Dynamic hip screw guide-wire placement.
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Biomedical subjects
Publications and source records attributed to A Y Bonshahi.
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Isolated lesser trochanter fractures are a rare presentation of hip fractures in the elderly. Classically, lesser trochanter fractures in adults are associated with tumours and result from little or no trauma. We present three elderly osteoporotic ladies who sustained isolated fractures of the lesser trochanter secondary to a definite history of trauma. Radiologically, none of them showed any evidence of pathological lesions or intertrochanteric fracture at presentation. Two patients subsequently developed displaced intertrochanteric fractures, which necessitated internal fixation. In the third patient, a dynamic hip screw (DHS) was inserted before mobilisation. Based on this experience, we recommend careful observation and follow-up of such cases and suggest that isolated lesser trochanteric fractures in the elderly osteoporotic population may be an indication for prophylactic DHS fixation.
Many procedures have been described for the correction of congenital dislocation of the patella. Most operations entail extensive soft tissue releases through curved skin incisions. A modification of the Langenskiold and Ritsila procedure is described. The main alterations include a limited and straight anterior skin incision, a fashioning of a 'buckle' of the transferred distal-patellar tendon to a distally based flap and the transposition of an extensive medial rotation flap. This report describes the early results (mean=19 months) of the modified procedure in three cases of congenital lateral dislocation of the patella.
Meniscal repair is a common procedure that can be performed by the inside-out, outside-in, and all-inside techniques. The all-inside technique using the meniscal arrow is increasingly popular. We report a case in which a broken segment of a meniscal arrow was found on exploration of a subcutaneous swelling around the knee three weeks following meniscal repair.
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