Midline disk herniations of the lumbar spine.

Most lumbar disk displacements occur through the lateral fibers of the posterior longitudinal ligament, whereas only a small percentage occur through the strong midline fibers. The midline disk herniation is identified as a focal midline dural sac compression and is better seen on the lateral myelogram and computed tomography scan. Of the 22 patients in this study, 14 had midline lumbar disk herniations at L4-5.

The erythrocyte sedimentation rate in orthopaedic patients.

The ESR, a sensitive measure of the inflammatory response, is elevated in 90% of patients who have serious orthopedic infections, e.g., discitis, septic arthritis, and hematogenous osteomyelitis.

Transient impotence from positioning on the fracture table.

A case of transient impotence caused by pressure from the perineal post of the fracture table is reported. The anatomic position of the pudendal and cavernous nerves appears to account for the impotence. The use of a foam-rubber fitting for the perineal post is recommended.

Pseduarthrosis of a tibial plateau fracture: report of a case.

In an elderly woman a tibial condylar pseudarthrosis was angulated with disabling pain, significant deformity, and progressive articular deterioration. The treatment of this non-union consisted of arthrotomy, mobilization of the ununited medial condyle, slight over-elevation of the tibial plateau, iliac bone grafting to reconstitute loci of bone loss, and rigid interfragmentary and buttress plate fixation. Postoperative management consisted of early knee motion and delayed weight-bearing to facilitate functional restoration of the extremity.