R. Ramón

Comminuted intra-articular fractures of the distal end of the radius treated with the Hoffmann external fixator.

In 1985 we began a prospective study of the use of external fixation in the treatment of intra-articular comminuted fractures of the distal end of the radius. A total of 30 patients have been treated by this method, representing 1.3% of the total number of patients treated in the Emergency Unit for a fracture of the distal epiphysis of the radius. The use of external fixation in instable fractures of the distal end of the radius improves the anatomic results. These correlate closely with the overall functional results obtained, which were excellent or good in 82.1% of cases, according to the rating system of Gartland and Werley. The main indications are fractures with a high degree of comminution, displacement, and articular affectation (unstable fractures) in young patients, corresponding to Frykman grades VII and VIII.

Use of bone allograft in tibial plateau fractures

Abstract To determine the behaviour of bone allografts in the treatment of tibial plateau fractures, 20 recipients of frozen bone allograft for a depressed tibial plateau fracture were studied. Incorporation of grafts took place in all cases, and no complication secondary to the allograft use has been detected. To avoid donor site morbidity associated with harvesting iliac crest, the use of frozen bone allograft is a good alternative in the treatment of depressed tibial plateau fractures.

Unusual locations of osteoarticular tuberculosis

Tuberculosis continues to occur frequently in some underdeveloped regions. Bone and joint tuberculosis is less common than the pulmonary form. Fourteen cases of bone and joint tuberculosis in unusual locations are presented. Tuberculostatic treatment and surgical approach were associated in all the patients. In 6 cases an arthrodesis of the affected joint was carried out. A surgical debridement was done in 6 patients and a needle biopsy in 2 patients in order to obtain samples for pathology and bacteriology. Twelve of the 14 patients recovered. One patient who was affected by atlanto-axial tuberculosis died within the immediate postoperative period. A second one affected by the acquired inmunodefiency syndrome died 4 months after surgery.

Bone allograft contamination in multiorgan and tissue donors

Abstract Multiorgan and tissue donors offer a large quantity and high quality of bone allograft that cannot be obtained from living donors. The risk of bone contamination must be borne in mind if secondary sterilization is not performed. The bacteriological cultures of 270 bone segments obtained from 53 multiorgan or tissue donors were analysed to study the relationship between previous organ and tissue procurements and bone retrieval contamination. We concluded that no significant differences in bacterial contamination percentage were found for each type of previous organ and tissue procurement, nor in the number of teams per donor.

Compression of the ulnar nerve in Guyon's canal by uremic tumoral calcinosis.

Abstract We describe the case of a 70-year-old woman with chronic renal failure on haemodialysis presenting with an ulnar nerve compression in Guyon’s canal secondary to uremic tumoral calcinosis. Excision of calcium deposits and external neurolysis of the ulnar nerve were successfully performed. Simultaneously, the hyperphosphatemia and hypercalcemia were corrected. The pathogenesis of this condition is different from primary tumoral calcinosis. Clinical and radiological features and therapy are discussed. Uremic tumoral calcinosis is an unusual etiology of ulnar nerve compression in Guyon’s canal not previously reported in dialysis patients.

Pubic osteolysis simulating a malignant lesion: case report.

A case of posttraumatic osteolysis of the pubic bone simulating a malignant lesion in a 55-year-old woman is reported. A review of the literature revealed that all reported cases occurred in post-menopausal women, associated with radiologic evidence of osteoporosis and a history of slight trauma. Biopsy was performed because of the possible malignant nature of the lesion, which should be suspected in all post-menopausal women with a destructive lesion of the pubic bone.

COMPRESSION OF THE ANTERIOR INTEROSSEOUS NERVE AFTER USE OF A ROBERT-JONES TYPE BANDAGE FOR A DISTAL END CLAVICLE FRACTURE: CASE REPORT

There are some controversies in the medical literature about the causes of the anterior interosseous nerve (AIN) compression syndrome. The present case is, to our knowledge, the first reported resulting from an extrinsic compression of the AIN from a Robert-Jones type bandage in a patient with a distal end clavicle fracture.