Posterior subscapularis release combined with transfer of latissimus dorsi and teres major for treatment of shoulder internal rotation contracture secondary to Erb's plasy

Fifteen children complaining of internal rotation contracture of the shoulders after obstetrical palsy, their mean age was 8.3 years, were included in this study. The preoperative average abduction and external rotation were 70 and 50 degrees, respectively. All patients had subscapularis release from the scapula and transfer of latissimus dorsi and teres major to rotator cuff. At the final follow up, all patients had an improvement of abduction and external rotation. The mean active abduction was improved to 120 degrees postoperatively. The average postoperative external rotation was 57 degrees. Subscapularis release and Hoffer transfer improved the shoulder abduction and external rotation in cases of birth palsy. All patients noticed an improvement of their functional activities of daily living as well as cosmoses

Fractures of the ulnar styloid in young adults: to fix or not?

In this study, 44 cases of fracture base of the ulnar styloid were treated by open reduction and internal fixation using tension band wiring. 68% of the cases were associated with unstable distal radius fracture. In 10% of the cases, the ulnar styloid fracture was isolated; in 11% of the cases, it was associated with carpal injuries, fractures and or dislocation as well as 11% were associated with Galeazzi fracture. The assessment of stability of the distal radio-ulnar joint was tested after fixation, during surgery. An additional percutaneous fixation of distal radio ulnar joint [DRUJ] by KW was done in four cases. The results were encouraging, 85% of the patients had painless free range of supination-pronation. A residual prominence of the ulnar head was observed in two cases

Percutaneous reduction and fixation of transscaphoid perilunate fracture dislocations

In this study, 12 manual worker men sustained high energy trauma presented with this injury were treated by closed reduction under fluoroscopic image intensifier control and percutaneous fixation. Their mean age was 31.4 years. The injury involved the undominant hand in eight patients. The average duration of follow up was 16.3 months. At the end of follow up, 11 patients were satisfied, had no or mild pain. Eight patients had more than 75% of the range of motion of that of the uninjured side. Ten patients had excellent and good results

Compression triple fusion using screws fixation

Fourteen patients complaining of painful and/or deformed foot resistant to conservative management treated by using triple fusion were included in this study aiming to evaluate the results of the efficiency of double approach exposure and compression internal fixation in improving the results of triple fusion. Ten feet had peroneal spastic foot, three had post traumatic arthritis and one had unstable paralytic foot. All were treated using medial and lateral exposure and rigid internal fixation. After a mean follow up period of 19 months, pain, gait, walking ability of the patients were improved in all but one patients. Triple fusion is a good salvage option for the treatment of resistant painful foot, if proper surgical technique is followed

Biological fixation of metaphyseo-diaphyseal fractures of long bone

Forty cases of fracture of the proximal or distal metaphases of the femur or tibia with or without diaphyseal extension but not extended to the joints were treated using indirect reduction of the fracture and biological fixation. There were 23 femoral fracture and 17 tibial fractures. After mean follow up of 19 months, bony union was achieved without any mechanical failure in all patients except two, three cases had delayed union and required bone grafting

Biological fixation of subtrochanteric intertrochanteric femoral fractures using dynamic condylar screw

Thirty-five subtrochanteric fractures type V Seinsheimer and type IIA and IIb Rausell -Taylor with intertrochanteric extension to the piriformis fossa were treated in this study. All fractures except 2 were fixed during the first week after injury using indirect reduction by traction on orthopedic traction table under image intensifier. No bone graft was used even in those fractures having significant comminution of the medial cortex, but all attempts were paid to avoid any exposure of the site of comminution. All fractures had united within 12 weeks postoperatively without loss of fixation or reduction. One case only [Type IIB] united with 10C varus deformity. There was only one case of early postoperative deep wound infection that responded to wound debridement, suction irrigation and antibiotic for 6 weeks and the fracture united 12 weeks postoperatively. The technique is easy with excellent results in spite of the stresses on the medial femoral cortex with relatively low complications rate, if meticulous biological principles are followed