If neglected or misdiagnosed, non-union of a scaphoid fracture will almost inevitably progress to radiographic and symptomatic osteoarthritis of the wrist with subsequent morbidity and lifelong disability, especially in young males in which the fracture is more common. Fractures of the scaphoid bone are the most common fractures of the carpus and second in occurrence among fractures of the wrist.The diagnosis and treatment are not simple. Familiarity with diVerent imaging methods and treatment options is required. The treatment in most cases is conservative and will lead to uneventful union, but an operation may be needed in certain cases primarily and in the treatment of non-union.The current literature on the diagnosis and treatment of scaphoid fractures is reviewed, and the authors try to make a clear and concise picture of this complex and sometimes controversial field. (Postgrad Med J 2001;77:235-237)
We report our experience with the Ilizarov apparatus in performing ankle arthrodesis in 6 patients. The average age of the patients was 52 (42-60) years. 3 patients had posttraumatic arthrosis and active infection of the ankle or distal tibia and the other 3 had posttraumatic arthrosis of the ankle without infection. Solid and painless arthrodesis was achieved in all patients in 7-15 weeks, including those with an active infection or failed multiple previous operations. While the method is useful for primary treatment of ankle arthrosis, we think it is better for treatment of certain complicated cases. n Painful ankle arthrosis that is refractory to medical treatment is the commonest indication for arthrodesis of the ankle joint. Ilizarov and Okulov (1976) originally proposed a method for performing ankle arthrodesis which, however, did not gain much popularity and only a few reports on it have been published. Hawkins et al. (1994) performed ankle arthrodesis with the Ilizarov apparatus in 21 patients having complex distal tibial pathology or previous failed ankle arthrodesis. They obtained good results in 16 of their patients. Johnson et al. (1992) treated another 6 patients. Tibiotalar fusion occurred at an average of 7 months in 3 of 4 infected patients with previous failed ankle arthrodesis, while the 2 primary ankle fusions healed at an average of 3.5 monthsWe have prospectively analyzed the results of the Ilizarov method for ankle arthrodesis in our institution. Patients and methodsAll 6 patients (4 men) who underwent tibiotalar arthrodesis by the Ilizarov method in our department during 1994-1998 were included in this study. They were under the care of MY who operated on them all. The average age was 52 (42-60) years. The average hospital stay was 10 (6-20) days, and they were followed in the outpatient clinic for an average of 36 (3-48) months (Table).3 patients had posttraumatic arthrosis of the ankle, following bimalleolar, trimalleolar or pilon fractures on average 12 (1-30) years before the arthrodesis. 2 of them had previously undergone surgery (internal fixation of the fracture, and the hardware had been removed in both) and 1 had been treated with a plaster cast. 1 patient had undergone open reduction and internal fixation of a distal tibial fracture and hardware removal 10 years earlier. This patient had chronic osteomyelitis of the distal tibia and severe arthrosis of the ankle, and had undergone several operations with debridement and drainage ( Figure). 2 patients had undergone open reduction and internal fixation of open trimalleolar fractures of the ankle 2 months earlier, and the hardware had been removed. Both had active wound and joint infections. Operative techniqueArthrotomy was performed through a lateral incision and an oblique distal fibulotomy. Debridement of devitalized tissue and irrigation were performed when there was an infection. Articular cartilage was removed with an osteotome, with preservation of as much bone as possible. The
Subungual exostosis is a benign osteochondral tumor usually involving the distal phalanx of the great toe. The lesion most frequently occurs in the second and third decades of life and is rare before the age of 10 years. There are few reports of its occurrence in children, and most of them advocate partial or complete nail excision to treat this lesion successfully. We report our experience with six children and adolescents using a simple surgical technique that involves approaching the exostosis under the nail to preserve nail coverage. Rapid recovery and excellent cosmetic appearance were achieved immediately after the operation.
A 12 year old girl presented to the ear, nose, and throat department with a history of foreign bodies in both nostrils. The young girl had attempted to wear magnetic earrings as nose rings. Unfortunately both magnets became polarised and attracted across the septum (see fig 1).We present a simple and easy solution for removal under local anaesthesia with a mixture of lignocaine and phenylephrine in an accident and emergency setting. It is possible to polarise a wax hook, which has magnetic properties, by rubbing it with another instrument (wax hook or Jobson horn). One of the magnets was then attracted away from the septum by the polarised wax hook, thus releasing the magnetic attraction of the opposing magnet.They were successfully removed without any significant trauma to the septum. The underlying mucosa, however, was indurated due to local pressure. The most common complication of foreign bodies is septal perforation, thus identification and removal of the oVending foreign body is paramount to its prevention.Complete open dislocation of the talus Elisha Krasin, Michal Goldwirth, Itzhak Otremski A 64 year old man fell from a ladder directly onto his right foot. Physical examination disclosed a wound on the lateral aspect of the ankle and the midfoot. The talus was completely dislocated and loosely connected to some soft tissue. There were no other apparent injuries except a non-displaced fracture of the fifth metatarsal head. After radiography of the
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.