Arthoscopic decompression in the management of subacromial impingement syndrome

Open acromioplasty has classically been described as a method of treatment for suhacromial shoulder impingement syndrome. However the arthroscopic method of management has also recently gained wide popularity. The aim of this work was to present clinical outcome of arthroscopic decompression in the management of subacromial shoulder impingement syndrome. A case series. The study involved 30 patients with stage Il-Ill impingement; 18 females [60%] and 12 males [40%] Arthroscopic decompression was done from the bursal side [subacromial decompression]. Among other exclusion criteria in this series; there were no cases with concomitant rotator cuff ruptures requiring repair. The primary outcome measure was success of the procedure as judged by postoperative University of California at Los Angeles [ULCA] score on the last follow up visit and Neer Criteria for satisfaction. The secondary outcome was complications of the procedure. Average age at time of operation was 43.3 years. The mean follow-up was 25 months [range, 9 45]. Outcome was satisfactory in 90°/; 53.3% excellent and 36.7% good. Three patients had unsatisfactory results; 2 fair and one poor. No postoperative complications were found. Results of arthroscopic subacromial decompression though somewhat technically demanding-are gratifying when performed properly in selected patients. Hospitalization is brief with rapid return to daily activities and little risk of deltoid muscle complications

Closed reduction and percutaneous pinning of displaced supracondylar humeral fractures in children

Supracondylar fracture of the distal humerus is the most common elbow fracture in children [60% of elbow fractures]. The peak age for Supracondylar fractures is between 6 and 7 years. This fracture is classified into extension or flexion injuries based on radiologic appearance. Between November 2002 and August 2005 120 child in the age group between 4 years and 13 [with mean age 7.1 years] including 80 boys [67.7%] and 40 girls [33.3%] with left elbow involvement in 71 patients and right elbow in 49 patients with displaced Supracondylar humeral fracture were treated by closed reduction and percutaneous pinning under image intensifler control using crossed pins for fixation [1.6 or 1.8 K-wires].The follow up ranged between 9 and 12 months. The patients are assessed according to both functional [Range of Motion] and Cosmetic factors [Carrying angle] and the overall results were excellent in 89 cases [74.1%], good in 21 cases [17.5%],fair in 2 cases [1.7%] and poor in 8 cases [6.7%] losed Reduction and percutaneous pinning is safe, cost effective and allows direct assessment of the carrying angle of the extended elbow after fracture stabilization