The American journal of orthopedics
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The purpose of this study was to evaluate neurologic recovery following an acute, traumatic central cord syndrome (TCCS) injury. We retrospectively reviewed 69 patients who were treated surgically following an acute TCCS injury. The American Spinal Injury Association (ASIA) motor scores (AMS) were obtained from the time of presentation, from the time of hospital discharge, and from the most recent follow-up visit. ⋯ Adverse events were encountered in 24.6% of the patients. There were no deaths. A history of a loss of consciousness, decreased rectal tone at presentation, the presence of a fracture, the timing of surgery, and surgical approach did not have a significant impact on motor recovery.
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Surgical fires are a serious threat to the patient and surgical team in the operating room. Burns have been reported at, and distant to, the operating site, as well as within the body. The essential point to remember is that at least 1 arm of the fire triangle-an oxidizer, fuel, and an ignition source-must be completely controlled to prevent an intraoperative fire. Here we give the example of a pulse lavage system as a possible ignition source.
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Case Reports
Traumatic C4-C5 unilateral facet dislocation with posterior disc herniation above a prior anterior fusion.
We report the case of a unilateral cervical facet dislocation above the level of a prior non-instrumented cervical discectomy and fusion, resulting in incomplete neurologic injury. Pre-reduction imaging demonstrated a large posterior disk extrusion. This finding altered our management approach from closed reduction to urgent anterior cervical discectomy, open anterior reduction, and fusion. The patient had excellent neurologic recovery and outcome at 12 months postoperative follow-up.
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Proximal humerus fractures are accounting for 4-5% of all fractures with increasing incidence. Proximal Humeral Internal Locking System (PHILOS) plate is a new plate which permits early mobility and lowers the risk of complications. The aim of this study was to evaluate the functional outcome and the complication rate after using this plate. ⋯ The average ASES score between patients 60 years and older and those 60 years and younger was not different significantly. One patient developed avascular necrosis of the humeral head, 2 patients developed an infection, and no patients developed a nonunion. Fixation with PHILOS plate can be considered a good method with high union rates for this kind of fracture, especially in the older population with osteoporotic bone.
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Case Reports
An unusual presentation of subacute osteomyelitis: a talus brodie abscess with tendon involvement.
Brodie abscess is a subacute localized osteomyelitis with a presenting report of intermittent pain of long duration. In this article, we report a case of talus Brodie abscess with tenosynovitis of posterior tibialis and long flexor tendons of the foot. We describe the radiologic and diagnostic features of this osteomyelitis and outline its management and prognosis. To our knowledge, this is the first report of such a case with this unusual presentation.