Bone fractures in the long-term care of a patient in a vegetative state: a risk to conflicts.

Purpose: This case report shows how recurrent bone fractures can increase the tension in the relationship between family and caregivers in the long-term care of a patient in a vegetative state (VS). The aim of this report is to prevent conflict situations elsewhere by informing the family in time about the risk of fractures in a situation of severe osteoporosis.

Results: A second opinion and a density test of the bone contributed to the acceptance of the family of that risk in the daily nursing care, after all adjustments to prevent fractures and to adapt the environment were undertaken.

Treatment of scaphoid non-union with a percutaneous corticocancellous bone graft.

Thirty-three symptomatic scaphoid non-unions were treated by a simple, minimally invasive procedure using a percutaneous autologous corticocancellous bone graft. After an average follow-up of 3.5 years, union was observed in 29 cases.

Resection of the radial head after Mason type-III fractures of the elbow: follow-up at 16 to 30 years.

We reviewed 21 patients with Mason type-III fractures of the radial head treated by resection, evaluating the results at 16 to 30 years by a standard questionnaire and clinical and radiological examination of the elbow and wrist. Seventeen patients had an excellent result, three were good and one fair. Resection of the radial head is a satisfactory method of treatment of such fractures.

Glenoplasty for recurrent posterior shoulder instability. Good results in 13 cases followed for 1-16 years.

After the failure of closed treatment, 13 shoulders in 10 patients with chronic posterior shoulder instability had an open wedge osteotomy of the collum scapulae, with interposition of an autologous graft from the iliac crest. After a median follow-up of 9 (1-16) years, there were no recurrent posterior luxations or signs of instability. All patients were satisfied, but 3 had slight pain after strenuous work.