A Novel Technique for Fixation of Non-union Unicondylar Hoffa's Fracture: A Case Report.

Hoffa fractures are rare and difficult fractures to manage. Hoffa fracture involves a coronal plane fracture of posterior femoral condyle. Non-union in Hoffa fracture is further difficult to manage. The surgical management for such nonunion includes open reduction with recon/LCP plate or screw fixation with bone grafting. The problem with plates is the difficulty in contouring the plates according to the shape of posterior femoral condyles. We describe a new technique with 2 L shaped neutralisation plates placed in a circular fashion. This technique provides a more rigid construct and gives better holding strength of screws in Hoffa fragment. This enhances union and mobilisation can be started early.

A Novel Technique for Fixation of Non-union Unicondylar Hoffa’s Fracture: A Case Report

@#Hoffa fractures are rare and difficult fractures to manage. Hoffa fracture involves a coronal plane fracture of posterior femoral condyle. Non-union in Hoffa fracture is further difficult to manage. The surgical management for such nonunion includes open reduction with recon/LCP plate or screw fixation with bone grafting. The problem with plates is the difficulty in contouring the plates according to the shape of posterior femoral condyles. We describe a new technique with 2 L shaped neutralisation plates placed in a circular fashion. This technique provides a more rigid construct and gives better holding strength of screws in Hoffa fragment. This enhances union and mobilisation can be started early.

Giant intramuscular calcifying aponeurotic fibroma of gluteus maximus: case report.

Calcifying aponeurotic fibroma (CAF) is a rare soft tissue tumour which occurs mainly in children and adolescents. It usually involves the distal portion of the extremities, i.e. the hands and feet. A 2-year-old child with a large CAF is presented. The case was unusual in view of its large size (10 × 7 × 5 cm), dense calcification in such a young child, and because it was situated in the substance of gluteus maximus muscle. There has been no recurrence at 3-year follow-up.

Early Arthroscopic Release in Stiff Shoulder

Purpose: To evaluate the results of early arthroscopic release in the patients of stiff shoulder Methods: Twenty patients of stiff shoulder; who had symptoms for at least three months and failed to improve with steroid injections and physical therapy of 6 weeks duration; underwent arthroscopic release. The average time between onset of symptoms and the time of surgery was 4 months and 2 weeks. The functional outcome was evaluated using ASES and Constant and Murley scoring systems. Results: All the patients showed significant improvement in the range of motion and relief of pain by end of three months following the procedure. At 12 months; mean improvement in ASES score is 38 points and Constant and Murley score is 4O.5 points. All patients returned to work by 3-5 months (average -4.5 months). Conclusion: Early arthroscopic release showed promising results with reliable increase in range of motion; early relief of symptoms and consequent early return to work. So it is highly recommended in properly selected patients. Level of evidence: Level IV

[Selenium plasma concentration level in children with food allergy]. / Ocena stezenia selenu w surowicy u dzieci z alergia pokarmowa.

Selenium (Se) is an essential component of many mammalian enzymes and therefore plays an important role in different metabolic processes. Se deficiency occurs in inadequate diet consumption as well as in some digestive tract and allergic diseases. In this research we showed that Se plasma concentration levels in healthy children was 71.8 mg/l, whereas in those with food allergy 54.1 mg/l (with smaller intestinal villus atrophy) or 50.4 mg/l (with greater intestinal villus atrophy). Obtained results indicate that children with food allergy display higher risk of Se deficiency. Antioxidative and immunomodulatory action of Se, connecting with promising literature data of Se supplementation, promote us to state, that this trace element could be used for accessory food allergies treatment.

Secretory meningioma of the brain. Report of two cases.

Two cases of cerebral secretory meningioma, occurring in 57 and 33-year-old females are reported. The tumors were located in the tentorial and frontotemporal region, respectively. The general histologic appearance of the tumors was of meningothelial meningioma (case 1) and meningioma with microcystic and angiomatous features (case 2). The most striking histological finding in both tumors were numerous pseudopsammoma bodies, localized chiefly around blood vessels. The inclusions were slightly eosinophilic, stained strongly with PAS method and were differing in size from 3 to 30 microns. Tumor cells containing or surrounding pseudopsammomas were immunopositive for cytokeratin and epithelial membrane antigen. In the first case, individual pseudopsammomas were strongly positive for carcinoembryonic antigen. Some diagnostic aspects of this antigen and problems regarding differential diagnosis in secretory meningioma are briefly discussed.

Topical heparin for the treatment of acute superficial phlebitis secondary to indwelling intravenous catheter. A double-blind, randomized, placebo-controlled trial.

OBJECTIVE: To assess the clinical efficacy of a topical gel containing 1000 IU x g(-1) of heparin, applied three times daily for a maximal period of 7 days to patients with acute superficial phlebitis secondary to indwelling intravenous catheter. METHODS: A Double-blind, randomized, placebo-controlled study was conducted in one of the internal medicine wards of a tertiary General Hospital in Barcelona, Spain. Inpatients of both genders over 18 years of age that developed superficial phlebitis and gave informed consent were included in the study. The sample size estimation was 132 patients. Sixty-six patients were allocated to each group. There were five protocol deviations and 24 withdrawals in the intervention group, and one protocol deviation and 25 withdrawals in the control group. Consequently, 37 patients in the intervention group and 40 in the control group completed the trial. The main outcome measure was the disappearance of the symptoms and signs of superficial phlebitis. Clinical course, investigator's global impression and adverse events were also recorded. RESULTS: According to the intention-to-treat analysis, after treatment for 7 days superficial phlebitis healed in 27 of the 61 patients (44.3%) who received topical heparin, and in 17 of the 65 patients (26.1%) receiving placebo, giving a relative risk [95% confidence interval (CI)] of 1.69 (1.03-2.78). This indicates that six patients (95% CI, 3-72) have to be treated in order to induce one additional healing. The clinical course and the overall clinical impression were similar in both groups. One patient treated with topical heparin developed mild urticaria. CONCLUSION: Topical heparin is safe and effective for the treatment of superficial phlebitis secondary to indwelling intravenous catheter.

[The state of hygiene and health care in Wilno at the end of the XIXth and at the beginning of the XXth century as described in the letters of doctor Wladyslaw Zahorski]. / Stan Higieny I lecznictwa w Wilnie na przelomie XIX I XX wieku w swietle listow doktora Wladyslawa Zahorskiego.

The letters of dr Wladyslaw Zahorski from Wilno published in "Nowiny Lekarskie" in the years 1899-1914 are a source of information on the condition of health and the level of health care of the Wilno population at the end of the XIXth and at the beginning of the XXth century. The sanitary condition of the city was very bad. Infectious diseases killed people in the thousands. Many superstitions and prejudices were being spread especially during an epidemic. Wilno did not have well equipped and organized hospitals. Apart from state hospitals, there were private small hospitals which had better conditions for treating people. Poor people were given some medical aid free. A fight against social ignorance, infectious diseases and to improve sanitary condition of the city was conducted by Wilno Medical Society.

[Carcinoid of the larynx]. / Rakowiak krtani.

The case of carcinoid of the larynx is presented. Attention is focused on the difficulties with establishing the diagnosis. The principles of treatment this kind of neoplasm are reported.

[Clinical and patho-morphological evaluation of patients dying from bronchial asthma]. / Ocena kliniczna i patomorfologiczna chorych zmarlych na astme oskrzelowa.

Mortality from asthma within 1978-1987 was analysed retrospectively. This analysis included selected factors determining the mortality in this disease. Some conditions being able to decrease death risk in asthmatic patients were defined. The results of autopsies of patients who died from asthma were also analysed with an attempt to interpret those results basing on the selected clinical data. Unified scheme of sampling for pathomorphological examinations was proposed together with proper interpretation of histopathologies in the lungs and myocardium. Presented data are preliminary and will be continued in foreseen prospective studies.

[Primary lung cancer from biopsy material of the Pathomorphology Department of the Silesian Medical Academy in Zabrze]. / Pierwotny rak oskrzela w materiale oligobiopsyjnym i Katedry i Zakladu Patomorfologii Slaskiej Akademii Medycznej w Zabrzu.

An analysis was carried out of material biopsied during fiberoptic bronchoscopic examination of 289 patients suspected of lung malignant disorders were present more often in males. In the group of patients older than 40 years the most often diagnosed malignant process was squamous cell carcinoma. A high correlation of clinical suspicion of malignant process and histopathological diagnosis was found. A low rate of diagnosis of operable cases was found.

Community mental health centers and insurance reimbursements.

This study represents the first of a two-stage project. The first phase of the study examined the funding sources for the 40 Community Services Boards in Virginia. Data provided from the Department of Mental Health and Mental Retardation in Virginia examined fee collections which are comprised of direct client, commercial insurance, Medicaid and Medicare. An analysis of quarterly reports from 1982 to 1984 revealed that Medicaid collections have decreased significantly, while commercial insurance reimbursements have increased significantly. These results, although limited to data from Virginia, point to the need to examine if these shifts are occurring nationwide, and to determine if the shift toward commercial insurance is impacting upon the delivery of services in Community Mental Health Centers.