Acta Orthop Belg
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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.
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Osteoid osteoma is a relatively frequent benign bone tumour, consisting of osteoid and woven bone, and surrounded by a halo of reactive sclerotic bone, with an average size of the nidus less than 1.5 cm. It is a condition of late childhood, adolescence and young adult age. It usually occurs in the appendicular skeleton and the spine, and is generally localised in or near the cortex. ⋯ Osteoid osteoma may have an unpredictable course, and may require treatment or resolve spontaneously. In some cases, the diagnostic approach is challenging; there are different treatment methods, some of which have been recently introduced, with promising results. We review the literature about the natural history, clinical presentation, diagnostic approach and classical or modern treatment modalities of osteoid osteoma.
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Randomized Controlled Trial Comparative Study
Delayed release of drain in total knee replacement reduces blood loss. A prospective randomised study.
Total knee arthroplasty is sometimes associated with major post-operative bleeding, often requiring transfusion. A prospective, randomised study was undertaken to assess the effect on post-operative bleeding of delaying release of the clamp on the suction drains. ⋯ Average drop in corrected haemoglobin and postoperative transfusion requirement were also less in the delayed group. The results show that delaying release of the drains by one hour reduces postoperative blood loss and transfusion requirement following total knee arthroplasty.