Acta Orthop Belg
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Case Reports
Complex dorsal subluxation of the metacarpo-phalangeal joint of the thumb requiring open reduction: a case report.
The authors present an case of a thumb metacarpophalangeal joint dislocation which was made complicated by the interposition of the sesamoid bone which required open reduction. The intact volar plate prevented closed reduction. The anatomy and surgical management of this unusual case is described.
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Comparative Study
The short term effects of a single corticosteroid injection on the range of motion of the shoulder in patients with isolated acromioclavicular joint arthropathy.
This study is aimed at evaluating the short-term effects of a single corticosteroid injection of the acromioclavicular joint on the range of motion of the shoulder joint using a three dimensional electromagnetic tracking system (FASTRAK) in patients with isolated unilateral acromioclavicular joint (ACJ) arthropathy. Eighteen patients (16 male, 2 female; mean age: 47.53 years), with isolated unilateral ACJ arthropathy were included in the study. Injection of the symptomatic ACJ with local anaesthetic and corticosteroid was performed under image intensifier guidance. ⋯ In patients with radiographical evidence of degenerative ACJ disease, there was also significant improvement in the range of horizontal flexion (p < 0.05). Injection of the ACJ with local anaesthetic and corticosteroid was found to produce short-term pain relief and partial improvement in the range of movement. FASTRAK is useful in the measurement and documentation of range of motion, and can be used to assess the treatment outcome in patients with isolated ACJ arthropathy.
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Comparative Study
Sciatic nerve block causing heel ulcer after total knee replacement in 36 patients.
Femoral and sciatic nerve blocks are often used for postoperative analgesia following total knee replacement surgery. In this report, we focus on cases of heel ulcers which occurred following the implementation of peripheral nerve block in concert with knee replacement surgery. ⋯ Pressure points in the foot should be protected after the implementation of nerve blocks to prevent pressure sores. An awareness of this unusual complication related to knee replacement surgery is necessary to prevent its occurrence and avoid delays in patient rehabilitation and recovery.
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We present a rare case of spontaneous rupture of the adductor longus tendon induced by ciprofloxacin. A 35-year-old man was diagnosed with pneumonia and was recommended ciprofloxacin 500 mg iv twice a day for 7 days. ⋯ There was no obvious underlying disease or other factor causing fragility of his adductor longus tendon. We review the pathophysiological mechanisms leading to fluoroquinolone-related tendon rupture as well as the risk factors and discuss proper management.
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Comparative Study
Radiological analysis of titanium mesh cages used after corpectomy in the thoracic and lumbar spine: minimum 3 years' follow-up.
This study analyses radiological outcome of titanium mesh cages used for anterior column support following corpectomy in the thoracic and lumbar spine in 34 patients with a minimum three-year follow-up. The aim of the study was to assess the complications and radiological outcomes of patients with structural cages implanted into the anterior column. Titanium mesh cages for the anterior column became popular for anterior column reconstruction following discectomy and corpectomy. ⋯ Short posterior and only anterior instrumentation systems were associated with settling. The anatomical location and diagnosis did not affect the development of cage settling. Following corpectomy and mesh cage implantation, isolated anterior fixation or short posterior fixation do not provide enough stability, and correction loss and settling can occur.