We present 4 cases of talus dislocation. In one case we had open total lateral dislocation of the talus and in 3 other cases we had closed subtalar dislocation (disruption of the talocalcaneal and talonavicular joints). Reposition of the dislocation was made and talocalcaneal transfixation completed with 3 Kirschner wires, placed like a spread fan, under fluoroscopic control. Reoccurring dislocations were not experienced nor were there signs of avascular necrosis in these 4 cases.
DDD treated surgically without discography did not reach the clinically significant improvement of 15 ODI points for the patients treated with fusion. Provocative discography screening with psychological testing in the trial group made improvement following fusion clinically significant.
Trans-scaphoid perilunate fracture dislocations (TSPLD) are uncommon injuries and constitute about 3% of all carpal injuries. Up to 25% of these high energy trauma cases go undiagnosed. Presented are 43 (3 female, 40 male) consecutive patients treated for dorsal TSPLD, all were closed fractures. Patients were between 17 and 66 years old. Twenty male patients were injured in active duty military service. Surgical treatment was made with a volar approach using titanium cannulated headless compression screws (3.2 mm) placed via a guide wire. Repositioning the dislocated carpus is then conducted using 3 temporary fixation Kirschner wires (1.6 mm). The patient had a volar short arm splint for 4 weeks, then given an orthosis. Triple fixation Kirschner wires were removed 6-8 weeks postoperatively. Mean followup period was 29 months (range 20-38). The average Mayo wrist score for all 43 patients is 87 (good) (range 65-99). All patients returned to their previous employment.
-Takayasu's arteritis (TA) affects the aorta and its branches. immunosuppressants are the usual course of therapy, while surgery has been used in acute cases. There is only scant information on TA in infancy, and the nonspecific symptoms in the initial stage of the disease make the diagnosis difficult and delayed, thus increasing the mortality rate. We describe a case of aggressive progression of TA in an infant. This child was the youngest to be affected with the disease as reported in the literature. A 3.5-month-old boy presented with cyanosis of both legs, tachycardia and antithrombin iii deficiency. Computed tomography angiography (CTA) revealed thrombosis of distal aorta and both iliac arteries. Thrombectomy was performed at the level of both common femoral arteries. in addition, thigh amputation of the left leg had to be performed. TA was diagnosed postmortem with thrombosis of the distal aorta, its branches and upper mesenteric artery which was not occluded on previous CTA, glomerulonephritis and pulmonary parenchymal granulomatous infiltrations.
This retrospective study investigated the impact of age on fracture occurrence through the comparison of two patient groups, 17-64 and 64+ age groups. Study data covered all fractures treated at a large hospital in eastern Croatia. A total of 15,519 patients with fractures were treated at the trauma department (inpatient and outpatient), with a total of 17,257 fractures presented, 71% managed as outpatients and 29% as inpatients. A total of 11,046 outpatients were treated for 12,187 fractures and a total of 4473 inpatients were treated for 5070 fractures. The group of 17-64-year old males had 5787 fractures, accounting for 34% of all fractures presented. The group of 17-64-year old females had 4094 fractures, accounting for 24% of total fractures. The group of 65+ year-old males had 2659 fractures, accounting for 15% of all fractures presented and the group of 65+ year-old females presented with 4717 fractures, accounting for 27% of all fractures presented. The 'fall in level' was the predominant cause of injury in all patients. The characteristics of osteoporotic bone fractures were evident in the population of 65+ females and to a lesser degree in 65+ males. The 17-64 age group, both males and females, had more fractures considered as high-energy fractures.
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