Primary plating of displaced mid third clavicle fractures with superiorly placed locking plate avoids complications of non-operative management and leads to early return to pre injury activities.
Context: It has been suggested that, with appropriate instruction and practice by the individual and normalization of the reaching distances, the SEBT can be used to provide objective measures to differentiate deficits and improvements in dynamic postural-control related to lower extremity injury and induced fatigue, and it has the potential to predict lower extremity injury. However, literature on its role in assessing proprioception deficits in anterior cruciate ligament deficient knees is limited. Objective: To provide a narrative review of the SEBT and its implementation and the known contributions to task performance and to systematically review the associated literature to address the SEBT's usefulness as a clinical tool for the quantification of dynamic postural-control deficits from anterior cruciate ligament deficiency.
Hemi-cauda equina Disc prolapse a b s t r a c tIntroduction: The presentation of cauda equina syndrome (CES) varies from its classical presentation, especially in its early stages of compression. We present a case of lumbar disc prolapse causing CES in an uncharacteristic way, knowledge of which is essential for orthopaedicians to diagnose this condition early and prevent neurological complications.Case report: A 32-year-old male patient presented to us with complaints of inability to lift his left ankle and numbness over his left leg and ankle for 14 days. Clinical examination showed involvement of left L3, L4, L5 and S1 nerve roots as evidenced by weakness of quadriceps, extensor hallucis longus, extensor digitorum longus muscles and tendo achilles. Knee jerk was absent. The opposite lower limb was normal and there was no evidence of bowel bladder involvement or saddle anaesthesia. The MRI showed L2 L3 posterocentral disc prolapse compressing the cauda equina. The patient underwent laminectomy and discectomy. Postoperatively, the patient showed significant improvement in his sensory symptoms with complete recovery of motor power in 12 weeks.Discussion: In contrast to the classical presentation of CES, several case series have been reported with varied clinical manifestations like unilateral leg symptomatology, unilateral or bilateral saddle anaesthesia with or without leg symptoms and CES with complete absence of signs and symptoms in the lower limbs. The disc prolapse in our case at L2-L3 level has compressed the left-sided L3, L4, L5 roots with minimal compression of S1. The classical features of CES would have occurred due to the lateral shift of the cauda equina in our case but for our early diagnosis and intervention.
Background: The management of distal end radius has undergone an extraordinary evolution over the preceding twenty years. The technical advance of palmar locking plating has again changed the management of this fracture in a real and seemingly permanent way. Perhaps most importantly it is becoming increasingly apparent that operative intervention needs to be customized to the patient, fracture and expertise of the surgeon. Materials and Methods:The study is hospital based prospective study centered in R.L. Jalappa Hospital from November 2013 to April 2015 between which thirty patient patients with intra articular distal radius fractures are treated with locking compression plate and screws. Results: Patients were regularly followed-up post-operatively. Thirty cases were available for follow up. Excellent results were seen in 20 patients, good results in 5 patients, fair results in 3 patients and poor results in 2 patients. Conclusion: Open reduction and internal fixation with locking compression plate and screws gives better functional and anatomical results in intra articular distal radius fractures. The successful use of locking compression plate for intra articular distal radius fractures requires careful assessment of fracture pattern, appropriate patient selection, meticulous surgical techniques, appropriate choice of fixation, screw size, judicious augmentation with internal fixation, careful post-operative monitoring and aggressive early institution of rehabilitation. The final functional result of treatment not only depends of on anatomical reduction but also depends on surrounding soft tissue injuries and early mobilization.
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