Repair of spondylolysis using a rod-screw construct

To assess the results of a technique of internal fixation consisting of pedicle screws and a V-shaped rod resting against the inferior aspect on the spinous process and the posterior aspects of the laminas and post operative bracing and rehabilitation programs. Twelve Patients with painful pars defect not responding to conservative treatment were considered to be eligible for direct repair of their spondylolysis. The surgical technique involved placement of screws on the pedicles of the involved vertebra and the fixation of the loose posterior arch with a solid rod bent in a V shape, taking purchase on the spinous process and laminae. A bone graft was placed under compression in the pars defect and postoperative bracing and rehabilitation programs were carried out. Nine patients had an excellent result, returned to normal every day life and work. The outcome in one patient was rated good and in one, fair. The procedure in one was considered a failure, although bone fusion seemed to have been obtained. No complications were encountered because of the specific design of the construct. This technique offers the advantage of being easy and fast, it can be performed using available spinal instrumentations using rods and pedicle screws. It avoids penetration of the spinal canal. This technique seems safe and effective but needs careful selection of patients. Post operative bracing and rehabilitation programs have very important role in follow up and improvement of our patients with good results

Results of sauve-kapandji procedure in treatment of posttraumatic derangement of the distal radioulnar joint

The Sauve-Kapandji procedure has been advocated as a method of treating derangement of the distal radioulnar joint [DRUJ]; especially post-traumatic problems. This work included 13 patients with post-traumatic DRUJ disorders who were treated with Sauve-Kapandji procedure. Eleven patients were available for review after an average follow up period of 31.7 months. The average age at the time of operation was 33.6 years. A Mayo wrist score was used for pre- and post-operative clinical assessment; especially pain, rotation of forearm, and complications. At the end of follow up, the functional results were excellent in six cases, good in three, fair in one and poor in one. All cases except one returned forearm rotation to within 8 degrees of the un-injured side. Nine patients had no pain; while two had moderate or severe pain on heavy work. One patient had instability of the ulnar stump. Sauve-Kapandji procedure is a good operation in posttraumatic derangement of the DRUJ and a reliable technique for restoration of range of motion and amelioration of pain with few complications