The American journal of orthopedics
-
Review Case Reports
L5 root compression resulting from an L2-L3 disc herniation.
We present the rare case of a patient affected by low back pain and bilateral L5 sciatica from an L2-L3 herniation. Only 2 cases of monoradicular L5 compression in the high lumbar spine have been reported. The initial computed tomography study of the L4-L5 and L5-S1 spaces revealed no significant alterations. ⋯ A bilateral laminotomy with discectomy on both sides of the L2-3 space was performed. Pain disappeared completely after surgery. The patient remains asymptomatic 2 years after the operation.
-
Review Case Reports
Intramedullary transmetatarsal Kirschner wire fixation of Lisfranc fracture-dislocations.
Lisfranc joint injuries are frequently the result of high-energy accidents. The usual method of treatment is open reduction and internal fixation or closed reduction with percutaneous pinning. In cases in which soft tissue injury may compromise open reduction and internal fixation or traditional pinning techniques, transmetatarsal Kirschner wire fixation may be performed, allowing the placement of temporary hardware away from the site of soft tissue injury. The following report details this technique as it has been used in 3 patients.
-
Duplex ultrasonography of the deep venous system of the lower extremities is often utilized in the diagnostic evaluation of total hip and knee arthroplasty patients suspected of pulmonary embolism in an attempt to identify the embolic source. A retrospective review of 135 patients who were clinically suspected of pulmonary embolism after 71 total knee arthroplasties and 64 total hip arthroplasties was performed. ⋯ The routine use of this imaging modality is not an effective strategy for identifying clinically significant deep venous thrombosis that leads to pulmonary embolism. A negative duplex ultrasound result should not preclude an extensive evaluation for pulmonary thrombosis in symptomatic patients.