Radioisotope scanning in bone tumours

Thirty-three patients having bone tumours [18 malignant 9 benign and 6 secondaries] are studied by technetium 99 m-phosphonate scanning. There was a higher percentage of diffusely increased activity [38.3%] in malignant tumours compared to that in benign tumours [22.2%]. The study showed that technetium 99 m bone scanning is of little value in the differentiation between malignant and benign bone tumours and in defining precisely the local extent of the tumour. On the other hand it showed a high sensitivity for early detection of bone secondaries

Cystic lesions of the cervico trochanteric region of the femur

Fifteen patients [8 males and 7 females] having cystic lesions in the cervico-trochanteric region of the femur were studied. Their mean age was 12.6 years. Their pathological examination was monostotic fibrous dysplasia [7], aneurysmal bone cyst [5], simple bone cyst [3]. They were treated by curettage and bone grafting, supplemented by internal fixation in five cases. The cavities were completely obliterated in 12 cases. Two cases recurred and reoperation by curettage and grafting resulted in complete cure. In the last patient there was slow taking of the graft, and progressive coxa vara, corrected by osteotomy with fair results

Different methods of tension band wiring for transverse fracture patella

A series of patients were suffered from transverse fracture patella. Three methods of treatment were applied. Group I. : Includes 11 cases and treated by tension band wiring. Group II. : Comprises 10 cases and treated by modified tension band technique. Group III. : 10 cases were managed by longitudinal anterior band. The average age was 39 years old. The male to female ratio was 3 : 1. Closed fractures were in 28 cases and open fractures in 3 patients. All cases were followed with an average 12 months. The details of the results and complications in the text. The longitudinal anterior band method obtained better results than the original tension band wiring and the modified tension band technique. The patella is a sesamoid bone, which acts as an intermediate link of cartilage cells making friction of cartilage to cartilage instead of cartilage to tendon[1,2]. From full extension to 90 the patellar facets of the femur articulate with the medial and lateral facets of the patella. Beyound 90 the patella rotates around a vertical axis and shift laterally, in this position the medial femoral condyle articulate with the odd facet[3]. The patella acts as a pulley which displaces the quadriceps tendon anteriorly in extension and this improves the function of the extensor apparatus[4, 5, 6]. It also of cosmetic value especially in females. The aim of this work is the treatment of transverse fracture patella by: 1. The tension band wiring. 2. The internal fixation with two Kirschner wires in addition to tension band wiring. 3. Longitudinal anterior band with or without circulage. A clinico-radiologic studies of the results of these three methods, hoping at finding the proper indication of every method and the advantages of each one

Treatment of pyogenic Arthritis of the knee joint

17 pts. of different ages having acute pyogenic arthritis of 18 knees due to variabla causes have been treated. The treatment regimen adopted was arthrotomy, thorough lavage with continuous suction drainage for 3 days following surgery. Early knee flexion were encouraged under light skin traction with later two weeks of cast immobilization. In all 12 cases presenting within the 1st week the functional outcome was excellent. In the other 5 cases presenting later than the 1st week, partial synovectomy was added to the above treatment program, with satisfactory results in 4 of them. It is concluded that acute pyogenic arthritis of the knee is best treated by urgent arthrotomy, with additional synovectomy in cases seen later. Early knee flexion exercises proved to be a worth-while addition in the management of such cases. There is general agreement regarding the necessity for urgent surgical drainage of an infected joint. Although antibiotics have reduced the number of deaths and of complications of suppurative arthritis, yet a large number of patients do not retain a functional joint after treatment. There are however, several methods of joint drainage including repeated aspirations, closed suction drainage, arthortomy and open arthrotomy [Ballard et al., 1975]. As regards post operative management, opinions are controversial; whereas most authors agree that the infected joint has to be immobilized immediately after drainge, yet others do encourage early active motion. In the present work we studied the results of treament of pyogenic knee arthritis by arthrotomy with closed suction drainage and early active movements, with additional synovectomy in some cases

Primary Austin Moore prosthesis replacement for femoral head fracture with posterior dislocation of the hip

Nine cases of femoral head fracture with posterior dislocation of the hip were treated by primary Austin Moore replacement. Five males, four females. Average ages 38.6 years old. All cases were followed for 12 months. Seven cases were good end result and two cases were fair. Detail of the results see the text. The main advantages of this method is the prevention of late development of secondary Osteo-arthritic changes of the acetabulum, in addition early mobilisation of the patient

Total condylar knee replacement follow-up study of 26 knees

Follow up study for 26 knees treated by TCR. Seven patients suffered from bilateral knee affection, and twelve were unilateral. Fourteen females and five males, twenty two were rheumatoid arthritis and four osteoarthritis. The youngest patient rheumatoid arthritis was 27 years old, the oldest one osteoarthritis was 62 years old. All cases were followed for average 21 months clinical evaluations were assessed according to the knee function assessment chart suggested by British orthopaedics Association. TCR shows it to be effective in achieving the aims desired in total knee arthroplasty. Decreased pain and improved function relatively few complications have been noted in most of the patients