The American journal of orthopedics
-
The sacroiliac joint itself and the specific diagnosis of sacroiliac dysfunction are both underappreciated causes of pain in the low back, the pelvis, and the proximal lower extremities. An anatomically atypical synovial joint, its extensive innervation accounts for multiple modes of pain presentation. The joint and its associated ligament complex are subjected to rather constant and significant stresses. ⋯ Nonoperative treatment is usually physical therapy, and both diagnostic and therapeutic injection of the sacroiliac joint may be employed. Surgery is a treatment of last resort. There is a lack of long-term studies that address the natural history of this problem and its treatment.
-
The treatment of Pott's disease remains controversial. The authors present two cases of spinal tuberculosis treated with posterior stabilization and supplementary abscess evacuation via the pedicular route with subsequent chemotherapy. The aim of this procedure was to increase the healing rate. Radiographic evidence of bone healing without any sequelae was demonstrated at 13 and 14 months.
-
Case Reports
Treatment of unstable intertrochanteric hip fractures associated with spinal fractures. A treatment dilemma.
Treatment approaches to a patient with polytrauma comprising combined spinal and hip fractures need more careful planning than those for a patient with an isolated spinal or hip fracture. The patient in this case presentation had multiple burst fractures of the spine, but was neurologically intact. ⋯ The presence of a thoracic or lumbar fracture, in addition to a hip or femur fracture, may require an altered therapeutic approach. We present an approach to treating this complex problem without the use of a fracture table.
-
Subluxation of the radial head, or "nursemaid's elbow," is a common injury among children aged 1 to 4 years. The authors present a technique for flexed-elbow stabilization designed especially for very young children, which provides adequate immobilization without the use of a sling.