Fractures of the humerus with radial nerve palsy

The radial nerve was explored in seven cases of fracutres of the distal third of the humerus with radial nerve palsy which are often oblique or spiral with or without butterfly fragement and typically angulated laterally, with the distal fragment displaced proximally. In all the cases, the nerve was found caught in the fracture site. This paper presents seven cases of fracture of the humerus complicated by radial nerve injury. The fracture occurs in the distal third of the bone at the point where the radial nerve traverses the lateral intermuscular septum and is in contact with the bone. The apex of the distal fragment is displaced nerve between the bone fragments. Primary open reduction and internal fixation is the treatment of choice for this kind of injury. Closed manipulation is contraindicated when the criteria of the syndrome are present

Reconstruction of the medial ligament complex of the knee for chronic anteromedial instability using a modification of the Nicolas procedure

Reconstruction of the medial ligament of the knee for chronic anteromedial instability possesses a major problem. Lots of methods and varieties of techniques were described. Hey Grove in 1917 described an operation for reconstruction of the Anterior Cruciate Ligament using the ilio-tibial band. In 1920, he expanded the technique to include reconstruction of the tibial collateral ligament. Slocum and Larson in 1968 described transfer of the pes ansencrius tendons. Opinions varied whether to attack the femoral attachment of the ligament [Augustine 1956 and Nicolas 1974] or the tibial attachment of the ligament [Mauck 1936 and O'Donoghue 1973]. However, no technique proved to be satisfactory. None was able to restore a ligament with proper isometric attachment which, in our opinion is the major cause of failure. In this paper we are presenting our experience with a rather new technique which is based on the principles used by Nicholas in 1973

Chronic anterior cruciate ligament deficiency: result after extra-articular tenodesis and combined extra-articular with intra-articular reconstruction using a free patellar tendon graft

58 patient with chronic anterior cruciate deficient knees were treated by surgical stabilizing procedures. Of these 28 cases had Macintosh's lateral substitution reconstruction and 30 cases had combined extra-articular and intra-articular reconstrusction using a free pateller tendon graft. Results were evaluated after an average follow up of 29. 8 months. In the group treated by extra-articular substitution alone jerk test was abolished in 21 cases [75%] and Lachman's test was abolished in only 8cases [28.5%], while in the group treated by combined extra-articular and intra-articular free patellar tendon graft, jerk test was abolished in 24 cases [80%] and Lachman's lest was abolished in 22 cases [73.3%] but at the expense of prolonged rehabilitation and some limitation of knee motion

Reconstruction on the anterior cruciate ligament using the ilio-tibial band by Marshall procedure

32 pateints with anterolateral instability who underwent Marshall procedure using the ilio-tibial band for reconstruction of the anterior cruciate ligament have been reviewed after a mean follow up of 22.8 months, the procedure abolished a positive pivot shift test in 23 patients [71.8%]. A review of literature on the different procedures used to correct this instability, as well as the underlying theoretical advantages of this procedure were presented

Result of surgical repair of acute medial ligament complex of the knee

Fourty two cases were the subject of repair for acute medial ligament injuries. Twenty five cases [59.5%] were rated as excellent, thirteen [30.9%] as good and four [9.5%] as poor. Repair or reconstruction of a concomitant cruciate injury should be attempted to at the same time: a peripherally detached meniscus should be sutured and preserved

treatment of unstable Colle's fractures using the external fixator

Fifty cases of unstable Colle's fracture were treated using small Hoffman external fixator using the principle of ligamento taxis across the wrist-joint. They were followed for a minimal period of one year. The final end results were; 32 cases as excellent [64%], 15 good [30%], 2 fair [4%] and 1 poor [2%]. This technique is strongly recommended by the authors in cases of unstable Colle's fracture

scapular spine a potential free vascularised bone graft anatomical study

Since the use of free vascularised rib graft by-Buncke 1978 and free vascularised fibular graft by Taylor 1975, investigators were on the search for new bones to be used as free vascularised grafts. Several bones where investigated since then, the iliac crest based on the superficial circumflex illiac or the deep circumflex iliac [Taylor 1979], the lateral crest of the scapula [Teot 1981] based on the circumflex scapular, the second metatarsal based on the dorsalis pedis artery [Macleod et al 1979]. Recently we have been trying to investigate the possibility of using the scapular spine based on the suprascapular vessels as a free vascularised graft