Nail Fit: Does Nail Diameter to Canal Ratio Predict the Need for Exchange Nailing in the Setting of Aseptic, Hypertrophic Femoral Nonunions?

Objectives: To evaluate patient-independent risk factors for aseptic femoral hypertrophic nonunion requiring exchange nailing, with particular reference to the fit of the nail at the isthmus within the canal.

Design: Retrospective case control study.

Setting: Level 1 trauma center.

Cancellous bone graft and Kirschner wire fixation as a treatment for cavitary-type scaphoid nonunions exhibiting DISI.

Background: Cavitary-type scaphoid non-unions represent one of the most difficult treatment challenges amongst all scaphoid non-unions as they exhibit bone loss, scaphoid shortening, flexion ('humpback') deformity and dorsal intercalated segmental instability (DISI), creating altered carpal mechanics which may proceed to the degenerative changes of scapholunate advanced collapse of the wrist. Our technique and its rationale are presented in the largest-to-date series on cavitary scaphoid non-unions exhibiting DISI.

Methods: Our technique for treatment of these cavitary non-unions is presented through a series of 27 patients.

The Australian arthroplasty thromboprophylaxis survey.

Previous surveys of orthopedic surgeons have shown considerable variation in thromboprophylaxis for venous thromboembolism after joint arthroplasty. This survey aimed to determine the current practice among Australian orthopedic surgeons. A questionnaire regarding the duration, reasons, and methods of chemical and mechanical prophylaxis for hip and knee arthroplasty patients was sent to the 1082 surgeons identified; 593 (55%) members completed the questionnaire.

Malignant optic glioma presenting as an acute anterior optic neuropathy.

Purpose: To describe an uncommon case of malignant optic glioma and the challenges in its diagnosis.

Methods: Case report with funduscopic, magnetic resonance imaging (MRI), and automated field test correlations.

Patient: A 60-year-old man presented with a 1-week history of left optic disk swelling and optic neuropathy that was initially diagnosed as nonarteritic anterior ischemic optic neuropathy (NA-AION).

Deep lamellar keratoplasty for pellucid marginal degeneration: review of management options for corneal perforation.

Purpose: To report a case of unilateral corneal perforation associated with pellucid marginal degeneration (PMD) and rapid onset and progression of PMD in the second eye. Both eyes underwent subsequent successful management with deep anterior lamellar keratoplasty (DALK).

Methods: Case presentation with corneal topographic correlation, along with the relevant literature pertaining to surgical techniques used in PMD.

Bilateral primary optic nerve lymphoma.

A 69-year-old man was examined for bilateral infiltrative optic neuropathy. Optic nerve biopsy confirmed a malignant B cell lymphoma. Systemic examination and investigations failed to show involvement of other sites.

Mycobacterium hemophilum infection presenting as filamentary keratopathy in an immunocompromised adult.

Purpose: To report a case of Mycobacterium hemophilum of the eye.

Methods: Case report with pathologic correlation. A 55-year-old Malaysian man with a 3-year history of graft-versus-host disease presented with dry eye and keratopathy.

Effect of moderate pressure distention on the human saphenous vein vasomotor function.

Background: Manual pressure distension, which is commonly applied to the human saphenous vein graft for coronary artery bypass, is believed to have detrimental consequences for the graft patency. The vasomotor function of the vein after distention during surgical preparation for grafting and after distention in laboratory conditions at pressure of 50 to 600 mm Hg was studied. The effect of a combination of vasodilative agents to prevent vasospasm was also tested.