Commentary. Responding to change.
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Biomedical subjects
Publications and source records attributed to M L Goldflies.
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Musculoskeletal pain of the posterior thoracic area has many etiologies. Referred pain from the abdominal organs is noted for the right sided viscera, the stomach, and the pancreas. Kidney pathology, however, is not listed among the differential diagnoses. A case of a renal calculus causing posterior thoracic wall pain is presented with an examination of the relevant pain pathways.
Although the presence of hyperuricemia and avascular necrosis of the hip is well documented, a similar association in the talus seems not to have been previously reported. The clinical and radiographic findings were confirmed by the histologic alterations in bone structure. Successful arthrodesis of the destroyed left ankle joint was accomplished by iliac bone graft.
Closed Ender nailing was used in sixty fractures of the femoral shaft. Follow-up examination in fifty-two cases is reported. There were only two failures of the method, both in fractures with supracondylar extension. Simple transverse and short oblique fractures and those with unicortical comminution were shown to be stable after nailing, while long oblique fractures and lesions with bicortical comminution had a tendency to shorten and often required cerclage wiring, cast-bracing, or traction. The average hospital stay was 23.7 days. The operations were simple and quick. There was one case of osteomyelitis, one of clinically apparent thrombophlebitis, and one of fat-embolism syndrome in a patient with multiple fractures and multisystem injuries. There were no cases of breakage of the nail, delayed union, or non-union. In most cases knee motion returned to the preinjury level, although in five knees removal of the nails was necessary. The two failures of nailing which required plate fixation occurred in fractures extending into the supracondylar region. Therefore, these fractures are not suitable for Ender nailing.