F Tehrany | PubMed Health

PubMed1997

Limb salvage in advanced chronic osteomyelitis in children.

Chronic osteomyelitis of the entire tibial shaft was treated in 9 children by medical and surgical management in 3 stages. In stage 1, the involved shaft was excised with debridement of the periosteum. Stage 2 consisted of continuous suction-irrigation of the periosteal space with local and systemic antibiotics. In stage 3, the ipsilateral fibular shaft was transferred into the tibial periosteal envelope with the muscles of the middle third and its blood supply. After 18 months, the transferred fibula grew into a new tibia in every case so that the children were able to carry out all their activities of daily living. This method remains the best way of salvaging the limb when the entire tibia is involved.

Child↗

PubMed1997

Anterior shoulder dislocation reduction technique--revisited.

Acute anterior shoulder dislocations are extremely painful conditions that force patients to present to emergency rooms or physicians' offices immediately. The diagnosis usually is established through a careful history and examination, and may be confirmed by appropriate radiography. The immediate treatment objective is to achieve reduction as early as possible, preferably through a closed reduction method with the least discomfort. Current methods of reduction are based on either traction or leverage maneuvers, with each having its own merits and disadvantages. This article, however, revisits the subject by a comprehensive literature review. It addresses obstacles to reduction and reports a closed reduction technique for the acute anterior dislocations of the shoulder that uses both traction and leverage maneuvers simultaneously. In addition, the technique eliminates failing factors of current reduction methods such as the surgeons' weakening or slippery grip when using traction methods. It is expected, by virtue of the method, that it would reduce the chances for complications such as humeral shaft fractures as can occur in leverage maneuvers. This method addresses all potential anatomical and pathological features of acute anterior dislocations of the shoulder to facilitate an earlier and more comfortable reduction.

Adolescent↗