Acta Orthop Belg
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Clinical Trial
Bassini's hernial repair and adductor longus tenotomy in the treatment of chronic groin pain in athletes.
A prospective study was initiated to evaluate the surgical treatment of chronic groin pain resistant to conservative treatment. Forty-one patients were treated using Bassini's hernial repair and percutaneous adductor longus tenotomy between 1984 and 1998. All patients were males aged 17 to 34 years and were mainly soccer players. ⋯ Thirty-seven performed at the same level and 4 at a reduced level. Only one patient performed at a lower level due to persistent groin pain. We conclude that, when conservative treatment for pubic pain in athletes fails, a combination of hernial surgery and adductor longus tenotomy can provide successful results.
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Case Reports
[Traumatic dislocation of the radial head associated with ipsilateral fracture of the radial shaft: a case report].
Ipsilateral radial head dislocation with radial shaft fracture is a rare injury. A few cases have been reported in the literature. ⋯ The dislocation was reduced by manipulation after open reduction of the radial shaft fracture, which was then fixed with a plate. The clinical and radiological outcome was good with 2 years follow-up.
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The purpose of this prospective study was to assess the functional outcome of conservative treatment with early ambulation of thoracolumbar burst fractures, using the Load Sharing classification. From 1997 to 2001, 60 consecutive patients with single-level thoracolumbar spinal injury, with no neurological impairment, were classified according to the Load Sharing scoring and were managed non-operatively. A custom-made thoracolumbosacral orthosis was worn by all patients for six months, and early ambulation was recommended. ⋯ However, the functional outcome was satisfactory in 55 of 60 patients with no complications recorded on completion of treatment. Load Sharing scoring is a reliable and easy-to-use classification for the conservative treatment and prognosis of thoracolumbar spinal fractures. Because of the three characteristics of the fracture site this classification can also predict the structural results of spinal injury, such as posttraumatic kyphosis, as well as the functional outcome in conservatively treated patients.
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Clinical Trial
Prevention of thromboembolic disease after non-cemented hip arthroplasty. A multimodal approach.
Thromboembolism following total hip arthroplasty is a common complication that may result in significant morbidity and mortality. Despite this, optimal prophylactic regimen is controversial. We investigated the efficacy of a comprehensive approach encompassing the use of aspirin, intermittent compression devices ('foot pumps'), and early mobilization in a cohort of 200 consecutive patients after non-cemented total hip replacements. ⋯ Venous thromboembolic disease after hip replacement surgery is largely associated with postoperative immobilization and venous stasis. It is the authors' opinion that a prevention strategy should include mechanical as well as pharmacological measures. The concomitant use of epidural anesthesia, "foot pumps", aspirin and early full weight bearing ambulation may be effective in further reducing the incidence of DVT after surgery.
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Review Case Reports
Delayed post-traumatic osteonecrosis of a vertebral body (Kummell's disease).
Kummell's disease is a rare spinal disorder characterized as avascular necrosis of a vertebral body occurring in a delayed fashion after minor trauma. The disease derives its name from the German surgeon Hermann Kummell, who described a series of patients with the disorder in 1895. ⋯ In addition, Kummell's disease exhibits different signal characteristics on magnetic resonance imaging when compared to osteoporotic compression fractures. In this review we discuss the pathophysiology, histopathology and treatment of this interesting disorder.