Journal of orthopaedic surgery (Hong Kong)
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J Orthop Surg (Hong Kong) · Dec 2009
Case ReportsSubcapital femoral neck fracture after fixation of an intertrochanteric fracture with a proximal femoral nail: a report of two cases.
Subcapital femoral neck fractures are a rare complication after fixation of an intertrochanteric fracture with a proximal femoral nail. We report 2 such cases where the patients had severe osteoporosis, based on Singh's index and pathological findings. In one case there was a technical error leading to a tip-apex distance of more than 20 mm, but osteoporosis appeared to be a more significant cause than any technical problems.
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J Orthop Surg (Hong Kong) · Dec 2009
Case ReportsCranial subdural haematoma with concomitant spinal epidural and spinal subarachnoid haematomas: a case report.
A 76-year-old man presented with a 4-day history of bilateral leg pain. Magnetic resonance imaging (MRI) of the lumbosacral spine revealed a spinal subarachnoid and spinal epidural haematomas. MRI of the brain revealed a chronic intracranial subdural haematoma with a midline shift. ⋯ At the one-year follow-up, the patient was symptom free with no leg pain or headache. The concomitant occurrence of an intracranial subdural haematoma with spinal epidural and spinal subarachnoid haematomas is rare. MRI of the brain and the entire spine is essential in the presence of a spontaneous spinal haematoma.
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J Orthop Surg (Hong Kong) · Dec 2009
Case ReportsTraumatic spondylolisthesis of the lumbar spine: a report of three cases.
Traumatic spondylolisthesis of the lumbar spine is uncommon and can result in canal narrowing and spinal cord injury. Early decompression promotes recovery of neurological function. ⋯ The connecting rods broke at 3 years and the patient had a residual neurological deficit. We recommend early decompression with posterior instrumentation and interbody fusion for maximum recovery of neurological function and stability of the spine.
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To evaluate the effects of a policy change from emergency to scheduled management of hip fractures in older patients. ⋯ Non-emergency management of hip fractures in older patients resulted in fewer cancellations and after-hour operations, and increased consultant supervision. Nonetheless, extra time slots for operating theatres are required to avoid an associated increase in preoperative and total length of hospital stay.
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J Orthop Surg (Hong Kong) · Dec 2009
Laminar fractures as a severity marker in burst fractures of the thoracolumbar spine.
To assess the correlation between the presence of lamina fractures, narrowing of the spinal canal, and the severity of injury. ⋯ In patients with burst fractures of the thoracolumbar spine, the presence of laminar fractures indicates a more severe injury.