Acta Orthop Belg
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Anterior scoliosis surgery is associated with potentially high blood loss, usually requiring allogenic transfusion either intra- or post-operatively. Blood loss in this type of surgery has been shown to correlate with surgical and anaesthetic techniques. In our centre the development of specific anaesthetic techniques as well as the routine use of cell salvage has dramatically reduced the rates of allogenic blood transfusion. ⋯ A significant difference was also noted in post-operative haemoglobin values. The mean post-operative haemoglobin was 9.6 g/dl in the control group, versus 10.2 g/dl in the study group (p = 0.007). Our experience confirms that re-infusion of salvaged autologous blood in anterior scoliosis surgery has a role in the minimisation of postoperative anaemia and allogenic transfusion requirements in this type of surgery.
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Case Reports
Combined approach for a locked unilateral facet fracture-dislocation of the cervicothoracic junction.
The authors present the case of a 36-year-old patient who sustained a unilateral fracture-dislocation C7-T1 involving all three columns, given the lesion of the C7-T1 disc on MRI. In view of the fractured facet, closed reduction without anaesthesia was not attempted. ⋯ In a second operation, anterior fusion C7-T1 was added, using a tricortical bone graft and instrumentation. The authors felt that this three-column lesion at the cervicothoracic junction necessitated combined posterior-anterior stabilisation.
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Nicolau Syndrome (also known as Embolia cutis medicamentosa and livedo-like dermatitis) is a rare but severe localized adverse drug reaction to a range of intra-muscular preparations. It manifests as acute pain, cutaneous, subcutaneous and intra-muscular inflammation and necrosis immediately following an injection, with potentially devastating sequelae. We describe the syndrome in a 21-year-old national level race walk athlete following an intramuscular diclofenac injection.
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We present the case of a benign groin mass associated with metal particle debris after hip resurfacing. We discuss the histological diagnosis of 'aseptic lymphocytic vasculitis associated lesions' (ALVAL).
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Fractures of the proximal humerus are common. Most can be treated conservatively with good results. However, there is no uniform treatment of displaced fractures. ⋯ The Constant-Murley shoulder score (CMS) to assess function and a visual analogue scale (VAS) assessing pain were used. At 24 months, the mean CMS was 76 (range: 34 to 100) for the fractured side and 85 (range: 66 to 100) for the uninjured side, the mean VAS was 22 (range: 0 to 78). We believe that this study shows that operative intervention is a viable option for displaced proximal humeral fractures.