The results of arthroscopic debridement and loose body retrieval for osteochondritis dissecans (OCD) of the capitellum in 29 symptomatic patients who had failed conservative management are described. There were no complications of surgery. At an average of 77 months after operation the majority of patients had mild or no pain but with some discomfort during heavy lifting and sport. All were capable of performing simple activities of daily living, and all but one had good or excellent outcomes and rated their satisfaction highly. Only 4 of 27 patients had to give up their preferred sport because of persistent elbow problems. Thirty-eight percent of patients had recurrence of locking or catching, although these symptoms were described as better than the condition before operation and none wanted further surgical intervention. It is concluded that arthroscopic debridement and removal of loose bodies is a safe and reliable procedure for patients with persistent symptoms from OCD of the capitellum.

Numerous orthopaedic injuries can follow a seizure and are often diagnosed late. This is the first documented case of a missed bilateral anterior shoulder dislocation following a seizure. The possible reasons for the greater incidence of posterior dislocations are examined and why bilateral anterior dislocations following a seizure are so rare. The article discusses the reasons for the delay and highlights potential pitfalls and learning points for junior emergency department doctors.

The direction of the torsional force producing spiral fractures can be determined from characteristic features on routine anterior-posterior and lateral radiographs. Determining the direction of the torsional force on radiographs does not always seem to be intuitive. These derived 6 principles will be a useful aid to physicians who manage pediatric spiral fractures where nonaccidental injury is being considered.

Background: The dynamic compression screw is a plate and screws implant used to treat fractures of the distal femur. The Biomet Matthews Nail is a new retrograde intramedullary nail designed as an alternative surgical option to treat these fractures. The objective of this study was to assess the comparative endurance of both devices.

No abstract