Biomedical subjects
Publications and source records attributed to P S Duun.
A case of epidural abscess following continuous spinal epidural catheterization is presented. The clinical signs included spinal ache, root pain, weakness and paralysis but no fever. Xanthomonas maltophilia, an organism closely related to Pseudomonas species, was the causative agent. This has not previously been described as the causative agent of epidural abscesses.
33 children with a mean age of 12 (7-15) years had open reduction and osteosynthesis for a displaced fracture of the medial humeral epicondyle. 8 (2-15) years after the operation a clinical and radiographic examination was performed. 22/33 had a prominent scar. No patients had symptoms from the ulnar nerve. Function and range of motion of the elbow were good in all cases, albeit with 20-25 degrees of extension in 3. There were 3 cases of asymptomatic nonunion. Surgery was found to reduce the frequency of nonunion, compared to previous reports of non-operative treatment.
Penetration into the pelvis by a sliding screw, with screwplate disengagement, is a rare complication after osteosynthesis of intertrochanteric fractures of the femur. This case highlights such an unusual event with fatal outcome. Unstable fracture, osteoporosis, and full weight bearing combined with the failure of the screw to slide within the barrel of the plate and with the absence of a compression screw increases the risk of complications. Optimal reposition and screw placement with a high plate angle, full screw-plate engagement and use of the compression screw is recommendable in unstable fractures.
Posterior dislocation of the shoulder is frequently overlooked. Early diagnosis is a prerequisite for successful treatment. Supplementary axillary or apical oblique projections should be included in the routine radiograms to confirm the diagnosis.
A case of a rare recurrent lipoma originating from the perirenal fat is reported. Onset of symptoms (abdominal pain, weight loss, appetite loss, abdominal swelling, nausea, constipation) is late and the treatment is surgical, but postoperative radiation or chemotherapy may be indicated. Ultrasound, CT and NMR scans, pyelograms and barium enemas are the most important diagnostic investigations. Follow-up in these patients is important.