Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1991
ReviewIndications for and results of operative treatment of spondylitis and spondylodiscitis.
We present a retrospective follow-up study of 24 patients with spondylitis or spondylodiscitis whose treatment included surgical intervention. Tuberculous spondylitis was diagnosed in 14 patients and 10 suffered from non-specific spondylitis. The average age of the patients was 50.2 years and average follow-up was 3 years. ⋯ We recommend radical debridement and spinal fusion through a ventral approach in patients with destruction of the ventral vertebral body, progressive neurological impairment, septicaemia and antibiotic-resistant, symptomatic infections of the spine. In the elderly patient, even in reduced states of health, early surgical intervention can be particularly valuable. Although surgical intervention should be reserved for specific indications, we were able to document favourable results in all 24 patients treated with debridement and spinal fusion.
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Arch Orthop Trauma Surg · Jan 1991
ReviewKnee ligament injuries combined with ipsilateral tibial and femoral diaphyseal fractures: the "floating knee".
The incidence of rupture of the knee ligaments was retrospectively studied in 47 patients with ipsilateral fractures of the femoral and tibial diaphyseal shaft. Fifteen patients proved to have an instability of the knee at the time of follow up. Disruption of the knee ligaments had not been recognised initially. ⋯ After stabilisation of both fractures in these cases, the knee ligaments had been repaired; at re-examination these patients had no complaints and their knees were perfectly stable. In view of the high incidence of missed cases, the possibility of disruption of the knee ligaments should be considered in all patients with fractures of both the femoral and tibial shaft. Meticulous examination of the knee at the time of injury is strongly advocated.
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Arch Orthop Trauma Surg · Jan 1991
Review Case ReportsMacrodystrophia lipomatosis in the foot. A case report and review of the literature.
A rare case of macrodystrophia lipomatosis in the foot is reported. The literature is reviewed and the different presentations of macrodactyly are discussed.
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Arch Orthop Trauma Surg · Jan 1991
ReviewCircumferential fusion of the lumbar and lumbosacral spine.
Seventy-four patients with circumferential fusion of the lumbosacral spine have been assessed after a mean follow up of 49.8 months. For the ventral procedure, an anterior interbody fusion with tricortical iliac bone graft was performed. The additional dorsal fusion was according to various techniques with mainly transpedicular internal fixation. ⋯ The results favour the technique of a combined anterior/posterior approach for fusion of the lumbosacral spine in patients with instability and deformity of all three columns, such as fractures and spondylolisthesis of more than 50%. Optimal stability with satisfactory reduction of the deformity may be achieved. The one-stage operation proved to be superior, with less complications and a shorter hospital stay.
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Arch Orthop Trauma Surg · Jan 1991
Review Case ReportsBilateral simultaneous rupture of the patellar tendon. Case report and review of the literature.
A case of bilateral simultaneous rupture of the patellar tendon due to apicitis patellae is presented. Clinical picture, diagnosis, pathogenesis and treatment are discussed. In addition, the literature on the subject is reviewed.