Musculoskeletal surgery
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Musculoskeletal surgery · Apr 2011
Randomized Controlled Trial Comparative StudyPostoperative pain monitor after total knee replacement.
Aim of this work was to study the postoperative pain within the first week of a total knee replacement by comparing three different forms of administration of analgesia. We proposed to verify the correspondence between a subjective pain assessment made by the patient on a Visual Analogic Scale (VAS) and an objective assessment made by assaying the serum algogenic cytokines interleukin-1 (IL1), interleukin-6 (IL6), and tumor necrosis factor-alpha (TNF-alpha). ⋯ The other two cytokines showed no differences preoperatively and postoperatively. On the basis of our results, we support the validity of IL6 dosage to monitor the postoperative pain during future studies.
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Musculoskeletal surgery · Apr 2011
Heterotopic ossification after total hip arthroplasty: our experience.
Heterotopic ossification is a condition characterized by the presence of mature lamellar bone and often bone marrow in soft tissues surrounding a major joint. It represents a common complication after total hip arthroplasty (THA). The etiology and predisposing factors are not completely known, but some authors reported that the implant of a non-cemented prosthesis seems to be associated with a greater incidence of HO. ⋯ Heterotopic bone was graded as class I in 32 (17.7%) hips, class II in 14 (7.73%) hips, class III in 6 (3,3%) hips and class IV in none (0%). The mean preoperative Harris hip score was 48; at the last follow-up, the mean postoperative score was preoperatively to a mean of 89 points (range, 76-97 points) in HO Hip and of 91 points (range, 78-100 points) in the other Hip. In our experience, non-cemented THA led to a higher incidence of class I and II HO according to Brooker Classification, the incidence of HO is comparable to the rates reported in recent studies about the HO finding after a non-cemented THA, the importance of clinical symptoms in the presence of HO is very low.
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Musculoskeletal surgery · Apr 2011
Case ReportsOsteoblastic osteosarcoma in monostotic Paget's disease.
Paget's disease is a disorder of bone remodelling affecting 1-2% of the general population, most frequently men over 50 years of age. Sarcomatous degeneration occurs in 0.1-0.95% of patients with Paget's disease. ⋯ In this article, we present the case of a 75-year-old man with secondary osteosarcoma arising in monostotic Paget's disease, initially misdiagnosed as rotator cuff tendinopathy. Imaging studies and biopsy were diagnostic.
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Pelvic fractures account for 4-5% of all fracturated patients, and they occur in 4-5% of polytraumatized patients. In the most of the cases, they are consequent to high-energy trauma with a high percentage of lesions of other organs (cerebral, thoracic, and abdominal lesions. The most of the patients (80%) who die are dying within the first hours after trauma for a massive hemorrhagic shock. ⋯ The stabilization of the pelvis also makes it easier to manage the patient and his mobilization for the implementation of subsequent investigations. In our experience, external fixator accounts for its characteristics the gold standard approach for the urgent stabilization of these lesions, and, for most of them, it can be used as the definitive treatment. External fixation is a quick and easy procedure for pelvic fractures stabilization for surgeons with experience with this technique.
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Musculoskeletal surgery · May 2010
The anatomical variation of the lateral femoral cutaneous nerve in relation to the anterior superior iliac spine and the iliac crest.
The location of lateral femoral cutaneous nerve (LFCN) in relation to the anterior superior iliac spine (ASIS) and the iliac crest was investigated in 96 embalmed cadaveric specimens. Fifty-six nerves (58.3%) passed medial to the ASIS. ⋯ The LFCN is usually located at 2.1 +/- 0.8 to 3.9 +/- 1.0 cm below the crest in the range of 2-5 cm lateral to the ASIS, respectively. When the anterior iliac crest bone graft harvesting is planned, the anatomical variation in this area should be concerned to reduce the risk of LFCN injury.