Acta Orthop Belg
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We report the case of a complete rupture of flexor pollicis longus tendon in a 30-year old-man 10 years after open reduction and internal fixation of a distal radius fracture with a volar buttress plate.
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Apophyseal fracture affecting the greater trochanter is a rare injury in children. We report a case of non traumatic avulsion of the greater trochanter in a 13-year-old boy who presented with a history of pain about his right hip over the past few months. ⋯ The symptoms resolved after percutaneous in situ lag screw fixation. Radiographs 18 months after treatment showed fusion of the trochanteric physis.
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A number of surgical procedures have been described for reconstruction of the disrupted acromioclavicular (AC) joint. Among these is the use of anchor sutures tied over a small button plate. The present study aims to evaluate the preliminary results with this technique in 15 patients with a mean age of 31 years (range: 19-48 years). ⋯ Residual subluxation occurred in one patient and dislocation occurred in another. All patients except one were satisfied with the results in terms of functional performance and cosmetic appearance. In conclusion, considering its low morbidity, unnecessary hardware removal and minimal complications from breakage or migration of metal implants, this technique appears to offer a good alternative in AC joint stabilization.
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The authors present the very rare complication of widespread pulmonary artery cement embolism after pedicle screw augmentation with bone cement for multilevel spine fusion. A 69-year-old woman with severe osteoporosis underwent a posterior T12S1fusion because of lumbar scoliosis. After two months the superior pedicle screws loosened, and a revision spondylodesis T8L1 was performed with bone cement augmentation of the pedicle screws. ⋯ The existing literature offers no clear strategy for prevention or treatment of pulmonary cement embolism. The authors feel, as far as prevention is concerned, that creating a cavity by means of balloon distention before pedicle screw augmentation allows to inject the cement under lower pressure, so that the incidence of cement embolism might be reduced. Treatment options include, besides surgical removal in symptomatic embolism, heparin or warfarin treatment for 3 to 6 months.
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Comparative Study
A comparison of post-op haemoglobin levels and allogeneic blood transfusion rates following total knee arthroplasty without drainage or with reinfusion drains.
The effects of re-infusion drains on the rate of allogeneic blood transfusion and post-op haemoglobin levels in Total Knee Arthroplasty were examined. A group of 22 patients undergoing primary Total Knee Arthroplasty using a CBCII Constavac Stryker re-infusion drainage system were compared with a group of 30 patients, matched for age, sex and type of prosthesis but without any drain usage. ⋯ There were no significant differences between the two groups regarding the rate of wound and transfusion related complications and mean length of post-operative stay. We found that reinfusion drains were ineffective in reducing allogeneic transfusion requirements as compared with non-drainage in total knee arthroplasty.