Efthimios Samoladas

A Case of Successful Treatment of Neuropathic Pain After a Scapular Fracture Using Subcutaneous Targeted Neuromodulation

Subcutaneous targeted neuromodulation is one part of the wider new peripheral neuromodulation development in the treatment of neuropathic pain. Although it has not received wider acceptance, there are many reports in the literature of successful use of this technique.

Surgical management of closed tibiotalar dislocation: a case report and 2-year follow-up.

UNLABELLED We report a case of a closed tibiotalar dislocation without an associated malleolar fracture, in the presence of medial malleolar hypoplasia, treated with closed reduction and surgical repair of the deltoid ligament, followed by cast immobilization. Post-reduction radiographs, before open repair of the deltoid ligament, revealed an Elisé test ratio of 0.43. The ruptured superficial and deep portions of the deltoid ligament and the anterior ankle capsule were primarily repaired with suture, after which cast immobilization and non-weight bearing were used before physiotherapy and rehabilitation. Two years after the injury, the patient was pain free with a full range of ankle motion, and there were no signs of residual instability or early osteoarthritis. Subjective clinical testing using a valid health measurement instrument revealed an excellent clinical outcome. Based on our experience in this case, closed ankle dislocation in the presence of a hypoplastic medial malleolus and stress manipulation evidence of medial instability indicates the need for primary repair of the deltoid ligament. LEVEL OF CLINICAL EVIDENCE 4.

Does aprotinin reduce blood loss in total hip arthroplasty

This prospective randomized study examined the effects of aprotinin during total hip arthroplasty (THA). Fifty patients who were enrolled in the study received aprotinin or normal saline. Mean intraoperative blood loss was reduced from 1496 mL in the control group to 1073 mL in the aprotinin group. The mean transfusion unit was 1.56 in the aprotinin group and 3.8 in the control group.

Allogenic versus autologous transfusions comparison of results following primary total knee replacement

This article evaluates the effectiveness of autotransfusion in reducing the need for allogenic transfusion following primary total knee replacement.

Aggressive and rapid progression of idiopathic bilateral avascular necrosis of femoral head in an old woman suffering from osteoporosis: A case report and review of the literature

BackgroundWe present an unusual case of an aggressive and rapid progression of idiopathic bilateral avascular necrosis (AVN) of femoral head in an old woman suffering from osteoporosis.Case presentation An 83-year-old woman with an unremarkable past medical history admitted to the Emergency Department of the Hospital with ongoing bilateral groin and buttock pain started a week ago. Clinical examination revealed painful hip movements with a slight limitation of joint range of motion. Anteroposterior radiographs demonstrated only osteoporosis of both hips without evidence of fracture or deformity. The patient was re-admitted to the Emergency Department 3 weeks afterwards with intractable bilateral groin pain and inability to walk. New X-Rays showed severe destruction and collapse of both femoral heads. The patient underwent cemented bipolar hemiarthroplasty in both hips. Histological examination established the diagnosis of AVN.ConclusionThis is the first case presented in English literature of such aggressive and rapid progression of bilateral idiopathic AVN. Due to the potential synergistic role of osteoporosis in the development of hip AVN, early MRI examination should be considered in patients with osteoporosis and acute hip pain.

A Combined Repair Technique for Early Neglected Achilles Tendon Ruptures

Objective:This study presents the long-term results of a combined technique, using both Duthies biological repair and a plantaris tendon transfer for the reconstruction of early neglected tendo Achilles ruptures.Materials and Method:Between January 2000 and November 2004, nine patients with an early neglected Achilles tendon rupture (≥ 4 and ≤ 12 weeks from injury), underwent surgical reconstruction. Eight patients were male and one female, their age was average 41 years and the median follow-up period was 3.66 years. The average clinical defect of the Achilles tendon was 4.33 cm.Results:All patients were examined by the clinical ankle scoring system of Leppilahti et al. (Clin Orthop 346:152–161, 1998). Six patients presented excellent results and three patients had good results. All patients had equal plantarflexion and dorsiflexion with the healthy side and all of the studys patients returned to work 3 months postoperatively. An average muscle atrophy of 0.83 cm was documented compared with the uninjured side. Only four of nine patients (44.44%) had a normal one-legged jump. There were no complications postoperatively and no re-ruptures of the Achilles tendons.Conclusion:This combined method appears to be safe and effective, with a low risk for complications, allowing us to obtain excellent results for the majority of our patients.