ABSTRACT
The adverse effects of excessive tourniquet pressure on underlying muscle were studied using a cat model. A direct effect of the magnitude of tourniquet pressure on the degree of muscle disability was observed. The effect of direct pressure on the muscle may contribute to the postoperative weakness seen in the quadriceps muscle. Our data, in conjunction with the results of other studies that correlate certain tourniquet times and pressures with potential adverse effects, suggest that the selection of an appropriate tourniquet pressure and duration will minimize the development of clinically significant complications.
Subject(s)
Muscles/physiology , Tourniquets/adverse effects , Animals , Cats , Muscle Contraction , PressureABSTRACT
The diagnosis of acute and chronic injuries of the ACL has been reviewed. Attention has been given to the history, physical examination, and other diagnostic tools available for evaluation of the ligamentous injury. Clinical correlations have been highlighted. Finally, our recommendations for surgical intervention have been presented.
Subject(s)
Knee Injuries/diagnosis , Ligaments, Articular/injuries , Acute Disease , Chronic Disease , Humans , Joint Instability/diagnosis , Joint Instability/physiopathology , Joint Instability/surgery , Knee Injuries/physiopathology , Knee Injuries/surgery , Ligaments, Articular/physiopathology , Ligaments, Articular/surgery , RuptureABSTRACT
Thirty-three patients who had cerebral palsy and scoliosis underwent posterior spinal fusion with Luque-rod segmental instrumentation. The mean curve measured 65 degrees preoperatively and 30 degrees postoperatively. The mean loss of correction was 3 degrees after a mean length of follow-up of forty months. As of the time of writing, pseudarthrosis had not developed in any patient. No patient had a broken rod or an increased neurological deficit. There were no major pulmonary complications. The most common early postoperative complication was wound infection, which occurred in five patients, none of whom required removal of the hardware. We concluded that posterior spinal fusion with Luque-rod segmental instrumentation is an effective method of obtaining and maintaining correction of a spinal curve, with minimum complications, in patients who have cerebral palsy and progressive scoliosis.
Subject(s)
Cerebral Palsy/complications , Orthopedic Fixation Devices , Scoliosis/surgery , Spinal Fusion/methods , Adolescent , Adult , Child , Humans , Lumbar Vertebrae/diagnostic imaging , Lumbar Vertebrae/surgery , Postoperative Complications , Radiography , Reoperation , Scoliosis/diagnostic imaging , Scoliosis/etiology , Spinal Fusion/instrumentation , Thoracic Vertebrae/diagnostic imaging , Thoracic Vertebrae/surgeryABSTRACT
Rheumatoid arthritis (RA) affects the articular surfaces and the ligamentous supporting structures of synovial-lined joints. In approximately one-fourth of the patients with RA, the sacroiliac joints demonstrate radiographic changes of subchondral bony erosions and articular destruction, as well as ankylosis. Subluxation or dislocation of the sacroiliac joint usually is associated with significant trauma to the pelvis. Nontraumatic disruption of the sacroiliac joint is a rare occurrence, but it should be considered in evaluating a patient with longstanding RA, sacroiliac joint tenderness, and radiating lower extremity symptoms.
