Redistribution of muscle power around the shoulder to improve the daily activities for brachial plexus birth palsies

This study included 19 children had adduction internal rotation contracture with internal rotation deformity of the shoulder and disability in their daily activities following obstetric brachial plexus palsy that involved the fifth and sixth cervical roots. These children were treated by courses of physiotherapy for different durations before and after surgery. At operation tenotomy of the pectoralis major muscle was done through anterior axillary incision. The insertions of latissimus dorsi and teres major muscles were identified and released through a second posterior axillary incision, then tranplanted to the rotator cuff as high as possible. The mean age at operation was four years, eleven month. The deformity was fully corrected in 17 cases and partially corrected in two cases. At an average of follow up two years, two months the mean increase in active shoulder abduction was 54 degrees and the mean gain of active external rotation was 43 degrees. The postoperative use of the affected limb in all daily activites was achieved in 16 cases. No neurovascular injury or post operative infection occurred

Glass injuries of the hand

Ninety seven consecutive patients had glass injuries of the hand. They were studied to determine the type of glass involved and its influence on hand injuries encountered. At the final follow-up [average, 12 months], 62 patients [63.9%] had involvement of deep structures indicating the need to keep in mind the possible affection of deep structures and to avoid hurried diagnosis. Most of the hand injuries were inflected by annealed glass. Prevention of glass injuries may be achieved through safety education in this respect and keeping glass wastes to be disposed in special containers

Posterior spinal fusion using corticocancellous allograft

To determine the efficiency of allograft bone in spinal surgery, the results of a study of the use of allograft versus autograft bone are presented. Two groups of patients were included in the study; i] 23 patients having autogenous bone from the iliac crest and ii] 10 patients having spinal fusion with banked bone from the femoral head. There was no difference between the two groups in the radiographic assessment of bone graft mass after six months. No major operative complications were faced. There was, however, a marked reduction in operative time and in blood loss in the patients receiving banked bone and also a much lower incidence of late symptoms relating to the operative site. One concluded that even in the presense of adequate iliac crest, the use of banked bone for grafting in spinal surgery and fusion technique is quite important

Evaluation of surgical release of post infected contracted proximal interphalangeal joint of the finger

Twelve cases of post-infective contracted proximal interphalangeal joint [PIP] were collected. The middle and the ring fingers were affected. Faulty management of the infective tenosynovitis of the flexor tendon sheath was the cause of contracture. The key for surgery is release of the adherent sublimis tendon which does not leave any disability and release of one collateral ligament that dose not leave any in stability. So long as the particular surface of the PIP joint was not affected nearly full range of movement was regained