The American journal of orthopedics
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A bioresorbable syndesmotic screw was used successfully for fixation in 4 patients, 3 with a bimalleolar Weber type-C ankle fracture and 1 with a Maisonneuve-type injury. The 5-mm screw consisted of a polyglycolic acid/polylactic acid copolymer placed in standard fashion at the time of open reduction and internal fixation. The patients healed without difficulty, and follow-up radiographs showed anatomic maintenance of the syndesmotic space. ⋯ Signs of minimal irritation were noted at the screw-head site in 2 patients at 3 to 4 months after surgery, but the irritation did not hamper activity or rehabilitation. The screws maintained alignment. Preliminary results suggest that a larger study to further evaluate the effect of this screw is appropriate.
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Review Case Reports
Vertebral sarcoidosis of the spine in a football player.
Osseous involvement is common in sarcoidosis, but most cases of osseous sarcoidosis occur in the long bones of the hands and feet. Vertebral involvement in sarcoidosis is rare. A case of vertebral sarcoidosis in a 19-year-old male football player is presented. ⋯ A review of the literature on sarcoid involvement of the spine is also presented. Although rare, sarcoid infiltration of the vertebrae is a recognized entity. Magnetic resonance imaging can be helpful in making the diagnosis, but biopsy is needed for confirmation.
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Fractures of the olecranon are common injuries with no single accepted treatment. Numerous clinical factors and biomechanical studies guide the surgeon in determining a treatment plan. The goals of surgical management include anatomical reduction and stable fixation, which allow early range of motion of the elbow joint. ⋯ The surgical technique depends on a combination of patient factors, the fracture pattern, and the mechanical stability of the fixation construct. Postoperative rehabilitation includes early active range-of-motion exercises and follows clinical and radiographic healing. Complications are related to the fracture, choice of implant, and surgical technique.
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The authors describe a rare case of Lisfranc's dislocation that occurred after a 13-year-old boy kicked the ground while playing soccer. He presented with complete pure dorsal tarsometatarsal dislocation of the first metatarsal. ⋯ No complication was found and he returned to his preinjury lifestyle at 3 months. No sequelae are found 3.5 years later.
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Comparative Study Clinical Trial Controlled Clinical Trial
Peripheral neuropathy in the hands of diabetic patients with lower extremity amputations.
One hundred unilateral ambulatory lower extremity amputees underwent sensibility testing of their remaining foot and right hands to determine if the magnitude of peripheral neuropathy present in the feet of patients with diabetes was of greater magnitude than that in their hands. Testing was performed with a series of Semmes-Weinstein monofilaments. Ninety-one of the subjects were male, and 9 were female. ⋯ There was no statistically significant difference when comparing hand and foot sensibility in any of the comparison groupings. The quantitative amount of peripheral neuropathy appears to affect the hands and feet of diabetics in a similar "stocking-glove" fashion. The results of this screening gives further support to the concept of prophylactic foot care programs in diabetics with peripheral neuropathy to decrease the risk for the development of foot ulcers, which are often the precursor of eventual lower extremity amputation.