Subject(s)
Orthopedics/trends , Rehabilitation/trends , Arthroplasty, Replacement/rehabilitation , Hand Injuries/rehabilitation , Hand Injuries/surgery , Humans , Neuromuscular Diseases/rehabilitation , Neuromuscular Diseases/surgery , Societies, Medical , Spinal Diseases/rehabilitation , Spinal Diseases/surgery , United StatesABSTRACT
This report documents the experience of using combined internal and external fixation in ankle arthrodesis. During the period from 1992 to 2000 a single surgeon used this method of fixation on 26 ankle fusions in 26 consecutive patients without exclusions. There were no nonunions and no delayed unions. The median time to union was 10.3 weeks and the mean time was 11.3 weeks (range, 7.4 to 23.2 weeks). Complications specific to this procedure included 3 (12%) minor pin tract infections which cleared with oral, out-patient antibiotics, 4 (15%) skin irritations from internal fixation pins sufficiently bothersome to require pin removal after union was obtained, and 1 (4%) painful pin tract which cleared spontaneously. Most of these complications occurred early in the series and subsequent changes in technique considerably decreased their incidence. This fixation technique produced excellent results. Combined internal and external fixation is recommended as a useful option in arthrodesis of the ankle.
Subject(s)
Ankle Joint/surgery , Arthritis/surgery , Arthrodesis/instrumentation , Arthrodesis/methods , External Fixators , Internal Fixators , Adult , Aged , Arthrodesis/adverse effects , Bone Nails , Bone Screws , Combined Modality Therapy , External Fixators/adverse effects , Female , Humans , Internal Fixators/adverse effects , Male , Middle Aged , Pressure , Surgical Wound Infection/prevention & control , Talus/surgery , Tibia/surgeryABSTRACT
With the aging population and improved methods of emergency transport, the number of surviving stroke and brain injury patients continues to increase. Aggressive rehabilitation of appropriate candidates is justified. In the period of spontaneous recovery, efforts are made to prevent fixed contractures using passive mobilization, splinting, nerve blocks, and electrical stimulation. If deformity persists and the patient is no longer recovering, operative management can help alleviate the functional and hygiene problems associated with these limb deformities.
Subject(s)
Ankle/surgery , Foot Deformities, Acquired/surgery , Foot/surgery , Brain Injuries/complications , Contracture/etiology , Contracture/prevention & control , Contracture/surgery , Foot/physiopathology , Foot Deformities, Acquired/etiology , Foot Deformities, Acquired/physiopathology , Foot Deformities, Acquired/therapy , Humans , Leg/surgery , Muscle Spasticity , Neuromuscular Diseases/etiology , Neuromuscular Diseases/surgery , Neuromuscular Diseases/therapy , Stroke/complicationsABSTRACT
Paget's disease of bone affects a significant percentage of adult and elderly patients. Although generally asymptomatic, the inflammatory changes and hypervascularity of the affected bone is prone to pathologic fracture and resultant hemorrhage. Epidural hematoma is well-described with vertebral fractures and can present as acute cauda equina syndrome. We describe a case in which an elderly female with Paget's disease sustained a minor coccygeal fracture and developed local hemorrhage and edema, which caused a sacral plexopathy that presented identical to acute cauda equina syndrome. A literature review will follow.
