Results of ulnar to median nerve pedicle grafts in the forearm

Nerve pedicle grafts in the forearm were performed on six patients with Volkmann's Ischaemic contracture with massive damage of both median and ulnar nerves. The operation was performed in two stages, in the first stage, flexor pronator release was done and the distal ends of the proximal segments of the median and ulnar nerves were sutured together and the ulnar nerves were incompletely sectioned high in the axilla. Six weeks later, the ulnar nerve was transposed distally and sutured to the healthy distal segment of the median nerve proximal to the wrist joint. All patients regained a reasonable motor and sensory recovery in the area supplied by the median nerve and sudomotor recovery was good. Trophic ulcers on the tip of medial three fingers have markedly decreased. The patients can manage variable independent activities of daily life. This procedure definitely should have a place in situation when the median and ulnar nerves have been damaged beyond hope of recovery

Closed intramedullary nailing for displaced tibial fractures

We treated forty tibial shaftractures in forty patients using Grosse-kempf interlocking nail. Twenty fractures were transverse or short oblique, twelve fractures were spiral, six were comminuted and two were segmental fractures. Twenty-six of the fractures were located in the middle third of the shaft. The median time passed since injury to operation was 12 days [range 4 hours to 12 days] the median time of postoperative weight bearing was four days range, [2 to 7 days] the median time to radiographic union was thirteen weeks [range, 10 to 40 weeks] two fractures required bone grafting. The results in forty patients were excellent in 32 patients [80%], good in 6 patients [15%] and in two patients [5%] was poor, the use of this method is excellent in treating closed tibial shaft fractures

Open reduction and internal fixation of comminuted, intra-articular structures distal radius

Thirty patients with severely displaced intra-articular fractures of the distal end radius were treated by open reduction and internal fixation. All fractures were type C according to the classification of AO system. At mean follow-up of 2.5 years and according to MecBride and Lidstrom system of evaluation the results indicated that patient satisfaction was high 90% Functional and radiographic results were excellent or good in 90% and poor in 10% of the patients

Open reduction and internal fixation for comminuted intercondylar humeral fractures [type C]: results in sixteen patients treated by open reduction and internal fixation

We review a series of sixteen intercondylar fractures of distal humerus. All patients had Muller [type C] fractures and [50%] of the patients had articular comminution [type C [3]]. The average follow up period was three years range [25 to 48 months]. Results were good or excellent in [75%] with an average range of movements 115° degrees. Complications include, post operative neuritis in five patients, two delayed union and myositis ossifications in one patient

Metatarsal osteotomy in the treatment of hallux valgus

One hundred feet in 85 patients operated upon for correction of symptomatic hallux valgus deformity. The ages of patients ranged from 14 to 60 years. Seventy patients had unilateral operation while 15 patients had been operated upon bilaterally. Forty four patients were females and 41 were males. Distal metatarsal osteotomies, Mitchell, modified Hohmaann, and Chevron techniques were utilized as well as Wilson oblique osteotomy. The results were rated excellent and good in 84.4% in Wilson group, 62.4% in Mitchell group, 64.7% in modified Hohman group and 50% in chevron group. The Wilson oblique osteotomy and modified Hohmann and the Mitchell osteotomies has been found the simplest and most proven methods of surgery recommended in adolescent and young adult and even older patient hallux valgus where there is no degenerative changes. Chevron osteotomy in spite of straight forward, simple procedure, yet it is recommended in the treatment of patients who have limited degree of deformity

Cast-brace in femoral shaft fractures in children

Sixty-four children aged 4 to 12 years with 64 fractures of middle and distal thirds of femoral shaft, were treated by cast-brace technique after initial period of skin traction. There had left the hospital in an average period of 21 days. The fractures healed in average period of 7 weeks. While the cast-brace was worn, all did not show any increase in the shortening or the angulation which had been accepted before application of the cast. Cast-bracing provided more freedom to the child, and the parents and minimized the hospital stay period

Posterolateral fusion for management of spondylolisthesis

Twenty-seven patients with L4-L5 and L5-S1 spondylolisthesis have, been treated surgically. The average age of the patients at the time of operation was 23.8 years. Bilateral intertransverse [posterolateral] fusion had been performed in 21 patients. Posterolateral fusion combined with decompression had been undertaken in 6 patients. Most patients left the hospital at the third week after operation. The average follow-up period was 3.5 years with range of 2 to 5 years. Solid fusion was achieved in 22 [81.5%] patients. 26 [96.3%] of patients returned to their original work and 24 [88.9%] of patients returned to their full activity without symptoms. There were neither serious complications nor significant degenerative changes in the lumbar spine after fusion. Our experience with this limited number of patients suggests that fusion in situ is a safe and reliable surgical method for treatment of spondylolisthesis