Acta Orthop Belg
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Poor outcome following bilateral sacroiliac joint fusion for degenerative sacroiliac joint syndrome.
The purpose of this retrospective study was to evaluate the clinical and radiological outcome of bilateral sacroiliac joint (SIJ) fusion, using a new technique, in patients with a chronic SIJ syndrome. Seventeen patients with chronic low back pain, with a positive response to specific diagnostic tests for the SIJ, were considered candidates for bilateral sacroiliac fusion. The surgical indication was based on the results of local anaesthetic joint infiltration, temporary external fixation or bone scan. ⋯ Reoperation was performed in 65% of the patients. Our results with bilateral posterior SIJ fusion were disappointing, which may be related with difficulties in patient selection, as well as with surgical technique. Better diagnostic procedures and possibly other surgical techniques might provide more predictable results, but this remains to be demonstrated.
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Paediatric elbow dislocations are uncommon injuries, accounting for 3-6% of all elbow injuries in childhood. A divergent elbow dislocation is an even more infrequent injury, where in addition to the elbow dislocation there is divergence of the proximal radius and ulna, either in a transverse (extremely rare) or in an anteroposterior plane, as a result of the distal humerus being forced between the proximal ends of the forearm bones. ⋯ The authors report a case of transverse divergent elbow dislocation in an 8-year-old boy, treated by closed reduction and immobilisation in a cast. At 6 months follow-up the patient had regained a full range of motion, without instability or pain.
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This prospective consecutive case series was done to evaluate indications, technical pitfalls and functional outcome of elastic stable intramedullary nailing of displaced midclavicular fractures in 14 athletes. Constant score and radiographs were evaluated after 1 and 6 weeks, 3 months and 6 months in 13 patients. Mean age was 28 years. ⋯ Compared to the contralateral side, average shortening of the clavicle was 1.7 mm. Overall, elastic stable intramedullary nailing provided good restoration of the length of the clavicle and allowed immediate active mobilisation with early return to normal activity. Functional results were excellent.
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Spinal tuberculous abscesses usually respond to anti-tuberculous drugs. The purpose of this study was to evaluate the results of surgical drainage after failure of first-line anti-tuberculous drugs. Patients with spinal instability or vertebral collapse were excluded from the study. ⋯ Drains were removed after two to three days. None of the patients required a second operation. Complications, such as spinal instability, vertebral collapse, or death did not occur.