Acta orthopaedica
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Low back pain (LBP) is a common cause of lost work days and disability. In 2001, expenditure for back pain represented 11% of the total costs for short-term sick leave in Sweden, and about 13% of all early retirement pensions were granted for back problems, of which LBP is the most important symptom. The magnitude of LBP as a health problem justifies a closer look at its burden of illness to society. ⋯ The cost of illness due to low back pain was substantial, but does not appear to have risen during the last 10-15 years.
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The time for femoral lengthening is shortened if external fixation is combined with intramedullary nailing. However, several complications have been reported with this procedure. ⋯ Although lengthening over a nail can reduce the duration of external fixation, caution is required to prevent major complications.
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In neuromuscular diseases, limb lengthening and foot deformity correction are associated with a high risk of complications associated with distraction callus and joint contracture. We have found no published articles of tibial lengthening and concomitant foot deformity correction using the Ilizarov method or traditional methods. To compare result of gradual distraction with triple arthrodesis for foot deformity combined with tibial lengthening, we investigated healing index and complications of two methods. ⋯ The gradual foot frame distraction method was associated with major complications, such as recurrent foot deformity, joint luxation, and arthritis. We therefore recommend triple arthrodesis as a concomitant procedure during tibial lengthening
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Dual energy X-ray absorptiometry (DEXA) has been used to measure bone mineral density (BMD) around total hip prostheses. With the recent increase in the use of metal-on-metal hip resurfacing, such as the Birmingham hip resurfacing (BHR), we aimed to produce a reliable method of measuring bone density around a metal-on-metal hip resurfacing. ⋯ We have designed and demonstrated a safe, noninvasive and highly reproducible method for interpreting and reporting the results of DEXA scanning of BHR implants in vivo. We will now use this method to prospectively study our BHR population to assess the changes in bone density following BHR within the femoral neck. This method may add to the current techniques available for detection of impending failure.