Management of pathological and impending pathological fractures around the hip

Author reviewed his experience in managing 27 cases of pathological or impending pathological fractures around the hip. The study included 27 hips in 27 patients [no bilateral cases]. There were 17 females and 10 males. The age ranged at time of surgery between 28 years and 61 years [with the mean average of 47 years]. Follow-up ranged between 6 months and 42 months postoperatively with a mean average of 28 months. At the final follow-up, one case necessitated revision due to recurrence of an aneurysmal bone cyst and another case necessitated conversion of a hemiarthroplasty into gridlestone procedure due to deep seated infection. Other than these two cases, the overall final result was considered satisfactory [92.6%]. It was concluded that surgical stabilization for pathological or impending pathological fractures yielded good results regarding the pain and function in the operated group

Two staged reconstruction of flexor tendons of the fingers using ipsilateral pedicled flexor digitorum superficialis tendon graft

Twenty-three patients with flexor tendon injuries were operated upon for flexor tendon reconstruction using a staged technique of Hunter rode replacement, followed by pedicled flexor digitorum superficialis graft. The indication for this technique was excessive scarring of the tendon bed. There were 16 men and 7 women ranging in age from 16 to 48 years. Four patients had 4 fingers involved, 2 patients had 3 and 6 patients had 2 fingers involved, while the rest 11 patients had one finger involved. The number of involved fingers were 45 fingers. The postoperative follow up period ranged from 1 to 3 years. The measurements of active range of motion of the involved finger were taken in the closed fist position. Twenty seven fingers in this series were rated as excellent, 15 as good, 3 as fair and no finger as poor. Two stage flexor tendon reconstruction using this technique proved to be a safe and effective technique with minimal complications

Arthroscopic release of the diabetic persistent frozen shoulder

Sixteen diabetic patients who developed frozen shoulder which failed to respond to conservative treatment were subjected to arthroscopic shoulder release between January 2000 and March 2001. They had persistent pain, stiffness and limited function. They were followed up for an average period of 22 months, ranging between 19 and 24 months and evaluated according to the modified score of UCLAwith an average improvement of 16.25 points; 3 patients scored excellent [18.75%], 12 good [75%] and 1 fair [6.25%] result. In addition, the patients were assessed preoperatively and postoperatively for forward flexion, external rotation, abduction and internal rotation. The study revealed a good measurable increase in the range of motion in all planes. The study also considered arthroscopic release of the diabetic persistent frozen shoulder to be an effective method of treatment

Periprosthetic fractures around the hip

Authors reviewed their experience with 19 cases of periprosthetic fractures in 19 patients [No bilateral cases]. Follow up period ranged between 18 months and 39 months [mean average of 28 months]. Patients aged between 42 years and 67 years [mean average 58 years]. There were 11 males and 8 females. All patients were classified according to the classification. Two were type A, 13 type B and 4 type C. Treatment was tailored according to stem stability varying from simple wiring or screw fixation for greater trichinae fractures [Ag type] to compete revision using made prosthesis. We had only one case of failed fixation [5.3%]. We concluded that sound and tailored surgical management based on a proper classifications gives good results on the final outcome