The American journal of orthopedics
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Dyspareunia after heterotopic ossification of the adductor longus is a rare complication. We describe a patient with symptomatic heterotopic ossification of the adductor muscle that developed years after sustaining a fracture of the inferior pubic ramus in association with an injury to the adductor longus muscle. The patient's pain was reduced and his dyspareunia resolved after excision of the adductor longus heterotopic ossification and subsequent physical therapy.
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Selective spinal injections are being performed with increasing frequency in the management of acute and chronic pain syndromes. Because these procedures require a needle to be placed in or around the spine, there is always a risk of complications. ⋯ Physician training and patient preparation and monitoring are required to maximize the safety and efficacy of the specific spinal procedures. This focused review article discusses the primary general and specific complications of spinal injection procedures as well as treatments.
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We evaluated the use of Kocher's original method (without humeral traction) for reduction of acute anterior glenohumeral dislocation in 28 alpine skiers and snowboarders at a single ski area during the 1995-1996 ski season. In all cases, reduction was begun within 1 hour of the acute injury. ⋯ Only 1 patient experienced discomfort significant enough to require analgesia, and no patients required sedation. The complication rate was minimal, with 1 patient developing hyperesthesia in the axillary nerve distribution; no fractures of the humerus or glenoid resulted from the reduction technique.
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Comparative Study
Transsacral versus modified pelvic landmarks for percutaneous iliosacral screw placement--a computed tomographic analysis and cadaveric study.
The alar roots of the first sacral body are the usual confines for iliosacral screw (IS) placement when stabilizing a sacroiliac joint injury or sacral fracture. The traditional transsacral method of IS placement aligns the screw horizontally through the sacral ala on both the inlet and outlet views of the sacrum. A modified oblique method of IS placement aligns the screw in an oblique fashion, directed inferiorly to superiorly and posteriorly to anteriorly. ⋯ All 5 screws were located within the confines of the S-1 segment by means of the modified oblique technique. Thus, the modified oblique placement technique allowed greater accuracy and reliability over transsacral landmarks in placing percutaneous ISs. The use of the modified oblique pelvic landmarks is warranted during percutaneous iliosacral screw stabilization of the posterior pelvis.
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Review Comparative Study
Pediatric analgesia and sedation for the management of orthopedic conditions.
Orthopedic injuries are common in the emergency department; this is especially true in children. The orthopedist must often supervise sedation and analgesia for the injured child. ⋯ The purpose of this review is to outline a reasonable approach to sedation and analgesia in the pediatric patient. In addition, current monitoring guidelines are reviewed, as well as the basic pharmacology of the most commonly used drugs.