ABSTRACT
Medial clavicle excision has been reported by several authors, but few cases are documented, and long-term follow-up information is lacking. The purpose of this study was to examine the long-term results of medial clavicle excision in regard to function, pain, cosmesis, and complications. Fifteen patients ranging in age from 18 to 64 years (average 43 years) were evaluated an average of 4.6 years (range 1 to 14 years) after proximal clavicle excision. The indications for excision were unstable anterior subluxation/dislocation of the sternoclavicular joint (four cases), unstable posterior dislocation (one case), sternoclavicular osteoarthritis (nine cases), and proximal clavicle osteomyelitis (one case). An average of 2.9 cm of the medial clavicle was excised (range 1 to 4 cm). Fourteen of the 15 patients received significant relief of pain. On a strict grading scale four patients had an excellent result, five a good result, four a fair result, and two a poor result. Regeneration of the clavicle appeared to contribute to a poor result. No operative complications occurred. These findings aid our understanding of surgical options and outcome in the treatment of sternoclavicular joint disease.
Subject(s)
Clavicle/surgery , Joint Dislocations/surgery , Joint Instability/surgery , Osteoarthritis/surgery , Osteomyelitis/surgery , Sternoclavicular Joint/injuries , Adult , Female , Follow-Up Studies , Humans , Joint Dislocations/epidemiology , Joint Instability/epidemiology , Male , Osteoarthritis/epidemiology , Osteomyelitis/epidemiology , Range of Motion, Articular/physiology , Retrospective Studies , Sternoclavicular Joint/physiopathology , Time Factors , Treatment OutcomeABSTRACT
Two hundred eight primary total hip arthroplasties were reviewed to evaluate the effect of closed suction drainage. This review included 45 hips in which closed drains were used and 163 hips in which drains were not used. These two groups were compared for possible differences in wound problems, temperature elevations, changes in Hgb/Hct, and the need for transfusions. There was no statistically significant difference in postoperative temperatures or decrease in Hgb. However, there were four superficial wound infections in the drained group and three superficial wound infections in the non-drained group (P < .025). There were no deep infections in either group. These findings suggest closed suction drainage provides no apparent advantage in uncomplicated primary total hip arthroplasty.
Subject(s)
Hip Prosthesis , Suction/methods , Aged , Blood Transfusion , Drainage , Female , Hemoglobins/analysis , Humans , Male , Middle Aged , Osteoarthritis, Hip/surgery , Postoperative Care/methods , Retrospective Studies , Surgical Wound Infection/prevention & controlABSTRACT
The peroneal nerve is susceptible to traction injury during inversion ankle sprains. Previously, these traction lesions have been identified only at the fibular neck and popliteal fossa level. This report illustrates a previously unreported condition of perineural fibrosis of the superficial peroneal nerve at the level of the ankle following an inversion ankle sprain. Perineural fibrosis should be considered in the differential diagnosis of patients with persistent pain after ankle sprain.
