Sacroiliac joint fusion for chronic pain: a simple technique avoiding the use of metalwork.

A previously undescribed method for posterior fusion of the sacroiliac joint (SIJ) utilizing the Cloward instrumentation is presented, suitable for cases with chronic pain and intact ligamental structures of the SIJ. The advantages of the method in comparison with other described options include minimal disturbance of the periarticular structures, avoidance of introduction of metalwork and preservation of the iliac crest contour. This technique has been used in five cases with follow-up longer than 2 years (mean 29 months, range 25-41 months). In all cases there was resolution of their painful symtomatology.

Dislocation of the Austin Moore hemiarthroplasty: is closed manipulation justified?

In a retrospective study the outcome of 13 patients who underwent manipulation under anaesthesia (MUA) following dislocation of an Austin Moore hemiarthroplasty was determined. Nine patients died within 4 weeks of an MUA. Seven patients had a successful MUA, two patients without further complication. Six patients had an unsuccessful MUA. Four patients were discharged from hospital. The outcome following MUA of a dislocated uncemented hemiarthroplasty is poor. Subjecting elderly patients to an anaesthetic for a closed manipulation is a procedure of little clinical benefit. We were unable to define any selection criteria to improve the result.

Scaphotrapezio-trapezoidal dislocation. A case report.

A complex hand injury with scaphotrapezial dislocation and dislocation of the trapezoid, third, fourth, and fifth carpometacarpal joints occurred when a motorcyclist was involved in a road accident. The extent of the injury was initially overlooked. Combined injuries of the carpus and carpometacarpal joints can easily be missed at radiographic examination. The true lateral radiograph of the wrist is necessary in the diagnosis of complex wrist injuries.