Orthopedics
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Clavicular fractures are common injuries, usually with uneventful sequela. A case of subclavian vein thrombosis following a clavicular shaft fracture is reported emphasizing the awareness and treatment of this uncommon complication.
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Regional anesthesia provides significant advantages for the patient and practitioner involved in ambulatory foot and ankle surgery. Reliable techniques for administering regional ankle blocks emphasizing their importance in the practice of ambulatory surgery are presented.
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Open reduction and internal fixation utilizing a full thickness fibular graft was performed on a patient who presented with a 9-year-old functional nonunion of a femoral neck stress fracture. During this period, the patient had remained fully ambulatory, with intermittent episodes of hip pain. Our experience indicates that the treatment of old, nonunited stress fractures of the femoral neck with a fibular bone graft and internal fixation contributes to a successful result, lending support while stimulating osteogenesis as the nonunion heals. Use of rigid internal fixation will eliminate motion at the site of the fracture, enhancing incorporation of the bone graft and, thereby, speeding the patient's recovery.
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Case Reports Comparative Study Clinical Trial Controlled Clinical Trial
Postoperative TENS pain relief after knee surgery: objective evaluation.
A comparison was made between the pain-relieving effect of placebo-transcutaneous electrical nerve stimulation (TENS), high frequency TENS, and epidural analgesia with dilute local anesthetics in 15 patients with open knee surgery. Assessment of pain was compared with the patients' ability to contract their quadriceps muscle; the ability was measured with integrated EMG (IEMG) before and after the different treatments. The results showed that placebo-TENS had no significant effect on either pain perception or on IEMG. ⋯ Epidural injection of a dilute local anesthetic decreased pain perception by 90% at rest and by 67% after contraction, and increased muscle contraction ability by 1,846%. TENS undoubtedly has a place in the postoperative pain treatment, although its effect is not as strong as that of epidural analgesia with local anesthetics. TENS, however, is easy to administer, lacks side effects, and can be administered by the patients themselves.