Isolated fractures of the distal humerus are rare. Their diagnosis is often late, and treatment has progressed but serious complications may occur. We conducted a retrospective study of a series of 10 cases at the Dep...Isolated fractures of the distal humerus are rare. Their diagnosis is often late, and treatment has progressed but serious complications may occur. We conducted a retrospective study of a series of 10 cases at the Department of Orthopedic and Traumatologic Surgery of the Ibn Sina University Hospital in Rabat over a 4-year period, from January 2018 to January 2022. All our cases were treated surgically with Herbert screws. The functional, clinical and radiological outcome was satisfactory with a return to pre-fracture activity in all patients.展开更多
Introduction: While autograft bone is the gold standard for multilevel posterolateral lumbar fusion, bone substitutes and graft extenders such as allograft bone, ceramics and demineralized bone matrix (DBM) have been ...Introduction: While autograft bone is the gold standard for multilevel posterolateral lumbar fusion, bone substitutes and graft extenders such as allograft bone, ceramics and demineralized bone matrix (DBM) have been used to avoid the morbidity and insufficient quantity associated with harvesting autologous bone. The primary objective of this retrospective study was to determine whether, in patients with increased risk of operative nonunion related to multilevel fusion, adding DBM fibers to mineralized bone allograft resulted in better fusion than using allograft alone. The secondary objectives were to evaluate how adding DBM fibers affects functional disability, low back pain, intraoperative blood loss and the nonunion rate. Methods: This retrospective study involved a chart review of consecutive patients who underwent multilevel lumbar spinal fusion and were operated on by a single surgeon. The patients were divided into two groups: 14 patients received mineralized bone allograft (control group) and 14 patients received a combination of mineralized bone allograft and DBM (experimental group). Patients were reviewed at a mean of 16.4 ± 2.2 months after surgery at which point CT scans were analyzed to determine whether fusion had occurred;Oswestry disability index (ODI) and pain were also evaluated. Results: A mean of 5 levels [min 2, max 13] were fused in these patients. Posterolateral fusion as defined by the Lenke classification was not significantly different between groups. The experimental DBM group had a significantly better composite fusion score than the control group (P Discussion: Adding DBM fibers to allograft bone during multilevel posterolateral spinal fusion was safe and produced better composite fusion than using allograft only as an autograft extender.展开更多
Total elbow arthroplasty as a treatment option for open elbow fracture is relatively rare described.We reported a 39 years old polytrauma patient with complex open elbow fracture(Gustilo-Anderson type IIIB).The patien...Total elbow arthroplasty as a treatment option for open elbow fracture is relatively rare described.We reported a 39 years old polytrauma patient with complex open elbow fracture(Gustilo-Anderson type IIIB).The patient presented with large soft tissues defect on dorsal part of the left elbow,ulnar palsy due to the irreparable loss of the ulnar nerve,distal triceps loss due to the complete loss of the olecranon,loss of both humeral condyles with collateral ligaments and complex elbow instability.Only few similar cases have been published.Reconstructive surgery included repetitive radical debridement,irrigation,vacuum assisted closure system therapy,external fixation,coverage of the soft tissue defect with fascia ecutaneous flap from the forearm.Four months after the injury,total elbow arthroplasty with autologous bone graft(from the proximal radius)inserted in the ulnar component,was performed.At 3 years postoperatively,the patient is able to perform an active flexion from 0to 110with full pronosupination.Only passive extension is allowed.The ulnar neuropathy is persistent.Patient has no signs of infection or loosening of the prosthesis.展开更多
文摘Isolated fractures of the distal humerus are rare. Their diagnosis is often late, and treatment has progressed but serious complications may occur. We conducted a retrospective study of a series of 10 cases at the Department of Orthopedic and Traumatologic Surgery of the Ibn Sina University Hospital in Rabat over a 4-year period, from January 2018 to January 2022. All our cases were treated surgically with Herbert screws. The functional, clinical and radiological outcome was satisfactory with a return to pre-fracture activity in all patients.
文摘Introduction: While autograft bone is the gold standard for multilevel posterolateral lumbar fusion, bone substitutes and graft extenders such as allograft bone, ceramics and demineralized bone matrix (DBM) have been used to avoid the morbidity and insufficient quantity associated with harvesting autologous bone. The primary objective of this retrospective study was to determine whether, in patients with increased risk of operative nonunion related to multilevel fusion, adding DBM fibers to mineralized bone allograft resulted in better fusion than using allograft alone. The secondary objectives were to evaluate how adding DBM fibers affects functional disability, low back pain, intraoperative blood loss and the nonunion rate. Methods: This retrospective study involved a chart review of consecutive patients who underwent multilevel lumbar spinal fusion and were operated on by a single surgeon. The patients were divided into two groups: 14 patients received mineralized bone allograft (control group) and 14 patients received a combination of mineralized bone allograft and DBM (experimental group). Patients were reviewed at a mean of 16.4 ± 2.2 months after surgery at which point CT scans were analyzed to determine whether fusion had occurred;Oswestry disability index (ODI) and pain were also evaluated. Results: A mean of 5 levels [min 2, max 13] were fused in these patients. Posterolateral fusion as defined by the Lenke classification was not significantly different between groups. The experimental DBM group had a significantly better composite fusion score than the control group (P Discussion: Adding DBM fibers to allograft bone during multilevel posterolateral spinal fusion was safe and produced better composite fusion than using allograft only as an autograft extender.
文摘Total elbow arthroplasty as a treatment option for open elbow fracture is relatively rare described.We reported a 39 years old polytrauma patient with complex open elbow fracture(Gustilo-Anderson type IIIB).The patient presented with large soft tissues defect on dorsal part of the left elbow,ulnar palsy due to the irreparable loss of the ulnar nerve,distal triceps loss due to the complete loss of the olecranon,loss of both humeral condyles with collateral ligaments and complex elbow instability.Only few similar cases have been published.Reconstructive surgery included repetitive radical debridement,irrigation,vacuum assisted closure system therapy,external fixation,coverage of the soft tissue defect with fascia ecutaneous flap from the forearm.Four months after the injury,total elbow arthroplasty with autologous bone graft(from the proximal radius)inserted in the ulnar component,was performed.At 3 years postoperatively,the patient is able to perform an active flexion from 0to 110with full pronosupination.Only passive extension is allowed.The ulnar neuropathy is persistent.Patient has no signs of infection or loosening of the prosthesis.
