INTRODUCTION Concern exists regarding potential damage to the rotator cuff from repeated corticosteroid injections into the subacromial space. PATIENTS AND METHODS In this retrospective, case-controlled study, 230 consecutive patients presenting to three orthopaedic units with subacromial impingement and investigated as an end-point with magnetic resonance imaging (MRI) of the shoulder were divided into groups having received less than three or three or more subacromial injections of corticosteroids. RESULTS With no significant difference in age and sex distribution, analysis by MRI showed no significant difference between the two groups in the incidence of rotator cuff tear (P < 1.0). CONCLUSIONS This suggests that corticosteroid use in patients with subacromial impingement should not be considered a causative factor in rotator cuff tears.
We present a prospective review of 23 patients having 25 primary total hip arthroplasties (THAs) over a two-month period. Patients were randomly allocated into two groups, one with wound drainage and the other without.
There were 12 hips in the Drain group and 13 hips in the No-drain group. Demographic characteristics and risk factors were similar in the two groups. The average wound score (ASEPSIS) was found to be higher for the No-drain group and this was statistically significant. In the No-drain group, 7 out of 13 hips developed infection (5 superficial and 2 deep). In the Drain group, 1 out of 12 hips developed deep infection. The difference in the average drop in the haemoglobin between the two groups was not statistically significant. In the Drain group, the average drainage volume was 463ml. The type of anaesthetic, duration of the operation, experience of the surgeon and the surgical approach used were not found to have a statistically significant correlation with postoperative wound infection.
Our small series supports the view that the use of closed suction drainage after THA results in lower incidences of drainage from the wound site and also of wound infection.
The Garden procedure produced good results for tennis elbow with minimal morbidity in an unselected group of patients. This retrospective study supports the view that the underlying lesion in tennis elbow is in the origin of extensor carpi radialis brevis.
Primary tumours of ribs are relatively uncommon in adults and are even rarer in children. (William in Am Surg June: 338-342, 1972; Eskenasy in Rev Roum Morph Embryol Physio 1:35-50, 1985) Osteosarcoma is the most common primary bone malignancy in children and young adults. (Whelan in Eur J Can 33(10):1611-1619, 1997) Very few cases of osteosacoma of the rib have been described in literature. We report a 7-year-old girl with primary osteosarcoma of the rib which was managed by wide excision followed by adjuvant chemotherapy. She is disease free after 12 months of follow-up. We believe our case to be the youngest with primary osteosarcoma of the rib. Primary osteosarcoma of the rib should be considered in the differential diagnosis in a child with rib swelling. Early diagnosis and treatment improves the outcome.
A stress fracture can be defined as a fracture of a bone caused by repeated (rather than sudden) mechanical stress. They have been reported in almost all bones of the body, with the lower extremity weight bearing bones, especially the tibia, tarsals and metatarsals, being affected most often. These injuries have a broad spectrum of severity and prognosis. Although the pathology of this injury is understood, the aetiology is less agreed upon. This can make it difficult for clinicians to diagnose and treat this common injury. Stress fractures of the proximal tibiae are common in elderly patients with osteoarthritis, and they are also reported in children. Here, we report an unusual case of an otherwise fit, young, adult male who presented with bilateral insufficiency stress fractures occurring simultaneously in both proximal tibiae. Stress fractures should be a differential diagnosis in any young, fit adult who presents with spontaneous knee pain.
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