Management of segmental bone defects by Ilizarov technique

This study included 20 segments in 20 patients with segmental bone defects [16 tibial and 4 femoral] due to non-union, chronic osteomyelitis or pseudoarthrosis. All tibial segments were managed by intercalary bone transport while, in all femoral segments, immediate excision of pathological segments and acute gap reduction were done according to the soft tissues around. Then bone transport with or without lengthening was started. Our average age was 19.2 y [9-42 y]. Male to female ratio was 11: 9. Also, the average length of the regenerated segment was about 6.9 cm [4 - 14.5 cm] with an average fixator time of 10.6 m [5 - 18m]. All cases were followed up after fixator removal for about 13m [6 -22m]. Some complications were met, but satisfactory results were obtained in most cases

Revision of failed Austin Moore prostheses to total hip arthroplasty

In this work we evaluated the functional results of the revision of eleven failed Austin Moore hemiarthroplasties to cemented total hip replacements. There were four females and seven male patients, with age ranged between 43 and 64 years [average 52 years and 6 months]. Our patients had their femoral head originally replaced by Austin Moore prostheses following displaced femoral neck fractures, but their implants failed after an average period of 11 months [range: 8-21 months] before considering revision. The causes of failure were either due to loosening [6 patients], protrusio i.e. acetabular wear [3 patients], or both loosening and protrusio [2 patients]. Harris hip rating score of our patients before revision was poor for a minimum of six months. Cemented Muller total hip prostheses were used for revisions. We reported either good or excellent results in ten patients, and only one patient scored a fair result after a follow up period of an average of 14 months [range 13: 38 months]

new four in one stabilizing operation for anterior recurrent dislocation of the shoulder joint

A preliminary study of a new surgical technique included eight male patients with recurrent anterior dislocation of the shoulder, all managed operatively after failure of the rehabilitation program. The new surgical technique included four main steps done in one operation, namely imbrication of the redundant capsule, anterior bone block by using the coracoid process, muscular dynamic buttress for anterior and inferior capsule and finally imbrication of the upper half and lower half of the subscapularis muscle. Our average age 27.88 years ranged from 22 - 40 years. All achieved satisfactory results [excellent to good]. Bony union of the transferred coracoid process has occurred in all patients. No recurrence of dislocation has happened after an average follow up period of 3.15years ranged from 8 months to 6 years

Porous coated cementless total hip replacement. A comparative study between its use in rheumatoid arthritis versus secondary osteoarthritis

This study was undertaken to evaluate the functional results of the cementless porous coated prostheses for hip replacement for relatively young patients [average age is 38 years, range 30:52 years], who had THR for either rheumatoid arthritis [group A] or a secondary OA [group B]. We followed our patients for an average period of 3.5 years, range from 2 to 5 years. The average preoperative Harris Hip rating score for the rheumatoid patients was 28.1 points [18: 61 points], this has improved to 82.4 points [28: 87.3 points]. The average of the pre operative score on Harris hip rating score for those who had secondary OA was 47.4 [29:76], this has been improved to 93.6 [34 : 100]. We had a total of three cases who developed mechanical failure of their implants during follow up, two of them were from group A and one from group B

Arthroscopically assisted anterior cruciate ligament reconstruction

In this work we reported the results of a total of sixteen patients who underwent arthroscopically assisted anterior cruciate ligament [ACL] reconstruction with the use of autogenous patellar ligament graft [APLG]. All the patients but one were males, and the right knee was involved in nine patients. The mean of their age was 26.57 years and the mean time between their injury and operation was 10.69 months. The mean of the follow up period was 12.3 months. We achieved satisfactory results in all patients [good to excellent on Lysholm score]. Also, there were substantive improvement in their symptoms mainly the giving way, and pain and we also report no cases of significant patellofemoral pain. Moreover, there was a significant difference in the number of patients who had some complications well known with ACL reconstruction with the use of [APLG] with arthrotomy like patellar problems, stiffness and quadriceps weakness