Hip arthroplasty for managem of failed treatment of proximo hip fractures

The purpose of the present study is to evaluate the results and complications of hip arthroplasty performed as a salvage procedure after the failed treatment of proximal hip fracture. sixteen patients [nine men and seven women] with a mean age of 63.6 years were treated at Ain Shams University Hospitals with hip arthroplasty after failed treatment of proximal femoral fractures. Three patients had a total hip arthroplasty with cementless cup, eleven had a bipolar hemiarthroplasty, and two had a unipolar hemiarthroplasty [Thompson]. There were some intra-operative complications that delayed recovery but did not affect the end result. The mean duration of follow-up was 15 months. The patients were evaluated both clinically and radiologically. Thirteen patients out of the sixteen had no to mild pain, three patients had moderate to severe pain. Fourteen patients are walking without support. Radiologically there were no signs of loosening. Hip arthroplasty is an effective salvage procedure after the failed treatment of proximal femoral fractures. But it is technically more difficult than routine primary hip arthroplasty

Management of chondral and osteochondral defects of the knee using osteochondral autograft transplantation

Evaluate the treatment of Chondral and Osteochondral defects of the femoral condyles of the knee using ipsilateral osteochondral autograft transplantation. This work was done at Ain Shams university hospitals, between 2003 and 2005. Eleven patients were submitted in this work aging between 20 and 53 years with lesions varying between an articular cartilage lesion and lesions involving cartilage and subchondral bone. They were treated using Osteochondral autograft transplantation [open technique]. Cases with malalignment, ligamentous instability; arthritic or mentally unreliable were excluded. Cases were evaluated 6 months following surgery using the HSS [Hospital of Special Surgery] scoring system. Ten out of eleven patients had a score ranging from excellent to good as they noted considerable improvement in symptoms especially concerning pain. Only one patient had a poor score. On the basis of these encouraging results, I believe that Mosaicplasty may be a good alternative for the treatment of localized chondral and Osteochondral defects

Total knee arthroplasty in patients with severe varus deformity

This study reviewed the clinical and radiological outcome of total knee arthroplasty [TKA] in 18 patients [21 knees] with a preoperative varus angular deformity greater than 20 degree. All cases were corrected by stripping the soft tissue insertions from the medial side of the tibia. Only five cases required an augmentation by medially inserted metal wedge. The preoperative diagnosis of all patients was osteoarthritis. The average follow up period was 14 months [11-25 months]. The patients were evaluated using the hospital for special surgery score [HSS score]

Biological plating in comminuted supracondylar fractures of the femur using the MIPPO technique

A prospective study was done to evaluate the outcome of 8 comminuted supracondylar fractures of the femur treated in accordance with the principles of indirect reduction and biological osteosynthesis using the minimally invasive percutaneous plate osteosynthesis technique [MIPPO]. The patients were followed for mean of 9 months. Two were open grade I Gustilo. The 8 supracondylar fractures were treated with la 95 DCS [4 fractures], 95 condylar plate [3 fractures] and condylar buttress plate [1 fracture]. One fracture was bone grafted. There was no immediate postoperative complication. All fractures united on an average of 16 weeks, irrespective to bone grafts. Late complications consisted of limited knee flexion [1 patient]

Posterior lumbar interbody fusion in spondylilytic sponydlolisthesis

Stabilization after decompression of spondylolytic spondylolisthesis is difficult because of a lack of fusional bone mass, gap between the transverse process bases and incompetent anterior disc support. Adding posterior lumbar interbody fusion [PLIF] to the procedure offers anterior support, reduction and a broad fusion base. Eleven female patients, with spondylolytic spondylolisthesis were treated by posterior decompression, pedicle screw fixation and PLIF using 2 pieces of iliac tricortical bone grafts. The patients were followed for a mean of 1 year, and were evaluated both clinically and radiologically. All 11 patients were improved except one who is still complaining of back pain due to graft collapse and non-union

Evaluation of transpedicular fixation in treating dorso-lumbar injuries

From April 1996 through July 1999, we encountered 27 patients with dorso-lumbar injuries of the spine and were treated by transpedicular rod fixation systems. 17 patients had burst fractures, and 10 patients had fracture-dislocations. Posterolateral fusion was done to all patients. 5 patients had complete paraplegia, 15 patients had various neurological deficits, and 7 patients were neurologically free before surgery. Indirect decompression was done for the patients who have canal compromise less than 50%. The average follow-up period was 18 months [range 6-30 months]. The average correction of the anterior wedge compression angle postoperatively was 11.5° with an average loss of 3.1° at follow-up. The average correction of the local kyphosis angle was 12.2° with an average loss 4.2° at follow-up

Early results of primary total hip in acetabular fractures

In this study we report a short-term results of 30 Acetabular components done in patients with acetabular fractures, 24 of them were united acetabular fractures with arthritic changes, and 6 were fresh acetabular fractures. Follow-up was for a mean 3.4 years [1.4 to 4]. The results were evaluated both clinically using the Harris Hip score and radiologically for the acetabulum using Delee and Charnley score system. Our average Harris hip score was 91. X-ray evaluation was done using the method described by Delee and Charnley 1976, and we had only one case of type 3-demarcation line