Results of internal fixation forearm shaft fractures

98 forearm shaft freactures were treated by AO plating. There were 3 surgeons oprating. Open fractures occurred in 18% of the fractures. Reviews after a mean of 20 months after the accident showed solid union in 95% of the fractures and satisfactory functional results in 88% of the forearms. Superficial infection occurred in 14 cases while deep infection occurred in 6 cases. Nonunion occurred in 4 bones necessitating operative intervention. 3 cases had cross union limiting supination and pronation. 6 patients sustained with the fractures nerve injury, and 2 cases during operation. All were repaired, but only 3 recovered, and tendon transfer was performed for these unrecovered cases. The results show that internal fixation with AO plates gives a satisfactory method for treatment of forearm shaft fractures provided that aseptic proper techniques are used

Proximal row carpectomy

Proximal row carpectomy was done in 21 patients. Eleven had an ununited fracture of the scaphoid bone. Seven complained of Kienbock's disease and three had unreduced lunate dislocation. The right side was affected in 12 and the left in 9. The patients included 13 males and 8 females, their ages ranged from 19 to 58 years. Eighteen patients had excellent results and could resume their previous work. Three cases were considered failure due to persistent pain, marked stiffness or weak grip. They were followed up for 1-6 years with an average 4.7 years with still good results

Early management of congenital clubfoot

213 feet of congenital clubfoot deformity were treated. The deformity was bilateral in 79 and unilateral in 55. It was mild in 91, severe in 111 and arthrograypotic in 11. Out of this material 143 [67.13%] could be fully corrected by conservative treatment and 70 [32.87%] needed surgical release. 7 cases showed signs of recurrence and needed tibialis posterior transfer. Talectomy was done for all arthrogrypotic cases. The results varied inversely with the age of the patient and the severity of the deformity

Experience with supracondylar fractures of the humerus

Three hundreds and forty five patients with supraeondylar fractures of the humerus were included in this study. Two hundreds and forty seven patients were treated conservatively by manipulation and posterior plaster of Paris slab with the elbow fixed in flexion and extension alternatingly. Sixty eight patients were operated upon through the medial approach. Thirty patients were operated upon through the posterior approach. In all groups the younger the patient the better was the result. Patients fixed in extension had better results than those fixed in flexion. Patients operated upon through the medial approach showed much better results than those of the posterior approach

value of strontium scanning in spinal lesions

This is a review of 85 cases of spinal back pain which have been investigated in the [Back Clinic] in the western infirmary, Glasgow. All patients were fully investigated clinically, radiologically and by laboratory tests to reach the diagnosis. Scanning with strontium 87 was used in the work up for the diagnosis of the corresponding pathology in 64 cases. There were 37 females and 48 males with their age ranging from 14-78 years with the average of 46 years. 34 cases had an increase in bony uptake suggesting an abnormal pathology which were further investigated when still in doubt, by needle biopsy to reach the correct final diagnosis. 30 cases had a normal uptake. 21 cases needed no scanning in the work up to reach the diagnosis. The conclusion was reached that scanning with strontium 87 offers a good look at the bones in a dynamic role, better than the conventional two dimensional radiology method and is used as a diagnostic screen for the patients pathology and help in formulating the patients' management

role of cephalexin in controlling infection during intramedullary nailing of the femur

Forty-two cases of fracture of the shaft of the femur were divided into two groups of 21 cases each and were treated by insertion of a Kuntscher intramedullary nail. One group was given cephalexin preoperatively, during operation and postoperatively; the other was not. samples of the tissue fluids from the intramedullary canal and the Redi-Vac were tested both by broth turbidity and by culture and sensitivity. The results were compared by both laboratory and clinical data and it was concluded that cephalexin is an effective drug for the prophylaxis of infection during orthopaedic operative procedures

new approach to low pack pain

This new approach to the problem of low back pain is based on prospective clinical study of a series of 900 patients. Of these 432 were unselected new patients [primary referrals] sent by GPs to routine back clinic and 468 were assessment, diagnosis and treatment of problems from other specialists [secondary referrals], serving the West of Scotland [population 3 million]. The series included 36 patients with tumors, 16 with infection, 24 with osteoporotic fractures, 22 with old traumatic fractures, 32 with spondylolisthesis and 24 with miscellaneous inflammatory and similar pathology