Total hip replacement in Kuwait. Preliminary results of exeter hip prosthesis and remarks on ethnic and causative factors

This study presents clinical and radiological characteristics of 49 cemented total hip replacements of Exeter type in a series of 44 patients operated upon in Al Razi Hospital during the period 1992-1999. Different forms of secondary hip pathology accounted for most total hip replacements performed in this study Diagnostic and ethnic aspects were discussed. All patients were operated through a posterolateral approach using conventional Exeter [Howmedica] instrumentation and implant. Clinical analysis was performed using Merle d'Aubigne and Postel hip score. The method of radiological analysis is described. A single surgeon operated on all patients. During the observation period [m=3.5 years], none of the implants loosened and the average clinical score of 9.8 pts preoperatively had improved to 16.8 pts at the last follow-up. In contrast with studies done in Europe and North America, the predominant pathology among the Arabs was secondary to avascular necrosis, rheumatoid disease, or trauma. Primary osteoarthrosis was rare. Our preliminary findings are that, in the average follow-up of 3.5 years, the Exeter hip replacement gave satisfactory results. Further research is necessary to explain ethnic differences in occurrence of coxarthrosis

closed rupture of the triceps tendon with fracture of the radial head A case report and review of the literature

Rupture of triceps tendon associated with fracture of the radial head is a very rare injury. Diagnosis may be difficult and requires advanced imaging to confirm the presence of the lesion. The clinical and radiological study took place at the Al-Razi Hospital and the Department of Radiology, Sabah Hospital, Kuwait. We present a case of a sixty-five-year-old woman with diabetes and hypertension who sustained a typical injury with complete rupture of the triceps tendon. Clinical examination and radiological documentation [X-ray, US, MRI] confirmed the presence of a lesion. Repair of the avulsed tendon with anchoring to bone with wire suture was done. The final functional and radiological result was excellent. It was confirmed by a full range of movement of the elbow, good power of the triceps muscle, and radiological imaging [ultrasound, X-ray and MRI]

Hackethal stacked nailing treatment of diaphysed fractures of the humerus

This study was undertaken to evaluate the clinical and radiological results of the internal fixation of fractures of the humeral shaft using the Hackethal stacked nailing technique. Twenty patients treated with this technique in Al Razi Hospital were followed up until union, when clinical and radiological assessment was performed. Details of the surgical procedures are given. All fractures except one united. Clinical and radiological results and complications are presented. Bundle nailing continues to be a valuable, safe and low-cost option in selected cases of fractures of the humerus shaft. The indication for this fixation was transverse and short oblique fractures without comminution

Intralocal pinning for fixation of unstable fractures of the distal radius

The objective of this study was the clinical and radiological analysis of a series of thirty-four patients with 36 unstable fractures of the distal radius treated by intrafocal buttressing-pinning during the period between 1996-1997 along with a follow-up period of at least 32 weeks. Methods The technique uses dorso-ulnar, dorso-radial and lateral intrafocal K wires to support and stabilize fragments. Clinical and radiological results were evaluated according to Gartland and Werley modified by Sarmiento and Lidstroem. Results Good to excellent clinical and radiological results were achieved in 86% and 90% of cases respectively. Conclusion Intrafocal percutaneous pinning is an encouraging procedure for managing selected cases of comminuted lower radial fractures. It combines the advantages of a closed line of treatment with the advantage of stability achieved by surgical fixation