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Infotrieve Online - Tables of Contents TitleTibial reconstruction using a non-vascularised fibular transfer
Author/sElsayed Morsi
SourceINTERNATIONAL ORTHOPAEDICS , 26(6):377-380 2002
AbstractAbstract. A non-vascularised contralateral fibular transfer was performed on seven patients with non-union of the tibia and a sclerosed segmental bone defect following injury. The average follow-up was 2.7 years with a minimum of 2 years. The operation was successful in achieving fracture union in six patients, with an average time to union of 4.5 months (range: 3–6). Shortening of up to 2.4 cm was found in two patients and mild residual ankle stiffness in one. This procedure is successful and simple when compared to microvascular and Ilizarov techniques.
UID00264:0378
ISSN03412695
PublisherSPRINGER-VERLAG NEW YORK, INC

Infotrieve Online - Tables of Contents TitleWhy are we still using pre-operative skin traction for hip fractures?
Author/sDaniel Yip, Chi Chan, Peter K. Chiu, Jimmy W. Wong, James K. Kong
SourceINTERNATIONAL ORTHOPAEDICS , 26(6):361-364 2002
AbstractAbstract. We performed a prospective randomised trial to evaluate the efficacy of pre-operative skin traction for proximal femoral fractures in 311 patients. We found a significant difference in pain score on the evening of admission and the first morning after admission between the groups with traction compared the group without. However, there was no corresponding increase in analgesic requirement during this period. The peak pain score pattern also was different in our population. No other objective benefit can be shown from using skin traction, and its routine use should be abandoned.
UID00264:0387
ISSN03412695
PublisherSPRINGER-VERLAG NEW YORK, INC

TitleA comparative study of trochanteric fractures treated with the Gamma nail or the proximal femoral nail
Author/sA. Herrera, L. Domingo, A. Calvo, A. MartÍnez, J. Cuenca
SourceINTERNATIONAL ORTHOPAEDICS , 26(6):365-369 2002
AbstractAbstract. The aim of the present paper is to compare the results obtained using two osteosynthesis systems developed for the surgical treatment of fractures of the trochanteric region of the femur, based on the principles of closed intramedullary nailing: the Gamma nail and the proximal femoral nail (PFN). A prospective study is presented of 125 trochanteric fractures of the femur treated with PFN and 125 treated with the Gamma nail in our service between the years 1997 and 2000, with the prerequisite of a minimum follow-up of 1 year. Fractures were classified according to the AO system, the most commonly recorded subtype encountered being the A2. Clinical and radiographic controls were performed upon admission and in the post-operative follow-up at 1, 3, 6, and 12 months, the corresponding assessment protocol being completed on each occasion. Of the 250 patients, 179 were women and the rest men. The average age was 78.9 years. Both systems enabled early mobilisation and walking in most of our patients. There were no significant differences in the use of either nail in terms of the recovery of previous functional capacity, nor in terms of the time required for fracture healing (12 weeks on average). With regard to t

Infotrieve Online - Tables of Contents TitleAcetabular roof reconstruction with pedicled iliac graft
Author/sDomagoj Delimar, Nikola iak, Hrvoje Klobuar, Marko Peina, Kreimir Korinek
SourceINTERNATIONAL ORTHOPAEDICS , 26(6):344-348 2002
AbstractAbstract. Reconstruction of the acetabular roof in patients with hip dysplasia shows disappointing mid-term results due to insufficient incorporation and collapse of the bone graft. We have developed a new reconstructive method using a pedicled iliac graft. We simulated surgical reconstruction of the acetabular roof in ten cadaver specimens. The purpose was to evaluate whether the deep circumflex artery was long enough to allow transfer of the graft without requiring micro-vascular anastomosis. In all cadavers, the length of the pedicle was sufficient to reach any desired position of the acetabular roof. The use of such a pedicled structural graft may provide good primary stability and allow local bony remodelling and incorporation under load.
UID00264:0381
ISSN03412695
PublisherSPRINGER-VERLAG NEW YORK, INC.

Infotrieve Online - Tables of Contents TitleSurgical treatment of resistant lateral epicondylitis Follow-up study of 19 patients after excision, release and repair of proximal common extensor tendon origin
Author/sNahum Rosenberg, Ian Henderson
SourceARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY , 122(9-10):514-517 2002
AbstractAbstract
Background. Lateral epicondylitis resistant to conservative treatment is a rare yet disabling condition. When diagnosed, it should be treated surgically. The appropriate surgical treatment relies on a precise diagnosis, usually based on physical examination. Exclusion of other pathologies in the lateral elbow area is essential.
Methods. We report on an outcome in a group of 19 consecutive patients treated by excision, release, reattachment and repair of the common extensor origin. These patients were followed clinically for at least 2 years.
Results. Eighteen patients reported recovery from pain and a satisfactory subjective gaining of strength in their forearm on average 3 and 4 months after the surgery, respectively.
Conclusions. The presented treatment method is highly effective in the treatment of resistant lateral epicondylitis.
UID00402:0421
ISSN09368051
PublisherSPRINGER-VERLAG NEW YORK, INC

Health24 - News Reeve surprises experts
December 11, 2002
Actor Christopher Reeve's continued progress since he was left paralysed seven years ago by a spinal cord injury runs contrary to the long-held medical belief about brain function that if "you don't use it, you lose it".
The 50-year-old actor's brain has preserved a near-normal ability to detect feelings and direct movement, according to tests administered at the Washington University School of Medicine in St Louis.
For years, animal studies have shown that when a spinal cord is severed, nerve impulses to parts of the brain are blocked. The brain reorganises itself and, in time, doesn't react at all to signals from the paralysed parts of the body.
Dr Maurizio Corbetta of Washington University said that while Reeve's brain shows some reorganisation, it also exhibits "strong evidence for stability which goes against the principle of 'use it or lose it'".
Another surprise, said Corbetta, is that Reeve's brain still receives signals from his paralysed body, even though the injury disrupted most of those signals. – (HealthScout News)

TitleOperative compared with nonoperative treatment of displaced intra-articular calcaneal fractures : a prospective, randomized, controlled multicenter trial
Author/sBuckley, Tough, McCormack, Pate, Leighton, PetriE, Galpin
SourceJOURNAL OF BONE AND JOINT SURGERY , 84-A(10):1733-1744 2002
AbstractBACKGROUND: Open reduction and internal fixation is the treatment of choice for displaced intra-articular calcaneal fractures at many orthopaedic trauma centers. The purpose of this study was to determine whether open reduction and internal fixation of displaced intra-articular calcaneal fractures results in better general and disease-specific health outcomes at two years after the injury compared with those after nonoperative management. METHODS: Patients at four trauma centers were randomized to operative or nonoperative care. A standard protocol, involving a lateral approach and rigid internal fixation, was used for operative care. Nonoperative treatment involved no attempt at closed reduction, and the patients were treated only with ice, elevation, and rest. All fractures were classified, and the quality of the reduction was measured. Validated outcome measures included the Short Form-36 (SF-36, a general health survey) and a visual analog scale (a disease-specific scale). RESULTS: Between April 1991 and December 1997, 512 patients with a calcaneal fracture were treated. Of those patients, 424 with 471 displaced intra-articular calcaneal fractures were enrolled in the study. Three hundred a

TitleScaphoid fracture in the young athlete - therapeutic outcome of internal fixation using the Herbert screw
Author/sKeiichi Muramatsu, Kazuteru Doi, Noriyuki Kuwata, Fujio Kawakami, Koichiro Ihara, Shinya Kawai
SourceARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY , 122(9-10):510-513 2002
AbstractAbstract
Background. A fractured scaphoid is a common disabling injury occurring in contact sports. This study was designed to evaluate the therapeutic outcome of Herbert screw fixation for scaphoid fracture in young athletes.
Methods. Thirty athletes with 30 scaphoid fractures were treated. According to the Herbert classification, 10 were classified as acute fracture (group I), 6 as fibrous union (group II) and 14 as pseudoarthrosis (group III). Twenty scaphoid non-unions were due to missed diagnosis or unsuccessful immobilisation.
Results. Bony union was evident at an average of 9.2, 8.0 and 11.9 weeks postoperatively in groups I, II and III, respectively, and times for returning to sports were 10.7, 14.0 and 22.9 weeks. The clinical outcome assessed using the Mayo wrist score was excellent in groups I (97.5 points) and II (93.3) and good in group III (85.4).
Conclusion. Early definitive diagnosis and treatment can allow early return to sports in young athletes. The Herbert screw technique produces an excellent clinical result for scaphoid fracture.
UID00402:0417
ISSN09368051
PublisherSPRINGER-VERLAG NEW YORK, INC.

Infotrieve Online - Tables of Contents TitleSuprascapular nerve entrapment. A meta-analysis
Author/sHarald Zehetgruber, Christian Wurnig
SourceINTERNATIONAL ORTHOPAEDICS , 26(6):339-343 2002
AbstractAbstract. We performed a review of the literature between 1959 and 2001. We found 88 cases of suprascapular nerve entrapment, which fulfilled our inclusion criteria. Suprascapular nerve entrapment is rare and mainly occurs in patients under 40 years of age. Males are more likely to suffer from a ganglion compressing the nerve than females. If the patient's history reveals a trauma, it is more likely that the ligament is compromising the nerve. Ganglions usually cause isolated infraspinatus atrophy, whereas a combined atrophy of the supra- and infraspinatus muscles is more common in cases in which the nerve is compressed by the ligament.
UID00264:0392
ISSN03412695
PublisherSPRINGER-VERLAG NEW YORK, INC

TitleOccurrence and treatment of nonunion in long bone fractures in children
Author/sHÜseyin Arslan, Mehmet SubaÝ, Cumhur Kesemenli, HÜseyin Ersuz
SourceARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY , 122(9-10):494-498 2002
AbstractAbstract
Background. Because of favorable local biological factors, nonunion is rarely seen in long bone fractures in children, and there are few studies on pediatric nonunion in the literature.
Methods. Twenty-six children under 15 years of age diagnosed with long bone nonunion were examined, and 19 received treatment. Patients with pseudarthrosis due to tumors or congenital causes were excluded from the study. The following factors were assessed for each patient: age and sex; cause, location, and type of fracture; form of initial treatment; incidence of infection and type of bacteria produced; time between fracture and diagnosis; and type of nonunion.
Results. Twenty-two of the patients had fractures in the lower extremities, and 4 in the upper extremities. The femur was the most commonly affected bone (12 patients), followed by the tibia (10 patients). The average age of the patients was 9.6 years (range 1–15 years). The frequency of occurrence increased after the age of 6, and all patients but two were above this cutoff age. In each case, there was at least one factor contributing to nonunion, such as open reduction and insufficient fixation, open fracture, and infection. Of the 19 patients treated2

LETTER FROM BANGALORE
Peculiar gifts
Sanjay A Pai

Elsewhere in this issue is a review of Complications by Atul Gawande. As the author and the reviewer emphasise, some people have to be at the receiving end, so to say, of tyros in surgery and other medical fields. This is unfortunate; however, it is the only way medicine can be learnt or taught. That this teaching can only happen in a teaching/university or a government hospital is a given fact.

However, because it is the poor who usually frequent such hospitals, I find that many Indian medical students are rude to their patients. I recently had the opportunity of visiting a teaching hospital. It would be an understatement to say that I was horrified at the shoddy, sub-human treatment - be it language, behaviour or attitude - meted out to the poor, often ignorant patients. These same doctors, though, are honey tongued, when in their private practices, some months later.

Physicians must also remember to respect their older patients. It is all too common to see young medical students address elderly patients by first name. (I am certain I did the same not so long ago. I regret it now.) They would do well to put themselves in the senior citizen's shoes and consider how they would feel if someone 40 years younger called them by their first name. Familiarity breeds contempt.



The reference to medical education brings me to another point. There must be very few, if

Fried Green al-Qaedas Tears blurred Diana's eyes as Danae then happily hopped down to play with the other children. Before the rains came, her daughter's words confirmed what Diana and all the members of the extended Blessing family had known, at least in their hearts, all along. During those long days and nights of her first two months of her life, when her nerves were too sensitive for them to touch her, God was holding Danae on His chest and it is His loving scent that she remembers so well.
You now have 1 of 2 choices...you can either pass this on and let other people

TOPIC PRESENTATION (NOV., Contd.,)

CLUB FOOT

DATE TOPIC PRESENTED BY
21.11.2002
(Thursday) NORMAL ANATOMY OF FOOT – AN OVERVIEW DR. RAJAN

PATHOLOGICAL ANATOMY IN CLUB FOOT DR. SAMEER . B.

26.11.2002
(Tuesday) CLINICAL FEATURES AND RADIOLOGY IN CLUBFOOT DR. DAVIS SAIGAL

MANAGEMENT OF CLUBFOOT – NON SURGICAL MEASURES DR. RAMESH

28.11.2002
(Thursday) SURGICAL MANAGEMENT OF CLUBFOOT DR. RAVI. U.


3.12.2002
(Tuesday) NONIDIOPATHIC CLUBFOOT---- PROBLEMS AND MANAGEMENT DR. DEEPAK

TOPIC PRESENTATION (NOV., Contd.,)

CLUB FOOT

DATE TOPIC PRESENTED BY
21.11.2002
(Thursday) NORMAL ANATOMY OF FOOT – AN OVERVIEW

PATHOLOGICAL ANATOMY IN CLUB FOOT DR. RAJAN


DR. SAMEER . B.
26.11.2002
(Tuesday) CLINICAL FEATURES AND RADIOLOGY IN CLUBFOOT

MANAGEMENT OF CLUBFOOT – NON SURGICAL MEASURES DR. DAVIS SAIGAL



DR. RAMESH
28.11.2002
(Thursday) SURGICAL MANAGEMENT OF CLUBFOOT DR. RAVI. U.
3.12.2002
(Tuesday) NONIDIOPATHIC CLUBFOOT----
PROBLEMS AND MANAGEMENT DR. DEEPAK

what is it i dont know

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