Journal of surgical orthopaedic advances
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Treatment of pseudarthrosis of the cervical spine has been debated extensively with various solutions being proposed. This article reviews 18 cases of pseudarthrosis after attempted anterior cervical discectomy and fusion with tricortical iliac crest autograft using the Smith-Robinson method. All cases were subsequently treated with posterior fusion using cancellous iliac autograft and fixation with Halifax clamps. ⋯ One device showed loss of fixation in the follow-up period. The Halifax clamp is technically simple to apply and can be done safely. High success rates in obtaining fusion after failed anterior discectomy and fusion in the cervical spine and ease of application make this method of posterior fixation and fusion an attractive alternative for dealing with pseudarthrosis.
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A ring or circular object (wide steel band/nut) impaled on a swollen finger can be most difficult to remove. Likewise, wedding rings in the preoperative setting do not necessarily need to be cut off. ⋯ The equipment for removal is readily available in all medical offices or emergency departments. This article presents a solution to a common problem.
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This study evaluated the efficacy of vacuum-assisted closure (VAC) for treatment of fasciotomy wounds for traumatic compartment syndrome. The authors reviewed the records of a consecutive series of 34 patients who had compartment syndrome of the leg requiring the standard two-incision release of all four compartments and received the application of VAC therapy until the time of definitive wound closure or coverage. A matched series of 34 consecutive antecedent patients with the same entry criteria, except for the use of the VAC, were also studied and served as a control group. ⋯ Subatmospheric treatment for compartment syndrome of the leg after fasciotomy theoretically helps to speed the resolution of the swelling and tissue edema that are often components of this clinical entity. Experimental work has shown vacuum-assisted wound management to be effective in hastening the resolution of wound edema, enhancing local blood flow, promoting granulation tissue, and thwarting bacterial colonization. These factors may account for its utility in the management of fasciotomy wounds in the setting of compartment syndrome of the leg.