1/71. erectile dysfunction due to a 'hidden' penis after pelvic trauma.We describe a twenty-six year old patient who presented us with a dorsally retracted 'hidden' penis, which was entrapped in scar tissue and prevesical fat, 20y after a pelvic fracture with symphysiolysis. Penile 'lengthening' was performed by V-Y plasty, removal of fatty tissue, dissection of the entrapped corpora cavernosa followed by ventral fixation.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
2/71. classification and treatment of intercondyloid fractures of the humerus.The authors describe the satisfactory results obtained in sixteen intercondyloid fractures of the humerus, thirteen of which were treated surgically. The preference for surgical treatment in such fractures is based in the assumption that, as in all articular fractures, a good functional result can only be achieved if there is the most perfect possible reconstruction of the fragments and the joint surface. A classification is therefore suggested which is based not purely on anatomical criteria, but is also related to treatment and prognosis. The slendor nature of the distal end of the humerus and the danger of metal reaction call for the use of fixation devices that are efficient but slender, such as fine screws and crossed wires. The precise method of fixation is conditioned above all by the direction of the fracture lines. More solid fixation with early mobilisation can be achieved by compression screws, and less solid fixation with longer immobilisation is achieved by fixation with crossed Kirschner wires. Consequently, the more oblique types of fracture with fragments with long beaks that allow more stable fixation with compression screws have the more favourable prognosis. In the evaluation of results, the authors emphasize the importance of using parameters which take into account the functionally useful range of joint movement.- - - - - - - - - - ranking = 9.4137081854604keywords = fracture, compression (Clic here for more details about this article) |
3/71. Reactions and complications after the implantation of Endobon including morphological examination of explants.In the study described here, the integration of hydroxyapatite (HA) ceramic implants (Endobon) was investigated. These implants have an interconnecting system of pores and are free from foreign protein. The material is not toxic, genotoxic, nor zytotoxic, and it is biocompatible. The progress of integration was investigated by means of clinical and radiological check-ups. From 10 patients, it was possible to obtain samples for histological analysis during a second operation (e.g., metal explantation). Microscopic examination showed bony integration with newly formed bone in direct contact with the HA ceramic; it also showed osteoblasts and osteoid seams. No second operation took place earlier than 4 months after the first operation, yet even after this relatively short period, bony integration was already evident. Clinical observation (based on x-rays, reports of pain, signs of inflammation) showed that in most cases healing was taking place without complications. More general operational complications such as thrombosis or nerve injury were observed in 4 patients. If the implant is not sufficiently protected from mechanical stress, bony integation will not take place, and the implant may fracture. HA ceramic, with a porosity between 30% and 80%, is not comparable to cortical bone but only to spongy bone. This factor must be taken into account when deciding whether a HA ceramic implant is indicated.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
4/71. Anterior hip pain.Anterior hip pain is a common complaint with many possible causes. Apophyseal avulsion and slipped capital femoral epiphysis should not be overlooked in adolescents. Muscle and tendon strains are common in adults. Subsequent to accurate diagnosis, strains should improve with rest and directed conservative treatment. osteoarthritis, which is diagnosed radiographically, generally occurs in middle-aged and older adults. Arthritis in younger adults should prompt consideration of an inflammatory cause. A possible femoral neck stress fracture should be evaluated urgently to prevent the potentially significant complications associated with displacement. patients with osteitis pubis should be educated about the natural history of the condition and should undergo physical therapy to correct abnormal pelvic mechanics. "sports hernias," nerve entrapments and labral pathologic conditions should be considered in athletic adults with characteristic presentations and chronic symptoms. Surgical intervention may allow resumption of pain-free athletic activity.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
5/71. radial nerve enclosed in the callus of a supracondylar fracture.At operation for the correction of cubitus varus by removal of a wedge based laterally, the radial nerve fortunately was first explored and found to run through a transverse bony tummel at the posterior level of a suprocondylar fracture sustained eight years previously. After elevation of the bony tunnel and nerve en bloc the osteotomy was completed; neurapraxia of the radial nerve soon recovered. With hindsight, the entrance and exit foramina of the tunnel could be clearly seen in the antero-posterior radiograph taken before the operation.- - - - - - - - - - ranking = 5keywords = fracture (Clic here for more details about this article) |
6/71. A new consideration in athletic injuries. The classical ballet dancer.The professional ballet dancer presents all of the problems of any vigorous athlete. The problems include osteochondral fractures, fatigue fractures, sprains, chronic ligamentous instability of the knee, meniscal tears, impingement syndrome, degenerative arthritis of multiple joints and low back pain. attention to minor problems with sound conservative therapy can avoid many major developments and lost hours. Observations included the extraordinary external rotation of at the hip without demonstrable alteration in the hip version angle and hypertrophy of the femur, tibia and particularly the second metatarsal (in female dancers). Careful evaluation of the range of motion of the extremities, serial roentgenographic examination, and systematic review of previous injuries, training programs and rehearsal techniques have been evaluated in a series of cases to provide the basis for advice to directors and teachers of the ballet.- - - - - - - - - - ranking = 2keywords = fracture (Clic here for more details about this article) |
7/71. bone marrow scan evaluation of arthropathy in sickle cell disorders.Twelve patients with sickle cell hemoglobinopathies and arthropathy were studied, using technetium tc 99m sulfur colloid bone marrow scans. Eight of 12 had decreased marrow radionuclide activity adjacent to painful joints, suggestion obliteration of vessels supplying bone marrow. Four patients without marrow defects on scanning had causes other than infarction for their joint symptoms, viz, small fractures, postinfectious synovitis, degenerative arthritis, and osteochondromas. Roentgenograms never showed bony abnormalities in five patients with marrow infarctions, and, in three others, showed defects several months later than did the marrow scans. bone marrow scans offer a sensitive and early diagnostic aid in sickle cell hemoglobinopathies with arthropathy.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
8/71. Fracture of the polyethylene tibial post in a posterior cruciate-substituting total knee arthroplasty mimicking patellar clunk syndrome: a report of 5 cases.Fracture of the tibial post in posterior cruciate-substituting total knee arthroplasty has been described in several reports. Additionally, wear of the cam and post mechanism, including polyethylene debris generation and osteolysis of the peri-implant bone stock as been described. Users of a cam and post type posterior stabilized total knee arthroplasty are also familiar with the rare occurrence of the "patellar clunk syndrome," in which suprapatellar fibrous nodular scar tissue becomes entrapped in the intercondylar box of the femoral component as the knee extends from the flexed position and produces a palpable and sometimes audible "clunk." This condition is easily managed with arthroscopic excision of the scar tissue. A small series of 5 patients who presented with symptoms of a patellar clunk syndrome but who in fact had a fracture of the tibial post causing subluxation of the femur on the tibia is presented. The diagnostic characteristics that will help differentiate between the 2 problems is highlighted.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
9/71. Osteorticular amyloidosis in a patient under dialysis treated by total hip arthroplasty: case report and review of the literature.The authors present the case of a patient affected by kidney failure, who had been undergoing dialysis for several years when areas of osteolysis and bone resorption in the proximal femur and pathologic fracture appeared. She was treated surgically by hybrid total hip arthroplasty. The patient also complained of pains in other joints. The bone tissue taken from the osteolytic area was examined histologically. The test showed the presence of an amyloid substance. microradiography and X-ray diffractometry carried out on the same samples confirmed the lack of mineralisation due to the presence of aluminum ions, presumably derived from dialysis. The high concentration of this element was confirmed by resum assay with spectrophometry in atomic absorption. Considering the results of the aforementioned tests, the patient was put on dialysis using a polymethylmethacrylate filter.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
10/71. Femoroacetabular impingement as a factor in the development of nonunion of the femoral neck: a report of three cases.OBJECTIVES: Description of an anatomic condition where a femoroacetabular impingement was identified as the cause for the development of nonunion of the femoral neck. DESIGN: Retrospective analysis. SETTING: University hospital. patients: Three patients, aged 27 to 74 years, in whom, after exclusion of other known factors, a femoroacetabular impingement was identified as the cause for the nonunion of a femoral neck fracture. INTERVENTION: Surgical correction of the femoroacetabular impingement. MAIN OUTCOME MEASUREMENT: Intraoperative verification of femoroacetabular impingement. Healing of the femoral neck non-union. RESULTS: In all 3 patients, femoroacetabular impingement was confirmed at surgery. After elimination of the cause for impingement, all nonunions went on to uneventful healing. CONCLUSIONS: A femoroacetabular impingement mechanism is proposed as a cause for nonunion of femoral neck fractures. Predisposing factors such as bulging at the fracture site or decreased femoral-neck offset should be addressed at the time of initial fracture treatment.- - - - - - - - - - ranking = 4keywords = fracture (Clic here for more details about this article) |
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