Trapezoid osteotomy for slipped capital femoral epiphysis.

Twenty-three patients with chronic or acute to chronic slip of the capital femoral epiphysis were treated using a modified trapezoid osteotomy of the femoral neck. All slips were greater than 60 degrees. After a follow-up period of 70 (54-93) months, the results were excellent or good in 18 hips, fair in 1, and poor in 4 hips. Avascular necrosis developed in 3 hips, and chondrolysis in 2.

Scintigraphic evaluation of tibial shaft fracture healing.

A scintigraphic study of the healing process of type A and B closed tibial shaft fractures was carried out in 40 cases treated non-operatively, comprising 32 men and eight women aged 30.6 yr on average. Scintigraphic scans were obtained with technetium methylenediphosphonate (MDP-Tc99m, 25 mCi) at 6, 12 and 24 weeks after the fracture and an activity index was calculated taking the mean of three consecutive uptake counts for both fractured and normal opposite leg, used for comparison. The results showed that the activity index in general decreased progressively from the first to the third evaluation, with little difference in behaviour between the two types of fractures. However, for B type fractures the activity index remained stable from the first to the second evaluation, followed by a marked decrease at the third evaluation, with a comparable end result for both fracture types. It was concluded that a decrease of the activity index occurs in both types of closed fractures undergoing uneventful healing and that such a decrease can be taken as a parameter for further studies which include delayed union and non-union.

Bilateral transscapholunate dislocations.

Bilateral transscapholunate dislocations were treated with immediate open reduction and internal fixation. Eighteen months after injury the patient was asymptomatic.

Fractures of the humerus in arm wrestling.

Two cases of spiral fracture of the humerus, which occurred during arm wrestling, are reported. The possible mechanism is discussed.

External fixation of intertrochanteric fractures of the femur.

Forty patients with intertrochanteric fractures of the femur were treated by external fixation between July 1992 and April 1994. They were selected because of their high surgical risk, and evaluated by radiographs immediately after operation, and at 30 and 90 days. The results indicate that external fixation is a useful method of treatment for this type of patient.

[The treatment of chronic osteomyelitis]. / Tratamento das osteomielites crônicas.

From 1986 to 1990, sixty patients were treated for chronic osteomyelitis with surgery and chemotherapy. The clinical and radiologic follow-ups ranged from twelve to sixty months. The surgery was associated with a six-month oral sulfamethoxazole-trimethoprim combination chemotherapy. Clinical cure was achieved when inflammatory signs and symptoms disappeared, as happened to 50 (83.33%) of the single surgery cases, and to 9 (15%) of the multiple surgery cases. For one case (1.67%) osteomyelitis was not cured.

Tumor maligno de células gigantes de bainha tendinosa do dedo indicador da mäo esquerda: relato de caso / Malign giant cell tumor of tendinous sheath of the index finger of the left hand: report of a case

Os autores descrevem um caso de tumor maligno de células gigantes de bainha tendinosa do segundo dedo da mäo esquerda, com evoluçäo de aproximadamente dez anos. Realçam a pouca freqüência da neoplasia, as dificuldadesdiagnósticas e a conduta adotada