ABSTRACT
The incidence and causes of perioperative ulnar neuropathy in a prospective series of 203 consecutive patients were examined. Three percent of patients had ulnar neuropathy develop in the entire prospective series. The incidence was 6% in patients having total hip arthroplasty. There was a highly significant association between a tilted body position on the operating table and development of ulnar neuropathy on the contralateral side. This position rotates the arm internally and places the ulnar nerve at risk for direct compression.
Subject(s)
Orthopedic Procedures/adverse effects , Postoperative Complications , Ulnar Nerve Compression Syndromes/etiology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Posture , Prospective Studies , Ulnar Nerve Compression Syndromes/physiopathologyABSTRACT
Polyethylene wear debri has been implicated as a major cause of aseptic loosening following total hip replacement. The purpose of this study is to classify patient activity levels following total hip replacement and determine if it has an effect on radiographic wear of the socket. 97 patients (115 hips) with osteoarthritis who underwent Charnley low-friction arthroplasty with a minimum of 10 year follow-up were selected. Nine patients had died. Eighty-eight questionnaires were sent of which 59 replied. However, only 40 patients (45 hips) with a complete set of x-rays were finally studied. Activity levels were classified according to post-operative occupation and activities into 'active' and 'less active' groups. Radiographic wear was measured by studying the post-operative and the 10-year review radiograph. There was a significant difference in acetabular wear between the active and the less active group (p = 0.024). No correlation was found between weight and acetabular wear (p = 0.475) or between age and acetabular wear (p = 0.278). It was concluded, therefore, that surgeons who advise their patients to avoid heavy or high intensity activities for prolonged periods, after Charnley low-friction arthroplasty, are justified in this approach.
Subject(s)
Activities of Daily Living , Arthroplasty, Replacement, Hip , Hip Prosthesis , Prosthesis Failure , Acetabulum/diagnostic imaging , Adult , Aged , Female , Humans , Male , Middle Aged , Polyethylenes , Radiography , Treatment OutcomeABSTRACT
A vertebral fracture occurred in a 51-year-old man with previously undiagnosed osteoporosis. The underlying cause of the osteoporosis was primary hypogonadism. Back pain was the presenting symptom in this case of primary hypogonadism.
Subject(s)
Back Pain/etiology , Fractures, Spontaneous/etiology , Hypogonadism/complications , Lumbar Vertebrae/injuries , Osteoporosis/etiology , Humans , Male , Middle AgedABSTRACT
A simple method of skeletal traction is described to facilitate management of complicated multiple fractures of the metatarsals following crush injuries of the foot. The system uses Brock's pins and a modified Nissen loop to achieve either balanced traction or fixed traction. Satisfactory alignment of the fractures can be maintained whilst soft tissue disorders are dealt with.
Subject(s)
Fractures, Bone/therapy , Metatarsal Bones/injuries , Multiple Trauma/therapy , Traction/methods , Fractures, Bone/diagnostic imaging , Humans , Metatarsal Bones/diagnostic imaging , Multiple Trauma/diagnostic imaging , Radiography , Traction/instrumentationABSTRACT
A consecutive series of 118 patients with fracture of the proximal end of the femur treated by the Pugh nail-plate, is reported. The contribution of failure of the device to failure of fixation is analysed. Fifteen subjects had a failure of fixation either requiring removal of the implant or resulting in malunion of the fracture. In only 2 of the fractures for which the nail-plate was designed could failure be directly attributed to the device alone. In the remaining failures of fixation the device was inappropriately used or inserted.
Subject(s)
Bone Nails , Bone Plates , Femoral Neck Fractures/surgery , Aged , Aged, 80 and over , Equipment Failure , Female , Femoral Neck Fractures/diagnostic imaging , Fracture Fixation, Internal , Humans , Male , RadiographySubject(s)
Arthritis, Rheumatoid/surgery , Hip Prosthesis , Knee Prosthesis , Adult , Aged , Female , Humans , Male , Middle AgedSubject(s)
Cartilage, Articular/physiology , Knee Prosthesis , Regeneration , Aged , Cartilage, Articular/pathology , Female , Follow-Up Studies , Humans , Middle AgedABSTRACT
In a series of 57 hemiplegic patients who subsequently fractured their hips, it was found that hip fracture occurred significantly more often on the hemiplegic side. Hip fracture was equally common in right- and left-sided hemiplegia, and often occurred within one year of the stroke. Two factors seem to be important in the genesis of hip fractures in hemiplegic patients: the tendency of stroke patients to fall to the affected side as a result of impaired locomotor function, and the development of disuse osteoporosis in the hemiplegic limb.
Subject(s)
Femoral Neck Fractures/etiology , Hemiplegia/complications , Aged , Cerebrovascular Disorders/complications , Female , Humans , Male , Middle Aged , Osteoporosis/complicationsABSTRACT
Three anaesthetic premedication regimens have been compared by double-blind controlled trial in 158 patients undergoing day-case surgery for varicose veins or hernia. Atropine plus droperidol was superior to atropine plus diazepam or atropine alone in lessening nausea and vomiting and in reducing the need for postoperative analgesia.
