AIM:To evaluate the functional outcomes of the Bristow-Latarjet procedure in patients with recurrent anterior glenohumeral instability.PATIENTS AND METHODS:Personal clinical records of 42 patients with 45 operated shoulders were reviewed retrospectively. Patient age at time of first dislocation, injury mechanism, and number of recurring dislocations before surgery were recorded. The overall function and stability of the shoulder was evaluated.RESULTS:Thirty five (78%) of the scapulohumeral humeral instabilities were caused by trauma. The mean number of recurring dislocations was 9 (95% confidence interval [CI], 0–18); one patient had had 17 recurrences. Mean follow-up 46 months (95% CI, 16-88). No dislocation happened postoperatively. Four patients have fibrous union (9%). Only two had clinical sign of pain and discomfort. One of them was reoperated for screw removal with very good post-operative result. The overall functional outcome was good, with a mean Rowe score of 88 points (95% CI, 78–100). Scores of 27 (64%) of the patients were excellent, 9 (22%) were good, 4 (9.5%) were fair, and 2 (4.5%) were poor.CONCLUSION:The Bristow-Latarjet procedure is a very good surgical treatment for recurrent anterior-inferior instability of the glenohumeral joint. It must not be used for multidirectional instability or psychogenic habitual dislocations.
Iselin’ disease is a benign adolescent growth disturbance of the base of the fifth metatarsal called epiphysitis or apophysitis by others caused by abnormal traction of peroneus brevis tendon. This abnormality is rarely reported in medical literature, probably due to the benign nature and spontaneous healing in almost all cases. The affection should be known to medical specialist like orthopedists, radiologists, physical therapists and pediatricians. The differential diagnosis is made with Jones’ fracture of the fifth metatarsal and os vesalianum which is a congenital anomaly. We present two our cases with their similarities in clinical findings, typical radiologic images and complete relief from symptoms with conservative treatment.
Osteopoikilosis is a rare bone anomaly usually benign which may be confused with other severe primary diseases or dangerous metastatic bone lesions. We present one new case describing typical radiological findings with no clinical signs or other associations. No malignant transformation or other complications happened in the last ten years. Osteopoikilosis is found in most cases incidentally, and in most cases is not associated with other serious medical complications. Screening of family members may be considered
Aims and objectives: This study was done to evaluate the functional and radiographic outcome of PFN in treatment of proximal femoral fracture and more common technical, mechanical complications and intraoperative difficulties during the implant implementation.
Materials & Methods: We conducted a retrospective study with ten cases of proximal femoral fractures treated between September 2017 and September 2018, which were accepted at the Department of Orthopedics, the University Hospital of Trauma and the American Hospital in Tirana. Fractures are classified according to classification AO and Boyd-Griffin. The age range of patients taking the study was 20-90 years. Ten cases were followed at regular intervals and the final assessment was made at the end of the 6 month period. In the result, functional clinical assessment according to Harris hip score was done .
Results: In our study,mean age was 66 y.o, 7 male and 3 females. Mean of hospitalization time 6 days, mean operation time 120 min. In our study at 6 months follow up, union was achieved in 9 cases, open reduction was performed in 3 cases (10 cases). Technical and mechanical complications were noted in one case. Reoperation rate was 10 % (one case). According Harris hip scoring system excellent results were seen 40 % of cases (4 cases), good results in 50 % cases (5 cases), and poor results in 10% cases (1 case).
Conclusions: In our study, in spite of low experience in proximal femoral nailing in cases with unstable trochanteric / subtrocanteric fractures, it was found that PFN is an attractive implant and suitable for proximal femoral fractures and its use in unstable trochanteric / subtrocanteric fractures is very encouraging. This study has also shown that this device can safely be used by an average surgeon to handle common but sometimes tough fractures. Operation is technically not difficult, but gradual learning and great patience is needed to make this method really minimal invasive.
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