["Footballer's ankle". Results of arthroscopic treatment of anterior talocrural "impingement"]. / "Fodboldanklen". Resultater ved artroskopisk behandling af anterior talokrural "impingement".

INTRODUCTION: Footballer's ankle may be caused by anterior talocrural impingement of exostosis. The aim of this study was to evaluate the outcome of arthroscopic resection of exostosis, which was performed in our department. MATERIAL AND METHODS: We reviewed 17 consecutive cases of arthroscopic surgery for the bony impingement. The patients were 17 men, with an average age of 34 years. All reported pain and limited dorsiflexion in the talocrural joint. Resection of exostosis at the distal range of tibia and partial synovectomy were performed in all cases. The postoperative range of movement was evaluated after an average of eight weeks. To complete the material, we conducted a telephone interview concerning pain and return to sports. RESULTS: Dorsiflexion had objectively improved in 59%. Seventy per cent reported less pain in the ankle after surgery, whereas 59% of the patients returned to sports, 23% had given up, because of the symptoms. CONCLUSION: In cases where anterior talocrural impingement is the cause of the symptoms, arthroscopic resection of exostosis is a safe and reasonably effective treatment. The best effect was seen on pain, whereas only half of the patients had improved movement.

Endoscopic resection of the septic prepatellar bursa.

The authors show how septic prepatellar bursitis of the knee can be treated arthroscopically. The arthroscopic resection of nonseptic prepatellar bursitis has been described before, but that of the septic prepatellar bursitis has not.

Efficacy of recombinant human erythropoietin administered subcutaneously to CAPD patients once weekly.

OBJECTIVE: The purpose of the present study was to compare the dosage requirements of recombinant human erythropoletin (rHuEPO) administered subcutaneously (SC) either one or three times weekly. DESIGN: A randomized, prospective study. SETTING: The patients were recruited from two university hospitals and five county hospitals. PATIENTS: Thirty-three anemic patients on continuous ambulatory peritoneal dialysis (CAPD) treatment for end-stage renal failure completed the study. INTERVENTIONS: Initially, all were treated with rHuEPO SC three times a week until hemoglobin blood levels (Hb) remained constant between 105 and 121 g/L for three months. Following randomization, 17 patients continued the same treatment schedule (group A), while 16 patients received the same dose, but administered only once weekly for three months (group B). MAIN OUTCOME MEASURES: The Hb levels and rHuEPO doses at the start and at the end of the three-month study period. RESULTS: In group A the median Hb at randomization was 118 g/L (109-119) (25-75 percentiles) and, after three months, was 113 g/L (106-119) (p = 0.13), while in group B the median Hb was 114 g/L (108-119) and 114 g/L (106-120), respectively (p = 0.50). In group A the weekly dose of rHuEPO remained virtually unchanged during the study period, 65 (55-86) and 66.3 (55-95) U/kg/week, respectively, while in group B it was increased from 60.2 (46-88) to 77 (60-90) U/kg/week. The 22% increase (p = 0.03) took place during the last two weeks. CONCLUSIONS: Our findings indicate that a once-weekly SC dosing regimen of rHuEPO in anemic CAPD patients was equally effective in maintaining a stable hemoglobin level as a thrice-weekly dosing regimen.

Deep infection after primary hip arthroplasty: results after treatment of 10 patients.

In the period 05.06.79 -31.12.91, 2037 primary total hip arthroplasties were performed, all in ultra-clean air, wearing body-exhaust system suits and all patients recieving Meticillin as prophylactic antibiotics. None of the non-cemented arthroplasties were infected and 0.61% of the cemented hip arthoplasties were infected giving a total incidence of deep infection after total hip arthroplasty in our clinic of 0.49%. The microorganism most commonly cultured was Staph. aureus, but in one hip Listeria was cultured, which is extremely rare. In the 10 patients with deep infection the infection reccurred in 30%. Patients with a revision prosthesis in situ at follow-up, had an average Harris-hip score of 79, and radiographs showed no signs of loosening or persistant infection. The rate of deep infection and the patients' condition after the revision procedures in our series are comparable to other published series.

Subcapital fractures of the fourth and fifth metacarpals treated without splinting and reposition.

The aim of the study was to evaluate the results after treating subcapital fractures in the fourth and fifth metacarpals with immediate mobilisation and without splinting or reduction. We undertook a prospective clinical evaluation of 36 subcapital fractures of the fourth and fifth metacarpals treated with immediate mobilisation and without splinting or reduction during the period 1 January 1990 to 31 December 1992 in the accident and emergency department, Holstebro Central Hospital. After 4 weeks only 4 patients (11%) had restricted movement in the metacarpophalangeal joint (less than 0-80 degrees of movement). The fracture had healed in 33 patients (92%), and 31 of the patients (86%) were completely satisfied. We conclude that subcapital fractures in the fourth and fifth metacarpals can be treated without immobilisation or reposition.