Elbow arthroscopy for management of loose bodies and synovial chondromatosis

Elbow arthroscopy has dramatically altered the approach to the diagnosis and treatment of a variety of elbow joint problems. Thirteen elbows Arthroscopy had been done removing different sizes of loose bodies from both anterior and posterior elbow compartments. In addition to loose bodies removal partial synovectomy of three cases with synovial chondromatosis had been done with excellent outcome. Pain relief and improvement of elbow range of motion were recorded in this procedure where eleven patients had scored as excellent and good. Average follow up were 6months. Elbow arthroscopy is valuable technique that must be encouraged to be used more and more in different elbow pathologies

Evaluation of the recurrence rate of aneurysmal bone cyst after different surgical reconstructive options

A review of 20 patients with aneurysmal bone cyst involving different anatomic locations in the skeleton who were evaluated and staged according to Enneking et al., [1-5] system as 11 active benign lesions [55%] and 9 aggressive benign lesions [45%]. Meticulous curettage was achieved in 15 patients and autogenous bone grafting was applied in 11 patients, 3 of them paternal bone grafting was used and in 4 cases no grafts was applied. In 5 patients resection of the affected bony tubular segment was achieved without reconstruction in 4 of them and a fibular grafting done for the fifth. The mean age at surgery was 16 years old. Union was achieved in all the cases at an average of 9 months. As regard the complications that needs reoperations was in 4 cases of local recurrence and graft resorption necessitating re-grafting, 2 cases with nerve palsy spontaneously improved during the follow up and one case with residual coxa vara which corrected after cyst healing. The mean follow up period was 22.4 months. The functional results of the procedure were rated as excellent in 18 cases [90%], fair in one case [5%], poor in one case [5%]. The end results of the procedure are justifiable for tumor surgery provides cyst healing and ossification with sufficient biological strength and durability with a stable limb and excellent functional end result

use of ilizarov technique in management of tibial non unions with bone loss

Sixteen patients aged 22-55 years were treated for tibial non-union [14 atrophic, two hypertrophic] with bone loss [1-10 cm, mean 5.2 cm] by the llizarov technique and fixator. Nine had chronic osteomyelitis, 12 had a bony defect [2-8 cm], mean 2.9 and 10 had a deformity. Non-union, bone defects, limb shortening, and deformity all were addressed simultaneously with the Ilizarov apparatus Bone defects were closed from within without bone grafts by the llizarov bone transport technique of sliding a bone fragment internally, producing distraction osteogenesis behind it until the defect is bridged [internal lengthening]. Length was re-established by distraction of a percutaneous corticotomy. The resulting distraction osteogenesis obviated the need for a bone graft in every case. Deformity was corrected by means of hinges on the apparatus. Infection was treated by radical resection of the necrotic bone and internal lengthening to regenerate the excised bone. Union was achieved in all cases. The mean time to union was 16 months. The bone results were excellent in 10 cases [62.5%] good in 4[25%] and fair in 2[12.5%]. The functional results were excellent in 11[68.75%] cases good in 3[18.75%] fair in 2 [12.5%]

Endoscopic laser assisted disc decompression [ELADD]

Percutaneous discectomy has become a viable alternative in the treatment of herniated lumbar intervertebral disc. Holmium: YAG laser delivered through laser fibers had been used under endoscopic control to treat 50 patients with lumbar disc prolapse, that had failed a minimum of 6 months conservative therapy. All patients were presented by radicular leg pain with or without back pain and a correlative imaging study. Surgery was done under local anesthesia using Xylocain with general intravenous sedation. The patients were monitored by an anesthesiologist and were discharged the same day of surgery. At one-year follow-up success rate was 92%. ELADD represents a more cost effective and safer treatment alternative to traditional invasive surgical procedure