Results of the percutaneous pinning of proximal humerus fractures with a modified palm tree technique.

Purpose: Many techniques are available for closed reduction and percutaneous fixation of proximal humeral fractures. The palm tree technique was described by Kapandji in 1989. In that technique three curved wires are inserted through one hole at the V-shaped insertion of the deltoid muscle.

Varicella-related musculoskeletal complications in children.

Eight children with post-varicella musculoskeletal complications were treated between 2001 and 2009. The complications that were observed were cellulitis (three children), pyomyositis (three children), osteomyelitis (two children) and gangrene (one child). On average, 8.

Combined pelvic osteotomy for the bipartite acetabulum in late developmental dysplasia of the hip: a ten-year prospective study.

In late developmental dysplasia of the hip in childhood, the deformed dysplastic acetabulum is malaligned and has lost its shape due to pressure from the subluxed femoral head. The outer part of the acetabulum involves the upper part of the original acetabulum, thereby giving a bipartite appearance. A clear edge separates the outer from inner part which represents the lower part of the original acetabulum and has no direct contact with the femoral head.

The use of the LARS artificial ligament to augment a short or undersized ACL hamstrings tendon graft.

The aim of this study is to evaluate the midterm results of using Ligament Advanced Reinforcement System (LARS) artificial ligament for augmentation of the short (<15 cm length) and small-sized (3-4 mm) diameter for the gracilis and (4-5 mm) for the semitendinosus harvested hamstring tendons in anterior cruciate ligament (ACL) reconstruction, and to assess the knee stability, patient satisfaction and early- and midterm complications following surgery. A total of 112 patients were included in this study and were operated with arthroscopic ACL reconstruction using (augmented hamstring tendon graft with LARS) between January 2004 and December 2006. Assessment before and after the surgery include the history, clinical examination, modified international knee documentation committee score (IKDC), KT1000 measurements for clinical knee stability and osteoarthritis outcome score (KOOS) for patient satisfaction.

Soft-tissue recurrence of giant cell tumor of bone associated with pulmonary metastases.

A soft tissue recurrence associated with pulmonary metastases developed in a 46 year old lady one year after intra-lesional excision and autogenous bone graft of giant cell tumor of bone of the distal end of the right radius. The different imaging modalities and procedures used for staging as well as the management were discussed. Brief review of relevant literatures addressed different factors that influence addressed different factors that influence recurrence, treatment Options of primary and recurrent GCT of distal radius, and metaplastic recurrent GCT of distal radius, and metaplastic bone formation in such lesions.

Ganglion cyst of the posterior cruciate ligament.

A ganglion is a fluid cyst with a myxoid matrix that arises close to the tendons and joints. Its occurrence inside a joint is rare. Among the various pathological conditions producing impairment of the knee function, ganglia of the cruciate ligaments are quite rare.

Relationship between postoperative infectious complications and glycemic control for diabetic patients in an orthopedic hospital in Kuwait.

Objective: To study the relationship between postoperative infectious complications and glycemic control for diabetic patients in an orthopedic hospital in Kuwait.

Subjects And Methods: Patients who underwent surgical orthopedic procedures between 2006 and 2007 were identified to provide demographic and clinical informations including age, gender, type of surgery, length of operation, HbA(1c) values, nature of specimens and species of the isolated pathogens. HbA(1c) <7% was used as the breaking point for diabetic control and occurrence of postoperative complications.

Anterior cruciate ligament reconstruction using autologous hamstring double bundle graft compared with single bundle procedures.

A total of 218 patients with unilateral anterior cruciate ligament deficiency were randomly assigned to one of four groups. In group A an anatomical double bundle anterior cruciate ligament reconstruction was performed; group B were treated by a single bundle using an Endobutton for femoral fixation; in group C by a single bundle using RigidFix cross pins for femoral fixation; and in group D by a single bundle using a bioabsorbable TransFix II screw for femoral fixation. For tibial fixation a bioabsorbable Intrafix interference screw was used for all the groups and the graft was fashioned from the semitendinosus and gracilis tendons in all patients.

Posterior intrafocal pinning for extension-type supracondylar fractures of the humerus in children.

We describe a method of pinning extension supracondylar fractures of the humerus in children. Following closed reduction, a posterior intrafocal wire is inserted and a second lateral wire added when needed for rotational stability. Between May 2002 and November 2005 we performed this technique in 69 consecutive patients.

Hackethal bundle nailing with intramedullary elastic nails in the treatment of two- and three-part fractures of the proximal humerus: initial experience at Al Razi Hospital, Kuwait.

Objective: To present the clinical and radiological results of a minimally invasive technique, the fixation of two- and three-part fractures of the proximal humerus according to the Neer Classification System, using the intramedullary bundle-wiring Hackethal technique.

Subjects And Methods: The operations were performed with the Hackethal technique (use of elastic titanium nails, Synthes) on 17 patients (8 males and 9 females) with two- and three-part fractures of the proximal humerus. In cases of two-part fracture only, intramedullary titanium nails were used while for three-part fractures, percutaneous cannulated screws were used to fix the greater tuberosity, followed by intramedullary insertion of titanium elastic nails.

Surgical treatment of chronic Achilles tendon rupture.

Unlabelled: Chronic Achilles tendon ruptures are often challenging to repair because of muscle and tendon atrophy, retraction, and short distal stumps. We undertook a retrospective investigation of 14 patients who were treated with the Ligament Advanced Reinforcement System (LARS) ligament for the treatment of chronic, neglected rupture of the Achilles tendon. The patients pursued a course of early functional rehabilitation, and postoperative outcome scores were obtained at 3, 6, and 12 months, based on the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot scoring system, and the Tegner Activity score.

Periprosthetic fractures of the femur after hip and knee replacement. Analysis of treatment results in Al Razi Hospital.

Objective: To present the clinical and radiological results of treatment of periprosthetic fractures of the femur after hip and knee replacements.

Subjects And Methods: Thirty-four patients (8 males and 26 females) with 34 fractures of the femur complicating hip and knee replacements are the subjects of this report. In 21 cases, the fracture affected the femur after hip replacement, and in 13 cases after knee replacement.

Cemented and cementless total hip replacement. Critical analysis and comparison of clinical and radiological results of 182 cases operated in Al Razi Hospital, Kuwait.

Objective: In this study we present the results of a series of cemented Exeter and cementless Zweymuller implants.

Subject And Methods: Eighty-seven cemented and 95 cementless hip replacements for different hip pathologies were followed for an average period of 36 months for cementless and 60 months for cemented cases. Clinical results were calculated using the Merle d'Aubigne score.

Surgical management of traumatic knee dislocation.

Purpose: The purpose of this study was to evaluate our method of surgical treatment of traumatic knee dislocation, by use of a standardized protocol, and to report our clinical results.

Methods: Thirty-six consecutive patients presented with a grossly dislocated or reduced knee. Ten of these patients were not included in this series.

Total hip arthroplasty in acetabular deficiency: experience in Al Razi Hospital, Kuwait.

Objective: To report clinical and radiological outcomes of cemented and cementless total hip arthroplasty for primary and secondary osteoarthritis with a deficiency of acetabular bone stock.

Subject And Methods: Thirty-seven patients (16 male and 21 female) having 41 hips affected by primary and secondary acetabular bone stock defect that were operated using cemented (n = 25) and cementless (n = 16) hip replacement were followed for an average period of 37 (range 12-100) months. Bone defect was classified according to American Academy of Orthopedic Surgery criteria.

Percutaneous fixation of comminuted fractures of the humerus: initial experience at Al Razi hospital, Kuwait.

Objective: To present initial experience of 12 cases of percutaneous plating of the comminuted fractures of the humerus using minimal access surgery and standard low-contact dynamic compression plate.

Patients And Methods: Twelve patients (11 males and 1 female) with an average age of 29.8 years (range 17-46 years) with comminuted diaphyseal fractures of the humerus were treated by minimal access surgery using standard AO/ASIF implants.

Combined pelvic osteotomy in the treatment of both deformed and dysplastic acetabulum three years--prospective study.

Kuwait has a very high incidence of all types of developmental dysplasia of the hip. One of the most complicated forms is the deformed dysplastic acetabulum, which has not only abnormal orientation but it also has lost its shape by the pressure of the subluxed femoral head. The outer part of the socket involves the upper part of the original acetabulum, thus giving it a bipartite appearance.

Surgical treatment for ipsilateral fractures of femoral neck and shaft.

Objectives: To review the primary and the final results of surgical management of ipsilateral femoral neck and shaft fractures.

Subjects And Methods: Seventeen patients (2 female, 15 male, average age 37 years, range 20-60) with ipsilateral femoral neck and shaft fractures were treated by compression plate fixation for the femoral shaft fractures and dynamic hip screw or cannulated cancellous screw fixation for the neck fractures in Al-Razi and Al-Jahra Hospitals, Kuwait, from March 1996 to June 2002. The clinical and radiological primary and final results were analyzed retrospectively.

Cementless Zweymüller hip replacement: a short-term follow-up in Al Razi Hospital, Kuwait.

Objective: To present initial experience of the first 71 cases of cementless total hip replacement in Al Razi Hospital.

Subject And Methods: Between 1996 and 2004, total hip replacement was performed in 71 patients (40 male, 31 female, average age 40.7 years, range 17-74) using Zweymüller cementless prosthesis.

The use of locked nails in the treatment of humeral shaft: delayed union and nonunion.

Objectives: To assess the results and clinical outcome of delayed union and nonunion humeral shaft treatment using locked medullary nails.

Subjects And Methods: The Russel and Taylor humeral locking nail was used to treat 21 patients with humeral shaft fractures at Al Razi hospital, Kuwait, from 1997 to 2001. Of these, 8 had delayed union and 13 nonunion.

Clinical evaluation of arthroscopically assisted anterior cruciate ligament reconstruction: patellar tendon versus gracilis and semitendinosus autograft.

Purpose: To evaluate the clinical results of anterior cruciate ligament (ACL) reconstruction in patients with ACL-deficient knee in 2 similar groups of patients.

Type Of Study: A prospective randomized comparison of patellar tendon (PT) versus semitendinosus and gracilis tendon (STG) autografts for ACL reconstruction.

Methods: Between 1994 and 1996, 85 consecutive male patients with chronic ACL-deficient knees underwent arthroscopically assisted reconstruction with either autologous PT or double-loop STG (4-strand) graft.

Radioanatomical measurements of the medullary cavity of the humerus in Kuwait: ethnic differences and clinical implications for fracture fixation.

Objective: To compare the difference in diameter of the medullary cavity of the humerus in Arab and South Asian patients in Kuwait.

Subjects And Methods: In 46 patients (29 Arab, 17 South Asian) treated at Al-Razi Hospital, Kuwait, for diaphyseal fracture of the humerus, the medullary cavity of the humerus on the radiographs of the uninjured (contralateral side) was examined. Bone density was also measured.

Percutaneous fixation of comminuted fractures of the femur and tibia. Preliminary study.

Objective: To present initial experience of treating patients with comminuted fractures of the diaphyseal and metaphyseal areas of the femur and tibia.

Subjects And Methods: Sixteen patients were involved in the study. All the 16 patients (11 males and 5 females, average age 34 years) with closed, comminuted fractures of femur (n = 9) and tibia (n = 7) were operated on using the principle of minimal access surgery and biological fixation that maximally preserved the soft tissues and fracture hematoma.

Surgical treatment of thoracic and lumbar tuberculosis by anterior interbody fusion and posterior instrumentation.

Objective: To evaluate the efficacy and clinical outcome of simultaneous or sequential anterior and posterior surgical approaches in the management of spinal tuberculosis in the form of anterior extirpation of the tuberculous lesion, strut bone grafting of the defect produced and posterior instrumentation for spinal fixation.

Subjects And Methods: Twenty-two patients who had tuberculosis of the thoracic and lumbar spine with moderate to severe localized kyphosis and variable degrees of neurological deficits were treated at Al Razi Hospital (Kuwait) in the period from 1998 to 2000 by anterior debridement and autogenous strut bone grafting with simultaneous or staged posterior spinal fixation using either USS or SOCON spinal instrumentation. Appropriate antituberculosis treatment was given to all patients for 9-12 months.