J Bone Joint Surg Br
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J Bone Joint Surg Br · Sep 1996
Case ReportsOsteoblastoma of the humerus associated with type-I Gaucher's disease. A case report.
We report a unique case of juxtacortical osteoblastoma of the humeral shaft, which stimulated the appearance of an extraosseous extension of Gaucher-cell deposits. The tumour was treated successfully by curettage and bone grafting. We can find no previous report of this association between osteoblastoma and Gaucher's disease.
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We used a saline load test in 50 consecutive patients with periarticular lacerations suggestive of joint penetration. The surgeon had predicted on clinical grounds whether or not the laceration penetrated the joint. ⋯ There were no complications from the use of the test. Our findings support the use of a saline load test in evaluating periarticular lacerations.
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J Bone Joint Surg Br · Sep 1996
Pain relief from preganglionic injury to the brachial plexus by late intercostal nerve transfer.
We performed intercostal nerve transfer in 19 patients to relieve pain from preganglionic injury to the brachial plexus. The procedure was successful in 16 patients at a mean of 28.6 months (12 to 68) after the injury.
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J Bone Joint Surg Br · Sep 1996
Distal rupture of the tendon of biceps brachii. Evaluation by MRI and the results of repair.
We report ten cases of rupture of the distal part of the tendon of biceps brachii in patients aged from 27 to 58 years. MRI allowed assessment of the degree of retraction of the tendon which was related to the integrity of the bicipital expansion. When the retraction exceeded 8 cm the expansion was always ruptured. ⋯ The MRI findings were confirmed at operation. Use of fixation points allowed minimal intervention, thereby reducing the risk of damaging the radial nerve. One year after operation, dynamometric evaluation of the strength of flexion and supination confirmed that the best results were obtained by reinsertion to the radial tuberosity.
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Over 200 high-velocity missile injuries treated in a low-technology environment were audited under the aegis of the International Committee of the Red Cross Hospitals in Afghanistan and Northern Kenya. Femoral fractures were treated either by traction or external fixation using a uniaxial frame. The results showed that patients treated by external fixation remained in hospital longer than those treated on traction. ⋯ In complex humeral fractures, external fixation resulted in long stays in hospital and a large number of interventions when compared with simple treatment in a sling. We conclude therefore that in an environment where facilities are limited and surgeons have only general experience very careful initial wound excision is the most important factor determining outcome. The application of complex holding techniques was generally inappropriate.