[Treatment of complex elbow injuries with the hinged fixation device DJD II. Technique and results]. / Behandlung komplexer Ellenbogenverletzungen mit dem Bewegungsfixateur DJD II. Technik und Ergebnisse.

Fractures and luxations with persistent instability of the elbow are severe injuries often followed by arthrofibrosis. The need for prolonged immobilization results in shortage of the ligaments and shrinking of the capsule. Treatment with dynamic hinged external fixation offers an option of protected early mobilization providing better results and avoiding stiffness and instability. In a retrospective study 22 patients with complex injuries of the elbow were evaluated with respect to the range of motion and subjective parameters (DASH score, DASH disabilities of the arm, shoulder and hand).

Treatment of multiple actinic keratoses with topical diclofenac 3% gel in organ transplant recipients: a series of six cases.

BACKGROUND: Non-melanoma skin cancer (NMSC) represents a significant cause of morbidity in organ transplant patients; the relative risk of squamous cell carcinoma and actinic keratosis (AK) is 100 and 250 times higher, respectively, compared with immunocompetent patients. OBJECTIVES: The aim of this study was to investigate the effects of 3% diclofenac gel on the clearance rates of multiple AKs in organ transplant recipients (OTRs). PATIENTS/METHODS: An open-label study was conducted in six patients (three kidney, one liver and two heart transplant patients) with histories of multiple NMSCs and extensive actinic keratoses (AKs). Patients were treated with diclofenac 3% gel, twice daily for 16 weeks. Complete and partial clearance rates of AKs were assessed after 16 weeks and biopsies were performed 4 weeks post-therapy on clinically typical AKs identified prior to the start of treatment. RESULTS: Three out of six patients showed complete clinical and histological clearance after 16 weeks of treatment with diclofenac 3% gel. Two further patients showed a marked (> or = 75% lesion reduction) improvement in their overall AK lesion count in the treatment area. One patient showed a 30% lesion reduction in the area treated. Local adverse events at the site of application were very mild and included mild erythema and marginal erosion. No systemic side effects were reported. CONCLUSIONS: Results suggest that diclofenac 3% gel may be useful in the treatment and control of multiple AK lesions in OTRs. Further studies are needed to investigate the efficacy and safety of this therapy for the local treatment of AK in greater numbers of immunosuppressed patients.