Open reduction and internal fixation of intra-articular smith fractures of the distal end of radius

The results of fifteen patients with displaced intra-articular Smith fractures of the distal end of radius treated by open reduction and internal fixation were evaluated. Buttress plate, Kirschner wire or both were used in all cases. At a mean follow up period of 31 month, 80% of the patients had a good or excellent rating by the scoring system of Gartl and and Werley, but only 60% had such a rating when the modified scoring system of Green and O'Brien was used. All of the fractures were healed at an average of ten weeks. A step-off two millimeters or more in the distal radial articular surface at the time of healing was important because the five patients in whom the fracture healed with this amount of incongruity had post- traumatic arthritis at the follow up period compared with only two patients with step-off less than two millimeters and did not affect the final result

Open reduction and ao osteosynthesis of displaced intra-articular fractures of the calcaneus

Twenty displaced intra-articular fractures of the calcaneus [in 20 patients] were treated by open reduction and AO osteosynthesis. Lateral approach, corticocancellous iliac bone graft, AO cervical plate, AO 4 mm cancellous screws were used in all cases. Active and assisted active movements of the subtalar joint started five to seven days postoperatively. Scoring system of Crosby and Fitzgibbons 1990 was used for clinical assessment. Radiological measurements were made from lateral and axial views. The articular congruity of the subtalar joint and any arthritic changes were also assessed. Thirteen cases were good, six were poor and one was fair after a follow up period ranged from 16-36 month [average 26 months] with an average of 73% of normal subtalar motion

role of the weight bearing dome and anatomic reduction in conservative treatment of central fracture-dislocation of the hip

Ten patients had central fracture-dislocation of the hip were treated conservatively by biaxial traction for 12 weeks. Judet and Letournel classification was used and the weight bearing dome [WBD] was evaluated by Matta roof measurements. The average follow up period was 26 months. The average functional result was satisfactory in 70%. The least satisfactory results were seen in fractures crossing the WBD of the acetabulum, in which congruency could not be achieved [three cases]. However, fractures crossing the WBD, which could be reduced by traction to less than 2 mm, gave good or excellent result [one case]. It was concluded that conservative treatment of acetabular fractures can be very successful even in fractures crossing the WBD providing that congruence is preserved during the period of traction

Treatment of kienboeck's disease by radial shortening

8 patients [8 wrists] who had Kienbock disease without degenerative changes in the joints were treated in the period from 1989 to 1992 in El-Minia University Hospital by radial shortening. Small DCP 6 holes was used in all cases through anterior approach of the lower third of radius. The segment of the bone removed was equal to the amount of negative ulnar varience that was measured radiologically pre-operatively. Average follow up period was 9.8 months. There was marked improvement of pain in all cases Range of movement of the wrist was improved in all directions and in all cases. Radiologcal improvement was reported in 2 cases by decreased sclerosis, increased trabecular pattern and increased size of the lunate

Reconstruction of anterior cruciate ligament with an intra-articular patellar tendon graft

20 cases of complete tear of ACL were diagnosed both clinically and arthroscopically, in El-Minia University Hospital, in the period from Feb. 1990 to Feb. 1992. Clancy modification of the original Jones procedure was used in the treatment of all cases, using the central one-third of the patellar tendon as a free autogenous graft. The aim of this study, is to evaluate the results of ACL reconstruction using this technique with some technical modifications [1] Fixation of the femoral component by cone method. [2] Fixation of the tibial component by 2 K-wires, [3] The collected fragments from drilling and curettage were used as a graft to the donar sites in the tibia and the patella for better healing and cosmosis. Lisholm score was used to evalute results, 60% excellent, 20% good and 20% fair

Treatment of persistent plantar heel pain by calcaneal osteotomy

Twenty-five patients with 28 feet suffering from persistent plantar heel pain [plantar fasciitis calcaneal spur syndrome], with average age of 39.5 years, were treated by calcaneal osteotomy, and approached the medial side of the heel. The late results, after a follow up period of 2 years in average, were satisfactory in 25 feet [89.3%] and unsatisfactory in 3 feet [10.7%]