No abstract available.
Hand Injuries* ; Hand*

No abstract available.
Hand Injuries* ; Hand*

PURPOSE: Simultaneous bilateral total knee arthroplasty (TKA) is associated with excessive blood loss and morbidity arising from postoperative reduction in hemoglobin (Hb). The purpose of this prospective randomized study was to determine if drains have any effect on blood loss, postoperative reduction in Hb levels and transfusion rates compared to no drainage in simultaneous bilateral TKAs. MATERIALS AND METHODS: Two hundred and thirty patients who underwent simultaneous bilateral TKA by a single surgeon were randomly allotted to drain or no-drain group (n=115 in each group). Postoperative Hb level, blood loss volume and transfusion rate were compared between the two groups. RESULTS: The mean postoperative Hb level (p=0.38), blood loss volume (p=0.33) and transfusion rate (p=0.52) in the drain group were not significantly different compared to the no-drain group. No statistical difference was found in terms of complications, readmissions and mortality rates between the two groups. CONCLUSIONS: No significant difference was observed in the two groups with respect to blood loss and blood transfusion. Non-drainage does not offer an advantage over drainage with respect to conserving blood in simultaneous bilateral TKA.
Arthroplasty ; Arthroplasty, Replacement, Knee ; Blood Transfusion ; Drainage ; Humans ; Knee ; Mortality ; Postoperative Hemorrhage ; Prospective Studies ; Suction

Adult ; Anticoagulants ; therapeutic use ; Heparin, Low-Molecular-Weight ; therapeutic use ; Humans ; Male ; Upper Extremity Deep Vein Thrombosis ; diagnosis ; drug therapy

STUDY DESIGN: Prospective cohort study. PURPOSE: Evaluation of the clinico-radiological outcome and complications of limited laminectomy and restorative spinoplasty in spinal canal stenosis. OVERVIEW OF LITERATURE: It is critical to achieve adequate spinal decompression, while maintaining spinal stability. METHODS: Forty-four patients with degenerative lumbar canal stenosis underwent limited laminectomy and restorative spinoplasty at our centre from July 2008 to December 2010. Four patients were lost to follow-up leaving a total of 40 patients at an average final follow-up of 32 months (range, 24-41 months). There were 26 females and 14 males. The mean+/-standard deviation (SD) of the age was 64.7+/-7.6 years (range, 55-88 years). The final outcome was assessed using the Japanese Orthopaedic Association (JOA) score. RESULTS: At the time of the final follow-up, all patients recorded marked improvement in their symptoms, with only 2 patients complaining of occasional mild back pain and 1 patient complaining of occasional mild leg pain. The mean+/-SD for the preoperative claudication distance was 95.2+/-62.5 m, which improved to 582+/-147.7 m after the operation, and the preoperative anterio-posterior canal diameter as measured on the computed tomography scan was 8.3+/-2.1 mm, which improved to 13.2+/-1.8 mm postoperatively. The JOA score improved from a mean+/-SD of 13.3+/-4.1 to 22.9+/-4.1 at the time of the final follow-up. As for complications, dural tears occurred in 2 patients, for which repair was performed with no additional treatment needed. CONCLUSIONS: Limited laminectomy and restorative spinoplasty is an efficient surgical procedure which relieves neurogenic claudication by achieving sufficient decompression of the cord with maintenance of spinal stability.
Asian Continental Ancestry Group ; Back Pain ; Cohort Studies ; Constriction, Pathologic* ; Decompression ; Female ; Follow-Up Studies ; Humans ; Laminectomy* ; Leg ; Lost to Follow-Up ; Male ; Prospective Studies ; Spinal Canal*

Humans ; Shoulder ; physiopathology ; Shoulder Impingement Syndrome ; physiopathology

OBJECTIVEThe treatment of multi-fragmentary, intraarticular fractures of the distal humerus is difficult, even in young patients with bone of good quality. Small distal fragment, diminished bone mineral quality and increased trauma-associated joint destruction make stable joint reconstruction more problematic. The anatomically preshaped locking plates allow angular stable fixation for these complex fractures. We evaluated functional results of patients treated with open reduction and internal fixation with distal humerus locking plates for complex distal humerus fractures.

METHODSForty-three consecutive patients with articular fractures of the distal humerus were treated by open reduction and internal fixation with AO distal humerus plate system and locking reconstruction plates. Forty patients were available for the final outcome analysis. According to AO/ASIF classification, there were 2 cases of type A2, 4 cases of type A3, 1 case of type B1, 1 case of type B2, 14 cases of type C1, 7 cases of type C2 and 11 cases of type C3. Open reduction with triceps splitting technique was used in all patients. The clinical and radiographic follow-up was performed and outcome measures included pain assessment, range of motion, and Mayo elbow performance score.

RESULTSForty patients were available for the final outcome analysis. There were 29 males and 11 females with an average age of 38.4 years (18-73 years). Clinical and radiological consolidation of the fracture was observed in all cases at an average of 11.6 weeks (9-14 weeks). The average follow-up was 12 months (10-18 months). Using the Mayo elbow performance score the results obtained were graded as excellent or good results in 33 patients (82.5%). One patient had superficial infection, and 4 had myositis ossificans. There were no cases of primary malposition or secondary displacement, implant failure or ulnar neuropathy.

CONCLUSIONAnatomically preshaped distal humerus locking plate system is useful in providing stable fixation for complex distal articular fracture and facilitating early postoperative rehabilitation. The low rate of implant failure in the present study indicates that the technique is promising and warrants further investigation.

Adolescent ; Adult ; Aged ; Bone Plates ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Humeral Fractures ; surgery ; Male ; Middle Aged ; Postoperative Complications ; Treatment Outcome

Dislocation of the radial head in adults is uncommon. A simultaneous dislocation of the radial head and fracture of the ipsilateral distal end of radius with no other associated injuries is extremely rare. As far as we know, such an injury after an unusual mode of injury has been seldom reported in the English literature. We report such a case without any associated injuries or comorbidity. Closed reduction was performed within two hours after injury and results were satisfactory. Immobilisation was continued for 3 weeks. Gradual mobilisation was started after removal of the plaster under the supervision of a physiotherapist. At 6 months'follow-up, the patient had no residual pain at the elbow with full flexion and extension. Almost full supination with a restriction of last 10 degrees of pronation was achieved. There was no evidence of instability of the elbow.
Accidental Falls ; Adult ; Casts, Surgical ; Elbow Joint ; injuries ; Female ; Humans ; Immobilization ; Joint Dislocations ; Radius Fractures ; therapy