Combined surgery in recurrent dislocation of the patella

Between January 2001, and January 2003, eight operations were done on eight patients suffering from unilateral recurrent dislocation of the patella. Six were females and two males. The age of them ranged between 19 and 24 years [average 21.5 years]. The right knee was affected in four patients. The procedure was combined including lateral release [and closure of the gap after the release by a strip from the deep fascia of the distal thigh], and medial transposition of the tibial tuberosity. The operations were done at El-Minia University Hospital, and the follow-up period ranged from 9 months to 16 months [average 14.5 months]. The results were good in seven cases [87.5%], and one case [12.5%] with recurrence after trauma four months from surgery

Evaluation of the results of intertransverse fusion in situ for spondylolisthesis in adults

Twelve patients with a mean age 45 years, suffering from spondylolisthesis were treated by intertransverse fusion in situ in El-Minia University Hospital. The mean follow-up period was two years. The technique of Wiltse and Spencer was used by splitting the sacrospinalis muscle longitudinally. The anterior part of the iliac crest was used for grafting instead of the posterior. This has the advantages of being safe procedure avoiding the risk of damaging cuneal nerves, blood loss, injury of the sacroiliac joint, lumbar hernia formation, pelvic dislocation and deep-seated infection of pelvic bones. The results according to the criteria of Seitslo et al. [1990] were nine cases good, two cases fair, and one case poor. This was because of superficial wound infection and premature cast removal by the patient

two-stage procedure for treatment of established Volkmann's contracture

Ten cases of established Volkmann's ischemic contracture in children were treated by two-stage procedure. In the first stage, the deformity was corrected either by skidding operation in mild cases or sliding operation and excision of the degenerated muscles in moderate and severe cases. Neurolysis of the ulnar and median nerves were done in all cases. In the second stage, tendon lengthening was done in moderate and severe cases by transfer of the cut ends of the superficialis to the profundus tendons. The age of the patients raged between 6 and 12 years [with a mean of 8 years]. They were six boys and four girls. The period of follow up ranged between 6 and 12 months. The results were evaluated according to modified Boyes' method and Sheehan's method. Two cases were excellent, four cases were good, two cases were fair and the two cases with poor result were due to severe contracture and deformity

Treatment of delayed union of humeral shaft fractures by interlocking nailing

Fifteen patients [nine males and six females with a mean age of 43 years] with delayed union of humeral fractures were treated by interlocking nail. The time delay between injury and operation ranged from 3.5 and 4.5 months with a mean of 4 months. Three patients had proximal fracture, 8 had middle third and 4 had distal third fractures. Antegrade nailing was done in 4 patients, while retrograde nailing was fine in 11 patients. Only 4 cases needed open reduction and iliac cancellous bone grafting, 2 of them had also primary radial nerve palsy. The mean period of follow up was 9.66 months and the mean period of healing was 5.8 months. The results, evaluated according to the criteria of Rommens et al. [1999], were excellent in 12 patients, good in one patient, fair in one patient and poor in one patient. The primary radial nerve palsy improved after neurolysis during surgery and the nerve function recovered gradually during follow up