Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology
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Cerebro-spinal fluid leakage from a spinal stab wound is rare, and usually not a life-threatening injury. Pneumocephalus, a possible rare complication of traumatic cerebro-spinal fluid leakage, can potentially lead to intracranial hemorrhage and death. We describe two cases of spinal stab wounds complicated by cerebro-spinal fluid leakage, one of them developing into severe pneumocephalus. Both patients recovered completely with the following treatment protocol: (a) trendelenburg positioning of the patient, (b) insertion of a continuous-drainage cerebro-spinal fluid catheter into the lumbar thecal sac, (c) primary suture of the leaking skin wound, (d) IV antibiotic therapy.
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Patient age, radiographic severity of osteoarthritis (OA), and severity of symptoms are typically considered as the three key factors in selecting the osteoarthritic patients for total knee arthroplasty (TKA). The purpose of this study was to evaluate the associations between the three selection criteria and the postoperative outcomes including patient satisfaction. We also attempted to determine whether the patients not fully satisfying the criteria are different from the typical candidates in postoperative outcomes. ⋯ This study indicates that, when considering TKA as a treatment option, orthopedic surgeons need to comprehend the selection criteria in an overall view to offer the best timing for optimal postoperative outcomes.