Distraction treatment of deformities due to physeal fractures.
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Biomedical subjects
Publications and source records attributed to J F Connolly.
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Normal fracture healing in long bones is a poorly defined process which to a great extent is dependent on periosteal response to injury. When this normally effective mechanism fails, electrical enhancement may prove an effective adjunct and less morbid solution than standard bone grafting procedures for periosteal reactivation.
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The status of the fibula is an index of the severity of injury. Open tibial fracture with associated fractured fibula is more likely to develop complications. Antibiotics should be started promptly. Judicious debridement is essential but bone fragments should be left whenever possible. When there is any question about contamination, the wound is best left open. Rigid occlusive dressings promote epithelial ingrowth. Fracture distraction and plate fixation are associated with a high incidence of complications.
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Unicameral bone cysts are benign processes of obscure origin. Surgical treatment has not been encouraging; however, in the past decade, corticosteroid injection has afforded good results. The reason for the efficacy of steroid treatment has not been demonstrated. We measured the prostaglandin level in the aspirated fluid of a unicameral cyst before and 4 months after corticosteroid injection. A basis for treatment of the benign bone cyst is postulated.
The etiology of the unicameral bone cyst remains undefined. Likewise, the treatment of the cyst has had proponents suggesting procedures ranging from decompression to diaphyseal resection. The use of intralesional steroids has gained popularity since its introduction in 1979 by Scaglietti. We present the results of aspirations of seven cysts, with serial measurements of prostaglandin levels in five cases, and suggest that the antiprostaglandin action of the steroid forms the rationale for treatment of the simple cyst.