International orthopaedics
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Six cases of spinal epidural abscess are presented. All patients were young with no predisposing conditions. ⋯ The patients with no neurological deficit recovered completely, while patients with pre-existing neurological deficit had a poorer outcome. Emphasis is given to early detection and surgical management to prevent irreversible damage to the spinal cord.
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We report on two cases of patients in whom hypocalcemic seizures during hemodialysis led to right scapular body fracture in one and bilateral femoral neck fractures in the other.
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Case Reports
Tetraparesis associated with ossification of the posterior longitudinal ligament of the cervical spine.
This is a case report of tetraparesis associated with extraordinarily severe ossification of the posterior longitudinal ligament (OPLL) of the cervical spine. There was no history of trauma. The object of this paper is to show that OPLL can progress relentlessly to a nearly complete quadriplegia even without trauma, but that adequate decompression can produce almost complete recovery.
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We report an uncommon case of locking of the knee in a 23-year-old girl. It was due to an osteochondroma at the medial aspect of the proximal tibia.
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In order to evaluate interobserver and intraobserver agreement of the Frykman and AO classifications and their variations between assessors with different levels of experience, three hand specialists, a fellow and two senior residents classified radiographs of 200 fractures of the distal radius in anteroposterior and lateral views. Reproducibility was assessed by the use of the proportion of agreement and kappa coefficient between pairs of observers. The Frykman classification showed moderate interobserver reproducibility (kappa = 0.43) and good intraobserver reproducibility (kappa = 0.61). ⋯ The younger group obtained higher intraobserver agreement than the senior. Possible causes for the low reproducibility of both classifications are discussed together with a review of the literature. We do not recommend the Frykman or AO classifications for clinical application because of their questionable reproducibility.