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.
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Nora's tumour is an uncommon benign tumour, involving mostly tubular bones of hands and feet, and characterized by a proliferation of chondroid, bony and fibrous tissues. Main differential diagnoses are osteochondroma, chondrosarcoma, and osteosarcoma. ⋯ Treatment was surgical, with complete excision. There are no clinical or radiological signs of recurrence on further review one year postoperatively.
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Acute urinary retention is a common complication after lower limb arthroplasty. The aim of our study was to assess whether the International Prostate Symptom Score (IPSS) and other patient related factors could predict the likelihood of patients developing urinary retention after lower limb arthroplasty. We have also reviewed the literature on this subject. ⋯ Of all the parameters studied, age was the only factor that correlated significantly with development of urinary retention. The risk factors for progression of benign prostatic hyperplasia could all be considered as factors for the development of this complication. However, apart from age more than 70 years, it is not practical to use the other parameters.