method of treatment of sectorial avascular necrosis by drilling and cancellous grafting

Ten patients with 15 osteonecrotic femoral head at stage 2 or 3 development were treated surgically. The average age was 28.6 years. Necrosis followed cortisone administration in eight patients and was idiopathic in two. The technique used was a combination of drilling aiming at decompression and Strut cancellous grafting of the weak necrotic segment of the head, supporting the articular cartilage. Partial weight bearing was allowed two months postoperatively. The follow up period ranged between 1-5 years. Hip pain was improved in six patients. Radiologically, progress or no improvement in the lesion was reported in 11 hips, especially in stage 3

Acetabular protrusion secondary to Austin Moore hemiar thoroplasty a long term study

Thirty-eight cases of Austin Moore hemiarthroplasty were reviewed for reporting acetabular protrusion. The mean age was 59 years and that of follow-up was 5.7 years. The acetabular score varied from 30 to 96 with a mean of 78.4 points. Protrusion was present in 23 cases, being most common in the age group 40-50 years, more in males than females, and increased with longer periods of follow-up. Osteoporosis, obesity and chronic medical condition have no significant effect on protrusion. The most significant factor was the level of the patient's activity after operation

Talectomy in severe club foot deformity

Talectomy operation way done on 25 feet with severe club foot deformity in 15 patients at El-Hadra University Hospital. The youngest patient aged 6 months; the oldest was 7 years. Follow up period was 4 years on the average. In 40 patients talectomy was combined with soft tissue release operation. Ninteen feet out of 22 followed up patients had satisfactory results while three were unsatisfactory

Incidence of congenital musculoskeletal malformation

A total of 5000 newly born infants were examined within the first 24 hours of their birth at El-Shatby Maternity and Alexandria Maternity hospitals for the detection of any skeletal abnormalities. Positive cases of skeletal abnormalities were subjected to radiological examination to assess the diagnosis. Ortolani's and Barlow's test were applied for the detection of cases of CDH. At this stage and positive case were re-examined a week later to confirm the diagnosis. In this series, 83 cases presented with breech, of which 16 cases showed skeletal abnormalities, i.e. 11-0.26% showed the increased incidence of skeletal abnormalities among babies presenting by breech. It was also found that drug intake [as antirheumatics, antiemetics, contraceptive pills, antifungals, antidiabetics] could cause skeletal malformations by affecting the growth of the limb buds, if taken during the first trimester of pregnancy. Concerning treatment of these abnormalities, it is universally agreed that the golden role remains, the earlier the treatment, the better the final end result both cosmetically and functionally

Rate of union in recent fractures of the scaphoid bone

Fourty cases of recent fractures of the scaphoid were met with in 37 patients during the period of 6 months from November 1984 to the end of April 1985. All patients were treated by the classical wrist guantlet type of cast. All fractures united, though the duration of immobilisation varied much. Eleven fractures united within two months, 17 between two and three months, 10 between three and four, 1 between four and five and the last between five and six months. The average duration for radiological union was 3.1 months. Tubercle and distal third fractures united in a shorter duration than waist and proximal third fractures

Infection and role of antibiotics in clean orthopedic operations

To study postoperative infection and test the effectiveness of the antibiotics currently used in our hospitals and their role in reducing infection a double blind prospective study involving 245 clean orthopaedic operations was carried out on alternating months. The cases were either given antibiotics or not regardless of their age, nature of the operation or the duration of the operative procedure. Accordingly 127 cases received prophylactic antibiotics while 116 did not. Fifteen injected cases were met with, nine in the group who received antibiotics [7%], and six in the group without antibiotic cover [5.1%]. The younger the patient and the shorter the operative procedure the less he was liable to infection. On the other hand bony operations were at a greater risk to infection [9.5%] if compared with soft tissue operations [1.8%]. The commonest offending organism was Staphylococcus aureus and commonest effective antibiotic was kanamycin

simple technique for anterior stress radiography in lateral ligament injury of the ankle

The technique described is recommended to diagnose injury of the lateral ligament of the ankle, and to verify or exclude the presence of rupture of the anterior talo-fibular ligament. Anteroposterior Rontgen views of the ankle were obtained whilst applying an anterior stress on the ankle