Parsonage-Turner syndrome (acute brachial neuritis).

The cases of seven patients who had had acute brachial neuritis (Parsonage-Turner syndrome) were reviewed retrospectively. The patients had been followed for a mean of six years (range, three to ten years) after the onset of the symptoms. All patients had had an acute onset of intense pain in the shoulder without antecedent trauma. The pain decreased spontaneously and eventually resolved completely in all patients. Weakness in the shoulder had developed at a mean of approximately four weeks after the initial onset of pain. The weakness decreased spontaneously but very gradually in all patients; three patients had persistent, mild weakness at the most recent follow-up evaluation.

Treatment of symptomatic hammertoe with a proximal interphalangeal joint arthrodesis.

This study examined 76 consecutive patients (100 feet) treated by a single surgeon for both flexible and rigid hammertoes with a PIP arthrodesis using custom-machined drills, a peg cutter, and hole cutter, combined with an extensor tenotomy and dorsal capsulotomy. Forty-eight percent of patients were defined as satisfied without reservation, 37% were defined as satisfied with reservations, and 15% were defined as dissatisfied. The incidence of radiographic fusion was 95% (130/137 toes). The most common reasons for either reservation or dissatisfaction included incomplete pain relief, residual toe angulation, and prolonged shoe wear restriction in the postoperative period. Based upon the results of this study, the authors suggest that when using a peg and socket arthrodesis for hammertoe correction (1) there is a 95% rate of radiographic fusion, (2) patients over 65 years old be alerted to a diminished rate of satisfaction, and (3) a distal flexor tenotomy be considered in patients with a preoperative DIP flexion contracture.

Total hip arthroplasty without cement in obese patients. A minimum two-year clinical and radiographic follow-up study.

A retrospective study of patients who had had a primary total hip arthroplasty without cement between 1983 and 1990 was done to examine differences in clinical and radiographic results between obese and normal-weight individuals. Patients were considered to be of normal weight if the body-mass index (calculated as weight in kilograms divided by height in meters squared) was between twenty and less than thirty, and they were considered to be obese if the body-mass index was thirty or more. There were 127 normal-weight patients (142 hips) and fifty-five obese patients (sixty hips) in the analysis. Eight obese patients (eight hips) who had a body-mass index of forty or more were considered to be morbidly obese and were examined separately as a subset of the obese group. The duration of follow-up averaged forty-eight months (range, twenty-four to ninety-two months). There were no differences between the groups with regard to age, diagnosis, the type of stem or cup, the type of bone, the postoperative level of activity, or the duration of follow-up. The obese patients had a significantly greater loss of blood during the operation than the patients in the normal-weight group. There were no significant differences between groups with regard to the prevalence of perioperative complications, the number of units of blood transfused, the operative duration, or the duration of hospitalization. Of the 202 hips, 184 (91 percent) were pain-free or only mildly painful at the latest follow-up examination.(ABSTRACT TRUNCATED AT 250 WORDS)