We determined the effect of the
1. Some of the more common and obvious clinical syndromes arising from mechanical and degenerative derangements of the lumbar spine are defined. 2. Some principles in the selection of cases for
There have been few reports regarding the efficacy
of posterior instrumentation alone as
The accessory navicular is occasionally the source of pain and local tenderness over the instep. If conservative measures fail,
We report our experience of
We analysed the influence of the timing of surgery (<
48 hours, group 1, 21 patients vs >
48 hours, group 2, 14 patients) on the neurological outcome and restoration of mobility in 35 incomplete tetra- and paraplegic patients with metastatic spinal-cord compression. Pain and neurological symptoms were assessed using the American Spinal Injury Association impairment scale. More improvement was found in group 1 than in group 2 when comparing the pre-operative findings with those both immediately post-operatively (p = 0.021) and those at follow-up at four to six weeks (p = 0.010). In group 1 the number of pre-operatively mobile patients increased from 17 (81%) to 19 patients (90%) whereas the number of mobile patients in group 2 changed from nine (64%) to ten (71%). These results suggest that early
Thirty-five cases of osteochondritis dissecans of the talus, operated on between 1950 and 1978, were studied. Twenty-four were available for follow-up an average of 47 months later. Three standard
We used the Ilizarov circular external fixator to treat 16 patients with persistent nonunion of the diaphysis of the humerus despite
The use of plate-and-cable constructs to treat periprosthetic fractures around a well-fixed femoral component in total hip replacements has been reported to have high rates of failure. Our aim was to evaluate the results of a
The costo-clavicular ligament is always ruptured in dislocation at the sterno-clavicular joint. Anterior, superior or posterior displacement of the medial end of the clavicle may occur. Acute dislocation usually responds to conservative treatment and operation is seldom required. Chronic, or recurrent, dislocation may cause pain and disability on strenuous activity and necessitate
We compared the ceiling effects of two patient-rating
scores, the Disability of the Arm, Shoulder and Hand (DASH) and
Patient-Rated Wrist Evaluation (PRWE), and a physician-rating score,
the Modified Mayo Wrist Score (MMWS) in assessing the outcome of
surgical treatment of an unstable distal radial fracture. A total
of 77 women with a mean age of 64.2 years (50 to 88) who underwent
fixation using a volar locking plate for an unstable distal radial fracture
between 2011 and 2013 were enrolled in this study. All completed
the DASH and PRWE questionnaires one year post-operatively and were
assessed using the MMWS by the senior author. The ceiling effects
in the outcome data assessed for each score were estimated. The data assessed with both patient-rating scores, the DASH and
PRWE, showed substantial ceiling effects, whereas the data assessed
with MMWS showed no ceiling effect. Researchers should be aware of a possible ceiling effect in the
assessment of the outcome of the
Between 1969 and 1989, we performed posterior segmental instrumentation on 38 patients with thoracic Scheuermann's kyphosis. We used a dynamic system without sublaminar fixation, and a kyphosis of 50 degrees was the main indication for surgery. The mean initial angle was 68 degrees (50 to 100) and the mean final kyphosis was 43 degrees at five-year follow-up, with a mean final loss after surgery of 3.7 degrees. Reconstruction of the vertebral bodies, vertebral wedging and the anterior-body height ratio were observed even in skeletally mature patients. There were no medical complications. There were three cases of loss of correction by more than 10 degrees and one of rod fracture with pseudarthrosis. The role of non-operative treatment is evaluated and early
1. The
Doubt remains as to the safest
We reviewed the
The National Institute for Health and Care Excellence
has issued guidelines that state fusion for non-specific low back
pain should only be performed as part of a randomised controlled
trial, and that lumbar disc replacement should not be performed.
Thus, spinal fusion and disc replacement will no longer be routine
forms of treatment for patients with low back pain. This annotation
considers the evidence upon which these guidelines are based. Cite this article:
We compared the long-term function of subscapularis after the Latarjet procedure using two
Aims
Patients and Methods
We studied prospectively 22 young athletes who had undergone
There has been an in increase in the availability
of effective biological agents for the treatment of rheumatoid arthritis
as well as a shift towards early diagnosis and management of the
inflammatory process. This article explores the impact this may
have on the place of orthopaedic surgery in the management of patients
with rheumatoid arthritis. Cite this article: