The method that we described has the potential to produce complete and reliable nerve coagulation. Moreover, it minimizes the risk of penetrating the great vessels. The efficacy of this approach should be tested in clinical trials.
Closed-loop control with BIS using isoflurane can safely be applied clinically and performs significantly better than manual control, even in phases with abrupt changes of stimulation that cannot be foreseen by the control system.
Cuboid compression fractures are rare injuries, usually occurring in combination with medial midfoot fractures or dislocations. During a three year period 12 patients with cuboid fractures were operatively treated at our institution. Eleven patients had involvement of the tarsometatarsal 4 and 5 joints, four of the calcaneocuboid joint, and three of both the proximal and distal joints. The lateral column was shortened in five patients. Open reduction was facilitated using a distracting external fixator. Iliac crest corticocancellous grafts were necessary in seven patients. Single or double plate fixation was performed in eight, screw fixation alone in four patients. Follow-up ranged from 12 to 47 months. Results were good with respect to restoration of length, reconstruction of the joint facets and overall return to function. Minor residual symptoms were noted in one (of four) injured calcaneocuboid joints, in none (of 11) of the tarsometatarsal joints 4 and in two (of 11) of the tarsometatarsal joints 5. More frequently and to a greater extent symptoms arose from the associated midfoot injuries. Deformity and disability from cuboid compression fractures can effectively be prevented by immediate aggressive treatment consisting of open reduction and internal fixation.
We present the case of a 13-year-old girl with bilateral anterior knee pain in which an unilateral dorsal patellar defect (DDP) was diagnosed. The pathology was extensively assessed with noninvasive imaging techniques including plain radiographs, computed tomography, magnetic resonance imaging, and scintigraphy. Based on the findings, a biopsy could be avoided. The characteristic findings and value of the above-mentioned imaging techniques as well as the differential diagnosis are discussed.
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