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PubMed1976

Total avascular necrosis of the capital femoral epiphysis in congenital dislocated hips.

Ninety-four hips involved with total avascular necrosis in the treatment of congenital dislocation of the hips were reviewed in a search for etiological factors and effective salvage procedures. Pre-reduction traction and adductor tenotomy did not prevent avascular necrosis. Abduction of the hip in the "frog" position was the incriminating common denominator. This position may cause (1) interference of the blood supply to the femoral head by compression of the medial branch of the deep profundus artery; and (2) pressure on the intraepiphyseal grooves by the glenoid labrum. The containment of the femoral head by acetabuloplasty (preferably) below age 8, followed at a later date (over age 10) by transfer distally of the greater trochanter, with the abductor muscles, offers a satisfactory salvage procedure.

Acetabulum↗
PubMed1998

[Evaluation of the surgical treatment of trapeziometacarpal arthroses].

The authors describe their experience, from July 1995 to December 1996, in the management of patients suffering from trapeziometacarpal degenerative arthrosis. Dell's classification is used for disease staging. The results of two different techniques are compared: 1) distal tenotomy of supranumerary insertions of abductor pollicis longus; and 2) trapeziectomy with tendon interposition arthroplasty and ligamentoplasty using the flexor carpi radialis.

Adult↗
PubMed1998

Simple methods of forced oral opening for cadavers oriented to causes of fixed jaw.

Forensic dentistry plays an essential role in personal identification procedures. An adequate interincisal space of relatively fresh cadavers would be required to obtain detailed dental findings. We developed novel and simple procedures of oral opening which are oriented to the causes of the fixed jaw and conscious of facial damage. Preliminary inspection disclosed three causes of the difficulty of oral opening, namely exceptional drying or parchmenting, rigor mortis and loss of extensibility of the temporalis muscles. Tenotomy on the temporalis muscles for cases with the last two factors, and/or mandibular periosteal stripping for those with the first one were employed to approach the oral cavity of cadavers, and a desired degree of interincisal opening was attained. Single or combinational operation of these methods is definitely effective to obtain odontological data without altering facial configuration.

Autopsy↗
PubMed1998

Diagnosis and treatment of isolated inferior oblique muscle palsy: a report of seven cases.

PURPOSE: To review and report our experience in attempting to surgically eliminate the vertical deviations and the anomalous head posture in patients with inferior oblique palsy (IOP) and to add to the literature another etiology for IOP: denervation/myectomy of that muscle. SUBJECTS AND METHODS: Seven patients demonstrating findings characteristic of an isolated IOP are reported. Six were unilateral and one was bilateral. All met the Bielschowsky/Parks' Three Step Test criteria to identify an isolated IOP. Six patients had surgery that consisted of weakening the superior oblique (SO) muscle of the affected eye alone or in combination with superior rectus recession of the fellow eye. RESULTS: All patients were ultimately successfully alleviated of their vertical deviations and anomalous head postures. (Two patients developed an iatrogenic superior oblique palsy (SOP) which responded well to additional surgery.) CONCLUSIONS: The treatment of choice for IOP is tenotomy or tenectomy of the ipsilateral superior oblique muscle alone or in combination with recession of the contralateral superior rectus muscle.

Adolescent↗