infected cancellous bone of the calcaneal body and filling antibiotic-containing calcium phosphate cements (CPC) within its bone defect. This one-stage surgery is useful to treat calcaneal osteomyelitis.
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BACKGROUND: Recent innovations in facial nerve reconstruction procedures or 'restoration of facial expression', extremely important in patients' social activities, have provided some interesting findings. However, there has been little discussion of immediate facial nerve reconstruction following resection of a parotid carcinoma. In this article, details of our techniques and the concepts are presented. METHODS: Ten patients underwent immediate facial nerve reconstruction following resection of a parotid carcinoma, with thorough 'recipient bed preparation', between October 2003 and October 2009. Postoperative radiotherapy was administered to seven cases, with an average radiation dosage of 55 Gy. Nerve reconstruction was performed using a sural nerve graft and either method 1, using a sternocleidomastoid and platysma muscle flap or method 2, using a pectoralis major muscle flap. RESULTS: Method 1 was used in six cases, and method 2 in four. Postoperative function was House Brackmann (HB) grade II in two cases, grade III in seven, grade IV in one and unassessable in one. Average Sunnybrook facial grading score was 50. No complications, such as contour deformity or Frey syndrome, were detected. CONCLUSIONS: We performed immediate facial nerve reconstruction following resection of parotid tumours with the emphasis on recipient bed preparation using a muscle flap, achieving the following objectives: (1) stable facial nerve reconstruction; (2) avoidance of contour deformity; and (3) prevention of Frey syndrome. We believe this is an extremely useful method, technically easy to perform and provides stable results.
