Clavicular nonunions treated with compression plate fixation and cancellous bone grafting: the functional outcome.

We evaluated fracture healing and functional outcome after surgery in 16 patients with midshaft clavicular nonunion. The operative treatment consisted of compression plate fixation and autologous cancellous bone graft. The follow-up examination took place at an average of 54 months (range 26 to 90 months) after surgery. Radiographs were reviewed, and 12 patients underwent clinical review. All fractures united successfully. Two patients had a second operation because of loosening of the screws shortly after the first operation. Eleven of 12 patients had a good or excellent Constant score (>70 points). Nine of 12 patients returned to their preinjury activity level. Treatment with compression plate and autologous cancellous bone graft yields a high rate of healing and an acceptable functional outcome.

[Necrotizing fasciitis]. / Fasciitis necroticans.

Necrotizing fasciitis is a rare soft tissue infection with a high rate of mortality. Decreased capacity of the immune response is the overall disposing factor. Necrotizing fasciitis can develop very rapidly, and a rapid diagnosis and aggressive surgery provides the best prognosis.

[Atraumatic avascular necrosis of the femoral head in adults. Diagnosis and treatment]. / Atraumatisk avaskulaer nekrose i caput femoris hos voksne. Diagnostik og behandling.

Atraumatic avascular necrosis of the femoral head is a well-known disease which in the majority of cases is associated with conditions like alcohol abuse or steroid therapy. Early diagnosis is important, in particular in younger patients, in order to preserve the femoral head. Plain radiography, computed tomography, scintigraphy, and magnetic resonance imaging are the radiological methods used for detection of avascular necrosis, and especially magnetic resonance imaging has like scintigraphy been found to be well suited for diagnosis in early stages. Characteristic magnetic resonance scan patterns are described. Surgical treatment is necessary in most cases. Various methods are used, according to the stage of the disease.

[Congenital kyphoscoliosis complicated by paraplegia]. / Kongenit kyfoskoliose kompliceret med paraplegi.

Congenital scoliosis accounts for 10% of all scolioses which require treatment. Correct treatment demands an exact and early detection of the deformity. Early intervention may only require a minor operation. Two cases are presented with paraplegia as the first presenting symptom of congenital kyphoscoliosis. In both cases anterior decompression and spondylodesis was followed by early neurological recovery. After a second operation with posterior spondylodesis and instrumentation ad modum Cotrel-Dubousset the patients were mobilised. Patients with congenital spinal deformity ought to be investigated and treated in a highly specialized department of spinal surgery.

Clinical importance of the extensor digitorum brevis manus muscle. Case report.

The extensor digitorum brevis manus muscle is a rare accessory hand muscle. It presents as a swelling on the dorsum of the hand and is often misdiagnosed as a ganglion. In symptomatic cases the treatment is division of the extensor retinaculum or ablation of the muscle.

Aneurysmal bone cyst of the hand. An unusual location in the first phalanges of the first finger. Case report.

A 40-year-old woman presented with a lesion on the first phalanx of her right thumb, which on radiography appeared to be a cystic lesion. This was treated with curettage and bone graft but recurred a year later. It was treated in the same way, and 18 months later there has been no sign of recurrence. Histological examination confirmed that it was an aneurysmal bone cyst.

[The intraosseous ganglion. The differential diagnosis of pain in the forefoot]. / Det intraossøse ganglion. En differentialdiagnose ved forfods-ledsmerter.

The intraosseous ganglion is a rare benign cystic lesion of bone which is frequently located in close association with the articular cartilage of the distal metaphysis of long bones. In many cases, it is clinically silent but it may cause persistent pain. The commonest location is at the ankle. It appears radiographically as a well-demarcated circular or oval radiotranslucent defect surrounded by a thin margin of sclerotic bone. Treatment consists of curettage and bone grafting.

[Accidental falls in homes for the aged]. / Faldulykker på plejehjem.

Accidental falls among residents of homes for the elderly have only received scanty notice in the literature. During a period of 15 months, 296 falls among 1,856 residents of homes for the elderly were analyzed prospectively. The age-specific incidences for falls and fractures of the neck of the femur which are treated in hospital were found to be higher for residents of homes for the elderly as compared with elderly persons living at home in the age group 65-85 years. Residents of homes for the elderly who constitute 7% of all ages over 65 years are responsible for 21% of all accidental falls and 32% of all the lower limb fractures treated in hospital.