Ureteral stents: a device for removal.
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PURPOSE: Common methods of assessment of the clinical distraction osteogenesis (DO) wound consist of serial physical examinations, plain radiographs, and computed tomography (CT). Ultrasound (US) is an inexpensive and efficient method of imaging that provides detailed assessment of bone formation across a defect. It has proved to be useful for the evaluation of long bone DO healing. The purpose of this study was to determine the efficacy of US for evaluation of bone formation in the mandibular distraction wound. PATIENTS AND METHODS: Ten patients underwent mandibular expansion (18 sides) with semiburied, unidirectional distraction devices. The wounds were assessed with plain radiographs and US immediately before device removal. Estimates of bone formation, using a semiquantitative bone fill score, were made for plain radiographs and US. US beam penetration depth, in millimeters, was also measured. During removal of the distraction device, bone formation and mandibular stability were assessed by the surgeon and graded on a semiquantitative scale. RESULTS: US bone fill scores correlated with intraoperative assessment of bone formation and stability (r = 0.758, P =.0018) at all 18 mandibular sites. Plain radiographic scores also correlated with bone formation (r = 0.592). However, in 14 of 18 sides, plain radiographs underestimated bone formation compared with US and operative findings. CONCLUSION: The results of this study indicate that US is an accurate noninvasive technique that may prove to be useful in assessing the mandibular DO regenerate in patients.
A removal procedure of a femoral cement mantle in hip revision arthroplasty has a risk of causing perforation or fracture, especially when removing a well-fixed distal cement plug. A high-powered drill equipped with a centralizer was developed to remove the distal cement plug safely. Using the drill equipped with a centralizer, the cement plug was removed well enough to insert a new component without causing perforation during the operation.
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A new system for endoscopic removal of a gastric prosthesis for treatment of obesity is presented. This technique permits rapid deflation of intragastric balloons as well as safe endoscopic removal of the gastric remnant. The method has been successfully employed in 26 patients, i.e. 74 events of balloon extraction.
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