A case of acute arterial insufficiency of the right leg of a young man is described, following a blow on the inguinal region from the handlebar of a motor-scooter. A review of the literature suggests that this is an uncommon but clear-cut syndrome.
Manipulation under anaesthesia is an important method to reduce cervical spinal dislocations in the acute stage. Causes of failure have not been clearly identi®ed and neurological complications can be the major concern. All cervical dislocations have been traditionally treated by manipulation under anaesthesia in the Christchurch Spinal Injuries Unit as the primary treatment. We reviewed all 31 patients treated from 1991 ± 1995, with detailed documentation of neurological progression and ®nal outcome. Three patterns were identi®ed: bilateral dislocation, unifacet dislocation and fracture dislocation. Most of the dislocations (74%) were successfully reduced by manipulation alone with minimum complications. The remaining 26% patients required open reduction. The predominant causes of failure of reduction by manipulation were co-existing fractures. The success rate of reduction by manipulation was 90% for pure bifacet and unifacet dislocations, but was only 22% for the fracture dislocations. The study concluded that manipulation under anaesthesia is a safe and e ective procedure for pure cervical spinal dislocations. Fractures related to the dislocation should be identi®ed early and open reduction be considered.
A Brindley‐Finetech sacral anterior root stimulator has been placed intradurally in the spinal canal around the S2, 3, 4 nerve roots in six paraplegics at the Burwood Spinal Injuries Unit, Christchurch, New Zealand. The apparatus developed by Professor G. S. Brindley and the Medical Research Council in London, UK, has proved very useful in driving micturition, in achieving a dry device‐free interval between electromicturitions, in reducing the incidence of urinary tract infections, and in some males in achieving a sustained erection. The clinical results are presented with a urodynamic analysis of the outcome.
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