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Query: UMLS:C0003090 (arthrodesis)
 8,374 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The treatment of 12 distal radius nonunions in 11 patients over a 24-year period is presented. The average age of the patients was 55 years (range, 35-72 years). The comorbid medical conditions in the patients with these fractures included diabetes mellitus, peripheral vascular disease, psychiatric disorders, alcoholism, peripheral neuropathy, scleroderma, and morbid obesity. Nine of the un-united fractures in 8 patients had insufficient metaphyseal bone to allow internal fixation; 6 of these fractures were treated with a wrist arthrodesis. Three un-united fractures in 3 patients had sufficient supporting bone to permit correction of the nonunion and preservation of the radiocarpal joint. Three nonunions in 3 patients were treated without further surgery. Bony union was achieved in all 9 nonunions managed operatively (6 wrist arthrodeses and 3 open reductions).
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PMID:Un-united fractures of the distal radius: a report of 12 cases. 976 72

Advancement in diagnostic and therapeutic applications for hip arthroscopy have dispelled previous myths about early hip disease. Arthroscopic findings have established the following facts: Acetabular labral tears do occur; acetabular chondral lesions do exist; tears are most frequently anterior and often associated with sudden twisting or pivoting motions; and labral tears often occur in association with articular cartilage lesions of the adjacent acetabulum or femoral head, and if present for years, contribute to the progression of delamination process of the chondral cartilage. Magnetic resonance arthrography represents an improvement over conventional magnetic resonance imaging, it does have limitations when compared with direct observation. Although indications for hip arthroscopy are constantly expanding, the most common indications include: labral tears, loose bodies, chondral flap lesions of the acetabular or femoral head, synovial chondromatosis, foreign body removal, and crystalline hip arthropathy (gout, pseudogout, and others). Contraindications include conditions that limit the potential for hip distraction such as joint ankylosis, dense heterotopic bone formation, considerable protrusio, or morbid obesity. Complication rates have been reported between 0.5 and 5%, most often related to distraction and include sciatic or femoral nerve palsy, avascular necrosis, and compartment syndrome. Transient peroneal or pudendal nerve effects and chondral scuffing have been associated with difficult or prolonged distraction. Meticulous consideration to patient positioning, distraction time and portal placement are essential. Judicious patient selection and diagnostic expertise are critical to successful outcomes. Candidates for hip arthroscopy should include only those patients with mechanical symptoms (catching, locking, or buckling) that have failed to respond to conservative therapy. The extent of articular cartilage involvement has the most direct relationship to surgical outcomes. Improvements in technique and instrumentation have made hip arthroscopy an efficacious way to diagnose and treat a variety of intra-articular problems.
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PMID:Arthroscopic intervention in early hip disease. 1557 81

Recurrent deformity in the adult flatfoot following previous tendon transfer represents a challenging treatment dilemma for even the most experienced foot and ankle surgeon. The evaluation must be comprehensive, resulting in a clear understanding of the extent to which previous surgical procedures either failed to address the deformity initially or led to progressive recurrence. Particularly in younger, more high-demand patients, every effort to preserve normal joint mechanics while alleviating pain and restoring functional alignment must be made. LCL coupled with MDCO and a comprehensive medial soft tissue reconstruction represents a joint-sparing modality for approaching even the most challenging flexible flatfoot deformities. Care to avoid overcorrection, particularly with a double calcaneal osteotomy, must be taken. In the presence of progressive degenerative changes or patient factors such as morbid obesity and advanced age, hindfoot arthrodesis, particularly realignment subtalar joint arthrodesis, provides a technically straightforward, predictable means of achieving a pain-free plantigrade foot. Talonavicular arthrodesis and double arthrodesis, although reliable means of achieving pain relief and functional alignment, do sacrifice considerably more hindfoot motion and are likely more appropriately reserved for elderly, low-demand patients or those with more severe fixed deformities.
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PMID:Management of the recurrent deformity in a flexible foot following failure of tendon transfer: is arthrodesis necessary? 2254 27