Acta Orthop Belg
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The purpose of this study was to determine the value of reconstruction of the medial patellofemoral ligament (MPFL) in the treatment of recurrent patellar dislocation and subluxation. We retrospectively reviewed 40 randomised patients with recurrent patellar dislocation or subluxation, who had undergone realignment surgery from July 1999 to December 2001. Group E consisted of 20 patients who had undergone an Elmslie-Trillat procedure. ⋯ At follow-up after 2 years, the apprehension sign remained positive in 6 knees of Group E, but in none of Group M. On a stress skyline radiograph, stability was significantly better in Group M than in Group E. Based on these findings, it appears that reconstruction of the MPFL is a useful addition to the treatment of recurrent patellar dislocation and subluxation.
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In a retrospective study, 12 patients with acute acromioclavicular dislocation Tossy stage III were reviewed after operative treatment with a clavicle hook plate. Mean follow-up time was 20 months. ⋯ Clinical outcome was superior to the radiographic results. Some questions about this technique remain open.
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Case Reports
Bilateral clavicle non-unions treated with anteroinferior locking compression plating (LCP): a case report.
The author reports the case of a 30-year-old female patient with bilateral atrophic non-union of the clavicle; the latter both healed after internal fixation with a locking compression plate fixed on the anteroinferior aspect of the clavicle, combined with autologous cancellous bone grafting. The advantages of the anteroinferior positioning of the plate on the clavicle are presented.
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Case Reports
Combined anterior and posterior shoulder dislocation as a manifestation of a brain tumour.
Seizures are sometimes the first manifestation of a brain tumour. They may give rise to shoulder fractures or fracture-dislocations. ⋯ The posterior dislocation was recognized with a delay of 16 days. After an episode of seizures, shoulder dislocation can occur in either direction, and bilateral shoulder dislocations may not be symmetrical.
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The aim of this study was to evaluate the clinical effectiveness of distal forearm intravenous regional anaesthesia (IVRA) with the tourniquet applied 3 cm above the wrist. One hundred and twenty patients undergoing out-patient hand surgery were operated for 13 different hand problems under distal forearm IVRA, using 10 ml of a solution containing 1.5 mg/kg prilocaine. Sensory block onset time was 4.5 minutes (3.5-6.5 min.). ⋯ The mean VAS score for tourniquet pain was 3.8 (range, 2-10). No local or systemic side effects related to the IVRA were observed. The study showed that distal forearm IVRA using 10 ml of a solution containing 1.5 mg/kg prilocaine provides safe, rapid and effective anaesthesia for patients undergoing outpatient hand surgery.