ABSTRACT
Radioactive synoviorthesis with 198Au, 90Y, 186Re, and 31P would seem to be the treatment of choice for recurrent hemarthroses in hemophilia. The clinical results, obtained by different centers, show a definite diminution of hemarthroses in 88% of cases. The advantages of radioactive synoviorthesis compared with surgical synovectomy are: better results, the requirement of substantially reduced antihemophilic factor, the possibility of performing the procedure on multiple cases concurrently on an ambulatory basis, no interference with articular range of movement, and the low cost of the procedure. In cases of failure, the procedure can be repeated after 6 months, and on as many as 3 occasions. Studies performed on the chromosomal changes that could be attributed to the radioactive material show the disappearance of these alterations a few years after treatment. No physical changes have been found that could be attributed to cytogenic alteration (hematologic or other) in any reported patients.
Subject(s)
Gold Radioisotopes/therapeutic use , Hemarthrosis/radiotherapy , Radioisotopes/therapeutic use , Rhenium/therapeutic use , Synovial Membrane/radiation effects , Adolescent , Adult , Child , Hemarthrosis/etiology , Hemophilia A/complications , Humans , Treatment OutcomeABSTRACT
After having dealt with over 150 cases of fracture-dislocations of the cervical spine, the authors conclude that conservative orthopaedic treatment leads to the best results. The lesions are classified in upper and lower cervical spine. The latter has been divided into two subgroups according to the presence or abscense of neurological involvement. The importance of skull traction and of a well-moulded minerva plaster jacket is stressed. An adjustable leather collar is a useful alternative for immobilisation and exercises, favouring spontaneous fusion. In neither group, should surgical fusion be considered a routine procedure.
