Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Dec 1986
Case ReportsClosed percutaneous drilling for osteochondritis dissecans of the talus. A report of two cases.
Two cases of osteochondritis dissecans of the talar dome treated by closed percutaneous drilling are presented to illustrate a procedure for high-risk patients. The operation is performed with the aid of an image intensifier. The ostoechondral fragment is percutaneously drilled to avoid open operation and osteotomizing the medial malleolus.
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Recognizing that not all patients with low back pain have lumbar disc disease, the authors began to inject facet joints in June 1982 and have experience now with 21 patients, each injected under fluoroscopic control with a mixture of local anesthetic and steroid. One technical problem occurred when large osteophytes blocked access to the facet joints. Otherwise, there were no complications and minimal morbidity. ⋯ Facet joint disease may be a significant cause of low back pain. The above three criteria are useful in clinical identification of patients with this problem. Facet joint injections play an important role in the diagnosis and treatment of low back pain.