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Orthopaedic Proceedings
Vol. 87-B, Issue SUPP_III | Pages 376 - 376
1 Sep 2005
Levin M Solomon H Picard C
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Purpose: 151 patients with intertrochanteric (IT) fracture of femur were treated in our department, between July 2002 and December 2003. We used this system as the only system of fixation for intertrochanteric fractures, no other system of fixation was even considered. We wish to evaluate our results and report the findings.

Materials and Methods: A total of 151 patients with an IT fracture were treated, all of them underwent surgery. 152 surgeries were performed in the 151 patients, one of the patients underwent a bilateral surgery. The follow up period was 9 months to a maximum of 12 months. 34 male and 117 female patients were operated. 75 of the fractures were right and 77 left sided. One of four surgeons was involved in all the surgeries.

Results: Time of surgery varied between 25 min to 1 hrs and 15 min, the vast majority of the surgeries took around 30 min. The time of surgery depended on the experience of the surgical team i.e. surgeon, nursing staff and fluoroscopic technician, ease and quality of reduction and its stability. All surgical wounds healed well. No wound infection was encountered, there was no immediate post operative mortality,. 151 out of 152 fractures had no significant loss of fixation and one patient broke all the 3 shaft screws with loss of fixation but the screws in the head continued to hold and had to be revised to a nailing. Almost every patient received a unit of blood to maintain a minimum of 9.0gm % of Hemoglobin level. Blood loss during surgery was estimated to be between 50 –150 ml as per surgical team estimates. Post surgical wound drainage varied between 25 ml to 75 ml.

Conclusions: The PCCP is a reliable and quick system of internal fixation for IT fractures, gives excellent results by all standards, with early and successful return to function.


Orthopaedic Proceedings
Vol. 84-B, Issue SUPP_III | Pages 312 - 313
1 Nov 2002
Schwartz O Arnon O Mendes D Solomon H Liberson A
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Purpose: The purpose of this study was to clinically evaluate the efficiency of extracorporal shockwave therapy for enthesopathies.

Materials, Methods and Results: 26 patients with mean age of 51 (range: 18–73) which suffered from enthesopathies in different regions were included in this study. Prior to treatment pain and function were assessed subjectively by using a visual analog scale ranging from 1 (maximum pain/minimum function) to 10 (no pain, full function).

The follow-up period was 6–18 months with an average follow-up period of 13 months.

All patients were treated with ESWT. One to three treatment sessions were provided to each patient with an interval of one week between the sessions. After all sessions were finished, pain and function were reassessed in the same method that was used before the beginning of the treatment.

The overall mean pain value was 1.96 before the treatment and 5.92 after the treatment.

8 patients (30.7%) reported no pain at all after the treatment and in 6 patients (23%) a significant improvement in pain was achieved. 7 patients (19%) reported of only slight relief of pain and 4 patients (15.4%) reported no change in pain level. Only in one patient (3.9%) worsening of the pain was observed.

The overall mean function capacity was 5.76 before the treatment and 8.65 after the treatment. 11 patients (42%) returned to full functional capacity and in 7 patients (27%) a significant improvement in functional capacity was observed. In 8 patients (30.7%) no change in the functional capacity was noticed.

Good results of improvement in pain severity and functional capacity were observed in cases of plantar fasciitis and tennis elbow.

Conclusion: We think the EWST is helpful for treatment of enthesopathies, especially plantar fasciitis and tennis elbow, and suggest to include it in treatment algorithms.