1/43. Reactions and complications after the implantation of Endobon including morphological examination of explants.In the study described here, the integration of hydroxyapatite (HA) ceramic implants (Endobon) was investigated. These implants have an interconnecting system of pores and are free from foreign protein. The material is not toxic, genotoxic, nor zytotoxic, and it is biocompatible. The progress of integration was investigated by means of clinical and radiological check-ups. From 10 patients, it was possible to obtain samples for histological analysis during a second operation (e.g., metal explantation). Microscopic examination showed bony integration with newly formed bone in direct contact with the HA ceramic; it also showed osteoblasts and osteoid seams. No second operation took place earlier than 4 months after the first operation, yet even after this relatively short period, bony integration was already evident. Clinical observation (based on x-rays, reports of pain, signs of inflammation) showed that in most cases healing was taking place without complications. More general operational complications such as thrombosis or nerve injury were observed in 4 patients. If the implant is not sufficiently protected from mechanical stress, bony integation will not take place, and the implant may fracture. HA ceramic, with a porosity between 30% and 80%, is not comparable to cortical bone but only to spongy bone. This factor must be taken into account when deciding whether a HA ceramic implant is indicated.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
2/43. Anterior hip pain.Anterior hip pain is a common complaint with many possible causes. Apophyseal avulsion and slipped capital femoral epiphysis should not be overlooked in adolescents. Muscle and tendon strains are common in adults. Subsequent to accurate diagnosis, strains should improve with rest and directed conservative treatment. osteoarthritis, which is diagnosed radiographically, generally occurs in middle-aged and older adults. Arthritis in younger adults should prompt consideration of an inflammatory cause. A possible femoral neck stress fracture should be evaluated urgently to prevent the potentially significant complications associated with displacement. patients with osteitis pubis should be educated about the natural history of the condition and should undergo physical therapy to correct abnormal pelvic mechanics. "sports hernias," nerve entrapments and labral pathologic conditions should be considered in athletic adults with characteristic presentations and chronic symptoms. Surgical intervention may allow resumption of pain-free athletic activity.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
3/43. Arthroscopic capsular release for contracture of the wrist: a new technique.SUMMARY: Stiffness of the wrist can occur following trauma or surgery. In some patients, loss of motion may be refractory to conservative treatment and operative treatment may thus be indicated. The authors report the results and technique of arthroscopic capsular release of the wrist. A cadaveric study was performed to assess the safety of arthroscopic capsular release. Arthroscopic capsular release was performed on 2 patients with limited wrist mobility. The average distance from the radiocarpal joint capsule to the neurovascular structures were 6.9 mm to the median nerve, 6.7 mm to the ulnar nerve and 5.2 mm to the radial artery. At 6 months follow-up, the average range of motion had improved from 17 degrees flexion and 10 degrees extension to 47 degrees flexion and 50 degrees extension. The average grip strength had improved from 13 to 31 kg. pain measured on a visual analogue score (0-10) had improved from 1.5 to 1.0. There were no complications. Arthroscopic capsular release of the wrist is a safe and minimally invasive technique that provides good improvement to range of motion.- - - - - - - - - - ranking = 34.557932259293keywords = median nerve, nerve, median (Clic here for more details about this article) |
4/43. Hyperostotic macrodactyly and lipofibromatous hamartoma of the median nerve associated with carpal tunnel syndrome.A new case with 14-year follow-up of an extremely rare variety of congenital hand macrodactyly is presented. The disease characteristically presents a diffuse proliferation of fibrofatty tissue, but in this special type, osteocartilaginous deposits around the joints can also be found. The case presented included the troublesome feature of a lipofibromatous hamartoma in the median nerve at the wrist and its branches producing carpal tunnel syndrome. The patient obtained benefit from carpal tunnel release and epineurolysis. The hyperostotic development was managed with conservative resection of the periarticular osteochondromas. The literature reviewed suggests that the hyperostotic cases of macrodactyly do not differ from general cases of this congenital condition, except for the osteochondral deposits. These tumours develop during adulthood or after previous trauma, before epiphyseal closure.- - - - - - - - - - ranking = 167.78966129647keywords = median nerve, nerve, median (Clic here for more details about this article) |
5/43. Ophthalmic manifestations of neonatal onset multisystem inflammatory disease.PURPOSE: To report the ophthalmic manifestations of neonatal onset multisystem inflammatory disease, a recently recognized, rare systemic disorder characterized by the triad of arthropathy, rash, and abnormal central nervous system development. METHOD: Case report. RESULTS: A 2-year-old female with neonatal onset multisystem inflammatory disease presented with visual acuity of fix and follow with each eye, bilateral optic nerve head pallor and gliosis, as well as marked sheathing of the peripapillary vessels. No vitreous inflammation or macular edema was found. visual acuity was stable from the neonatal period through the 3 months of follow-up after the changes involving the optic nerve heads and peripapillary vessels were observed (a total of 33 months). CONCLUSIONS: This report provides a description of the ocular manifestations of neonatal onset multisystem inflammatory disease and supports earlier suggestions that swelling of the optic nerve heads can occur. In this case, optic nerve head pallor may have been a sequela of such swelling. The pathogenesis of neonatal onset multisystem inflammatory disease is unknown.- - - - - - - - - - ranking = 4keywords = nerve (Clic here for more details about this article) |
6/43. Delayed reimplantation arthroplasty for candidal prosthetic joint infection: a report of 4 cases and review of the literature.Fungal prosthetic joint infection (PJI) is rare, with candida species being the most frequently reported pathogen in the medical literature. The risk of relapse following delayed reimplantation arthroplasty for candidal PJI is unknown. We describe 4 new cases and summarize 6 previously reported cases of candidal PJI treated with delayed reimplantation arthroplasty. Ninety percent of the patients received antifungal therapy. Eight patients received amphotericin b either alone or in combination with other antifungals. One patient received fluconazole alone. The median duration of time from resection arthroplasty to reimplantation for total hip and total knee arthroplasties was 8.6 and 2.3 months, respectively. Eight patients did not have relapse of candidal PJI following delayed reimplantation arthroplasty after a median duration of follow-up of 50.7 months (range, 2--73 months). Candidal PJI can be successfully treated with delayed reimplantation arthroplasty after receipt appropriate antifungal therapy.- - - - - - - - - - ranking = 0.80067707324225keywords = median (Clic here for more details about this article) |
7/43. radial nerve enclosed in the callus of a supracondylar fracture.At operation for the correction of cubitus varus by removal of a wedge based laterally, the radial nerve fortunately was first explored and found to run through a transverse bony tummel at the posterior level of a suprocondylar fracture sustained eight years previously. After elevation of the bony tunnel and nerve en bloc the osteotomy was completed; neurapraxia of the radial nerve soon recovered. With hindsight, the entrance and exit foramina of the tunnel could be clearly seen in the antero-posterior radiograph taken before the operation.- - - - - - - - - - ranking = 7keywords = nerve (Clic here for more details about this article) |
8/43. Synovial cysts of the proximal tibiofibular joint: three case reports.Synovial cysts are fluid-filled masses lined with synovium and located within or about joints. The main symptoms are pain and/or neurological deficits. They can be intraneural or extraneural or develop between or within muscles. Synovial cysts that arise at a distance from a joint raise diagnostic challenges. We report three cases of synovial cysts of the proximal tibiofibular joint, including an intramuscular cyst responsible for paralysis of the anterolateral leg muscles. Tibiofibular synovial cysts are less common than popliteal cysts, and their pathophysiology is poorly understood. pressure on the common peroneal nerve is the main complication and requires careful surgical excision of the cyst. Injection of a glucocorticoid into the cyst can be used as the first-line treatment in patients without common peroneal nerve symptoms.- - - - - - - - - - ranking = 2keywords = nerve (Clic here for more details about this article) |
9/43. Scapulothoracic fusion for painful winging of the scapula in nondystrophic patients.A modified technique of scapulothoracic fusion was used in 6 patients who did not have muscular dystrophy and who were later evaluated clinically. The cause of the painful winging of the scapula was traumatic disruption of the trapezius and the accessory nerve in 3 patients, injury to the brachial plexus in 2, and Sprengel's deformity in 1. To obtain fusion, double wires were passed around each of 4 ribs. A Rush pin was then contoured to fit the curvature of the scapula, and the wires were passed through the scapula and tied over the Rush pin with bone graft. The mean age of the patients was 30 years (range, 22-39 years), with a mean follow-up of 49 months. The mean increase in elevation was 18 degrees with significant pain relief. The medium-term results showed that this operation was successful in achieving stability of the scapula while improving pain and function in patients without facioscapulohumeral dystrophy.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
10/43. Ganglion cyst of the proximal tibiofibular joint causing foot drop-diagnostic problem of differentiating from neuritic leprosy.A six-year old boy presented with pain around the knee joint and abnormal gait of one month duration. There was no history of hypopigmented anaesthetic patches, neuritis or family history of leprosy. Clinical examination revealed a localized cystic swelling of 1 x 1 cm in size in the region of left common peroneal nerve, with sensory loss on the lateral aspect of the left leg which was mistaken for a nerve abscess.- - - - - - - - - - ranking = 2keywords = nerve (Clic here for more details about this article) |
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