Ilizarov treatment of humeral shaft nonunion in an antiepileptic drug patient with uncontrolled generalized tonic-clonic seizure activity

Nonunion of the humeral shaft in patients with antiepileptic drug associated metabolic bone disorder constitute a challenging surgical problem difficult to treat due to seizure activity, osteoporosis, and poor stabilization options. We report a case of nonunion of the humeral shaft in an antiepileptic drug patient with uncontrolled generalized tonic-clonic seizure activity successfully treated with Ilizarov external fixator and a follow-up of 4 years

Popliteal artery damage during total knee arthroplasty

AbstractInjury of popliteal artery during total knee arthroplasty is a relatively rare complication. We report on one case of transverse semi-dissection of the popliteal artery during the tibial cut and one case of popliteal pseudoaneurysm formation caused by Hohmann retractors. Diagnosis was made early in the first case but it was delayed in the second due to misdiagnosis of deep vein thrombosis. Both injuries were managed eventually by open surgery. Postoperative clinical examination and ultrasound imaging confirmed the successful restoration of the blood flow. This case report also describes the classification system of the type of vascular damage and describes the mechanism, the clinical presentation, diagnostic modalities and treatment options for these rare complications of total knee arthroplasty surgery

Proximal screws placement in intertrochanteric fractures treated with external fixation: comparison of two different techniques

<p>Abstract</p> <p>Background</p> <p>To compare two different techniques of proximal pin placement for the treatment of intertrochanteric fractures in elderly patients utilizing the Orthofix Pertrochanteric Fixator.</p> <p>Methods</p> <p>Seventy elderly high-risk patients with an average age of 81 years were treated surgically for intertrochanteric fracture, resulting from a low energy trauma. Patients were randomly divided in two groups regarding to the proximal pin placement technique. In Group A the proximal pins were inserted in a convergent way, while in Group B were inserted in parallel.</p> <p>Results</p> <p>All fractures healed uneventfully after a mean time of 98 days. The fixator was well accepted and no patient had significant difficulties while sitting or lying. The mean VAS score was 5.4 in group A and 5.7 in group B. At 12 months after surgery, in group A the average Harris Hip Score and the Palmer and Parker mobility score was 67 and 5.8, respectively. In group B, the average Harris Hip Score and the Palmer and Parker mobility score was 62 and 5.6, respectively. No statistically significant difference was found regarding the functional outcome. The mean radiographic exposure during pin insertion in Group A and Group B was 15 and 6 seconds, respectively. The difference between the two groups, regarding the radiographic exposure, was found to be significant.</p> <p>Conclusion</p> <p>Proximal screw placement in a parallel way is simple, with significant less radiation exposure and shorter intraoperative duration. In addition, fixation stability is equal compared to convergent pin placement.</p

Electroacupuncture for the Treatment of Calcific Tendonitis. A Pilot Study

Current treatment for calcific tendonitis consists of arm rest, antiinflammatory medications, and corticosteroid injections. If unsuccessful, a lot of clinicians suggest several physiotherapy modalities, such as shockwave therapy and electrotherapy. The purpose of our study was to assess the efficacy of electroacupuncture, as a substitute for failed medical treatment in calcific tendonitis.In a pilot study, we prospectively followed 10 patients treated with electroacupuncture for calcific tendonitis who failed to respond to medical treatment. Its efficacy was assessed by evaluating the level of pain, the Beck Depression Inventory, the range of active elbow mobility, and by repeated radiological evaluation of the course of calcific deposits. All clinical and radiological observations were recorded before and within 6 months after the onset of treatment.After electroacupuncture treatment (2 Hz, 180 mA for 30–60 seconds at GB21, GB34, LI4, LI 14, LI15, TW5, TW14, Chien Chien SI9, SI12, S37, S38), the visual analog score decreased notably, and the range of motion returned to normal. Radiological evaluation demonstrated almost complete absorption of calcific deposits within 6 months, after treatment.We conclude that electroacupuncture relieved skeletal pain, improved the quality of patient's life, and contributed to total regression of the calcific depositions in followed patients. So, electroacupuncture may be a valuable treatment option for calcific tendonitis, when medical treatment fails to relieve symptoms. Keywords: calcific tendonitis, electroacupuncture, electrotherapy, medical treatmen

Popliteal artery damage during total knee arthroplasty

Injury of popliteal artery during total knee arthroplasty is a relatively rare complication. We report on one case of transverse semi-dissection of the popliteal artery during the tibial cut and one case of popliteal pseudoaneurysm formation caused by Hohmann retractors. Diagnosis was made early in the first case but it was delayed in the second due to misdiagnosis of deep vein thrombosis. Both injuries were managed eventually by open surgery. Postoperative clinical examination and ultrasound imaging confirmed the successful restoration of the blood flow. This case report also describes the classification system of the type of vascular damage and describes the mechanism, the clinical presentation, diagnostic modalities and treatment options for these rare complications of total knee arthroplasty surgery