Acta Orthop Belg
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Removal of hardware in orthopaedic surgery is usually encountered in revision fracture surgery for non union, mal union, infection and peri-implant failure. If the hardware has broken this can make revision surgery even more demanding. ⋯ We describe a simple and innovative technique to remove the distal portion of broken intramedullary nails without causing any further trauma. This technique can be extended to include most hollow intramedullary nails.
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The authors present a case in which paraplegia developed following administration of caudal epidural steroid injection (ESI) and discuss the different pathophysiological mechanisms involved. The authors strongly recommend that 0.5% bupivacaine should be used with caution for caudal epidural injection.
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Different methods of internal fixation are used in the treatment of femoral shaft fractures. Results of locked plate fixation in adults have been encouraging. A locking plate construct with a standard broad Dynamic Compression Plate (DCP) and 4.5 mm nuts was used in the treatment of femoral shaft fractures in 15 skeletally immature patients. ⋯ There was an average femoral lengthening of 2.3 mm in six patients and 2 mm of tibial lengthening in four patients. All patients returned to their pre fracture level of activity. The locking plate construct used in this study appeared as a reliable method for the treatment of femoral shaft fractures in skeletally immature patients.