S. P. Chow

Anterior spinal fusion for deranged lumbar intervertebral disc. A review of 97 cases

Ninety-seven patients who underwent anterior interbody fusion for lumbar disc derangement were examined two to 15 years after the operation. Complete relief of back pain was obtained in 60% and of sciatica in 85%; marked improvement of back pain was obtained in 29% and of sciatica in 10%. The fusion rate was 63% and was only slightly correlated with symptomatic improvement. Many complications were encountered, most of which were transient.

Open treatment of fingertip injuries in adults

Ninety patients with 100 fingertip injuries of more than 1.0 cm 2 in area were treated by repeated dressing and a strict rehabilitation program. Healing time varied from 2 to 9 weeks. Although there was a 27% incidence of nail deformity, other complications such as amputation neuroma, painful stump, or stiffness of joints were extremely rare. This prospective study shows that the open method has a definite place in the treatment of certain fingertip injuries.

An experimental study on incompletely cut chicken tendons--a comparison of two methods of management.

One hundred and twenty tendons in the chicken were partially cut to a different extent either transversely or obliquely. In half of the tendons, the cuts were sutured and then immobilised for three weeks, while in the other half, they were left unsutured and started on free movement on the third day. From the gross examination and histological studies, the results were significantly better in the sutured and immobilised group. The results became significantly worse when the cut was more than 50%, and there was no difference between an oblique or a transverse cut.

Retroperitoneal fibrosis after anterior spinal fusion

Three patients with lumbar anterior spinal fusion (two with Dwyer instrumentation) developed retroperitoneal fibrosis in relation to the operative site. This complication is possibly a reaction to the retroperitoneal insult. Haematoma, low-grade infection and metallic implant are other likely contributory factors. Its occurrence is affected by the laterality of surgical approach and extent of dissection. Radiologists should be aware of such a complication when investigating post-fusion patients. Early diagnosis and treatment prevent further renal damage.

Pulmonary thromboembolism and venous thrombosis in the Chinese.

: In 3,876 autopsies performed between 1964 and 1974 in adult Hong Kong Chinese, the incidence of pulmonary thromboembolism was 0.75%. In a prospective study of 70 autopsies, the right lungs were inflated, fixed, slab-sectioned, and studied for pulmonary thromboembolism. Twenty-seven per cent had evidence of pulmonary thromboembolism, although in only one case was the lesion the cause of death. In another 62 autopsies, routine dissection of pelvic and both lower extremity veins revealed that 18% had evidence of thrombosis. Eighty-three per cent of these had pulmonary thromboembolism; in 3 of these 62 cases (5%) pulmonary thromboembolism was the cause of death. Massive pulmonary thromboembolism in the Hong Kong Chinese is much less frequent than in Caucasians. The finding of many small asymptomatic pulmonary thromboemboli in both racial groups suggests that pulmonary circulation performs a physiologic filtering function. The rarity of massive clots in the Chinese warrants further investigation and special attention to biomechanics of thrombosis formation and detachment.

Surgical treatment of scoliosis following poliomyelitis. A review of one hundred and ten cases.

We reviewed the cases of 110 patients with paralytic scoliosis due to poliomyelitis who were operated on. In the lumbar region, anterior Dwyer instrumentation with posterior fusion gave excellent correction of scoliosis and pelvic obliquity. In the more rigid thoracic curves, combined anterior Dwyer instrumentation and posterior fusion gave better results than posterior fusion alone, but had more morbidity. Long c-shaped curves benefited more from a combined anterior Dwyer procedure at the apex of the curve and long posterior Harrington instrumentation. Traction was found to be of use only in rigid curves and in those larger than 80 degrees. With combined anterior and posterior fusion, there was a pseudarthrosis rate of 7 per cent in lumbar curves, none in thoracic curves, and 12.5 per cent in long c-shaped curves. The pseudarthrosis rate rose to more than 25 per cent in patients who had a posterior fusion alone.

The Healing of Freeze-Dried Rabbit Flexor Tendon in a Synovial Fluid Environment

Deep flexor tendons from the forepaws of rabbits were removed and cut into two segments, sutured and freeze-dried. About one week later each tendon was placed in a knee joint of the same rabbit from which the tendon had been removed. At one, two, three and six weeks the tendons were retrieved and examined grossly, histologically and by electron microscopy. For comparison a control group using non freeze-dried tendons was also studied. Although there was evidence of central necrosis, superficial healing of the freeze-dried tendons occurred and was presumably due to cells from the synovial fluid.

The pattern of deep-vein thrombosis and clinical course of a group of Hong Kong Chinese patients following hip surgery for fracture of the proximal femur

In a prospective study of deep-vein thrombosis following hip surgery for fractures of the proximal femur, 45 Hong Kong Chinese patients were examined by bilateral functional ascending phlebography 7 to 28 days postfracture and 5 to 15 days post-surgery. In 14 patients, the phlebography was repeated 10 to 32 days later. The patients were followed for 27 to 32 months. The phlebographic pattern of the venous thrombi were analyzed, and the clinical course of the patients was presented. Despite the fact that the overall incidence of deep-vein thrombosis in this group of Chinese patients was similar to that reported in the West, clinical pulmonary embolism was not observed. The study suggested a difference in the distribution, pattern and probably the natural history of the venous thrombi among the Chinese when compared with the Western series.

Triggering Due to De Quervain's Disease

Triggering of the thumb due to de Quervains disease is a rarity. When it occurs in a boy of seven years old, it has never been reported before in the English literature.

The effect of davallina orientalis on bone healing. A preliminary report

A crude methanol extract of the herb Davallina Orientalis was given intraperitoneally to test its effect on bone healing in mice. The results indicated that it could increase the breaking strength of a fracture site. In our experimental model, the lower dosage has a better result probably because of less toxicity.