Bulletin (Hospital for Joint Diseases (New York, N.Y.))
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Review Case Reports
Symptomatic displacement of the lesser trochanter following trochanteric fracture fixation.
Unstable intertrochanteric hip fractures are characterized by comminution of the posteromedial cortex, resulting in a fragment of variable size containing the lesser trochanter. Controversy exists as to whether it is necessary to perform reduction and fixation of this fragment. This case lends further support to the practice of fixating the lesser trochanteric fragment in unstable intertrochanteric fractures.
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Review Case Reports
Neuropathy of the saphenous nerve as a cause of knee pain.
Neuropathy of the infrapatellar branch of the saphenous nerve is a frequently overlooked cause of persistent medical knee pain. The author wishes to identify this as a distinct entity and to present five cases. ⋯ The most commonly recognized nerve entrapment condition is carpal tunnel syndrome. Another condition, saphenous nerve entrapment, is all too frequently overlooked and underdiagnosed.
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This study was undertaken to assess the factors influencing the postoperative range of motion after total knee arthroplasty (TKA). From January 1986 to December 1991, 111 TKA (Miller-Galante I System) surgeries were performed in 71 patients. Of those, 90 joints in 60 patients were kept under observation as the materials of this study. ⋯ In the poor group of 90 degrees or less there were 21 knees in 17 patients. Each group of patients was examined preoperatively, operatively, and postoperatively for factors relating to range of motion after TKA. The results of this study indicated factors influencing the ROM were: preoperative ROM, the primary indication, heights of postoperative joint line, patellar thickness, postoperative pain, and successive postoperative rehabilitation.
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Case Reports
Anterior vascularized rib strut graft in the treatment of Pott's disease in the young child.
Two young children suffering from acute thoracic kyphosis due to vertebral tuberculosis (Pott's disease) are described. One patient presented with recent onset spastic paraplegia due to cord compression. Anterior decompression and stabilization with a vascularized rib strut graft was performed in both patients. The neurological recovery in the compromised patient was remarkable; spinal stability was achieved in both patients, thus avoiding the necessity for a posterior spinal fusion.
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Palsy of the suprascapular nerve may be easily overlooked in the differential diagnosis of the painful shoulder. Although the diagnosis is well documented in the literature, opinion is still divided regarding its etiology and treatment. This case report offers an example of successful nonoperative management of a suprascapular nerve palsy which followed an acute episode of muscular stress in a young male athlete.