Implant removal may not be needed for patients with burst fractures of the thoracolumbar and lumbar spine after fixation without fusion. However, information should be provided beforehand regarding the possibility of screw breakage.
With effective anti-TB chemotherapy, a posterior only procedure without debridement of anterior lesion is effective in the treatment of TB spondylitis, and an anterior procedure can be reserved for those patients who have not improved after posterior surgery. Cite this article: Bone Joint J 2016;98-B:834-9.
Fractures of the posterior wall of the acetabulum form a special group in acetabular fractures. This study aims to evaluate the results in the management of such fractures. Thirty-two patients with fractures of posterior wall of acetabulum were reviewed retrospectively. The follow-up period was 7 (range 3-10) years. Twenty-four were associated with initial posterior dislocations. Twenty-seven were managed with open reduction and internal fixation, while the remainder were managed conservatively. Reductions were rated as congruent in 30 cases and as noncongruent in 2. The functional results were excellent in 16 cases, good in 10, fair in 2, and poor in 4. Two early complications were met, namely 1 iatrogenic sciatic nerve injury and 1 superficial wound infection. Sixteen late complications were noted, including 10 heterotopic ossifications, 3 avascular necroses of femoral head, and 3 symptomatic arthritides. The incidence of late complications was high, but the functional results were generally satisfactory. Congruent reduction was the key in obtaining satisfactory results in the management of these fractures.
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