Clinical orthopaedics and related research
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Based on a follow-up study of 15 distal femoral epiphyseal fractures, the following conclusions are drawn: Closed reduction with cross pinning of the distal femoral epiphysis provided slightly better results and prevented loss of reduction; angulation deformity, requiring corrective surgery occurred in four patients, two of whom had initial anatomical reductions; significant leg length inequality was not seen; abduction injuries of the distal femoral epiphysis are not uncommon in teenage football players.
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Clin. Orthop. Relat. Res. · Mar 1976
Case ReportsGiant synovial cyst of the calf and thigh in a patient with granulomatous synovitis.
A giant synovial cyst with granulomatous synovitis was removed from the thigh and calf in an 80-year-old woman. The lesion included necrotizing, epitheloid cell granulomata with Langhans' type giant cells. ⋯ The treatment consisted of synovectomy and total knee arthroplasty with an uneventful recovery. A giant calf cyst, usually associated with rheumatoid arthritis, but in this situation, noted in granulomatous synovitis seems not to have been reported previously.
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On the basis of a 9-year experience with 231 patients with post-laminectomy and post-spinal fusion stenosis of the lumbar spinal canal, we emphasize the importance of recognizing and adequately decompressing such lesions. In the majority of such patients pain relief has been achieved, but some of the failures can be attributed to technical reasons. ⋯ The indications for fusion however were few and require further investigation and evaluation. The significant failure rate points to the need for continuing research into the causes of low back pain and adequate management programs for the patient with the "multiple operated back" who still has disabling pain and drug dependence.
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Injection of irritant fluid precisely into the facet joint causes referred pain patterns indistinguishable from the pain complaints frequently associated with the "disk syndrome." Even straight leg raising and diminished reflex signs can be obliterated by precise local anesthetic injection into the facet joint. The use of radiographically localized injection of steroids and local anesthetic into the facet joint has been presented as a diagnostic-therapeutic procedure. Clinical experience with a group of 100 consecutive patients suggests that this treatment alone can achieve long-term relief in one-fifth of the patients with lumbago and sciatica and partial relief in another one-third of these patients. This information suggests that the structures related to the facet joint can be a persistent contributor to the chronic pain complaints of individuals with low back and leg pain.