RESUMO
Numerous techniques have been described for the arthrodesis of various forefoot and midfoot joints. These techniques include the use of plates, screws, wires, staples, and Steinman pins. The ease of the dorsal approach in instituting these techniques has persuaded most orthopaedic surgeons to instrument the dorsal, or compression, side of the arthrodesis. By instrumenting the compression side, the deforming forces of the arthrodesis may cause distraction on the plantar side. The use of the tension band technique in foot arthrodeses changes the plantar distraction forces to a compressive force without necessitating the exposure of the plantar surface.
Assuntos
Artrodese/métodos , Articulações Tarsianas/cirurgia , Fenômenos Biomecânicos , Fios Ortopédicos , Antepé Humano/cirurgia , HumanosRESUMO
A review of the recent orthopaedic literature reveals little information on the endocrinopathic associations of polyostotic fibrous dysplasia. This article illustrates the need for endocrinologic evaluations at both initial diagnosis and at follow-up examinations. Two patients with polyostotic fibrous dysplasia and acromegaly are presented. In both cases, diagnosis was made by endocrinologic and radiographic evaluations, including computed tomography (CT) scan of the skull. One patient had pituitary macroadenoma, and the other had pituitary microadenoma. Irradiation therapy was performed successfully in both patients without any complications.
Assuntos
Acromegalia/complicações , Displasia Fibrosa Poliostótica/complicações , Acromegalia/diagnóstico , Adulto , Displasia Fibrosa Poliostótica/sangue , Displasia Fibrosa Poliostótica/diagnóstico , Hormônios/sangue , Humanos , Masculino , Testes de Função Adreno-HipofisáriaRESUMO
A simple and efficient method of achieving and maintaining reduction of a boxer's fracture (neck of the fifth metacarpal) is described. This method can be implemented during drying of the plaster splint, and adequate roentgenograms can be taken without the presence of redundant plaster over the fracture site found with the traditional ulnar gutter splint.
Assuntos
Fraturas Ósseas/terapia , Metacarpo/lesões , Contenções , Moldes Cirúrgicos , HumanosRESUMO
A retrospective review was performed on 28 patients with low-velocity gunshot wounds to the cervical spine. These composed 31% of all spinal gunshot wounds seen during the study period between 1979 and 1988. Surgical decompression did not seem to improve neurologic recovery in either the incomplete or complete patients. Neurologic recovery also appeared to be unaffected by the presence of retained intracanal bullet fragments. The authors found no advantage to routine neck exploration of this penetrating injury. Complications were seen in 93% of the patients. Most complications were thromboembolic, pulmonary, and urinary tract infections. No cases of instability occurred as a direct result of the gunshot wound. No deaths occurred in this series. Two cases of posttraumatic syrinxes were diagnosed. The authors' current treatment recommendations for these patients include selective wound management and observation of retained intracanal bullet fragments in patients with complete lesions. Surgical decompression after this injury is not recommended.
