Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsModification of the Wagner lengthener to permit dynamic axial loading.
The Wagner lengthener is mechanically excellent, but it lacks a function allowing dynamic axial loading (dynamization), which stimulates bone consolidation at the lengthened section. The authors devised a simple metal insert with which they modified the Wagner lengthener to permit dynamization. The modified appliance was successfully used in two patients.
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Arch Orthop Trauma Surg · Jan 1990
Ultrasonographic detection of foreign bodies in soft tissue. A human cadaver study.
The usefulness of ultrasound in the detection of foreign bodies was examined in a blind study in human cadavers using glass, plastic and wood as foreign bodies. Of 65 foreign bodies placed in 102 cicatrices, 58 were found using a 5 MHz transducer. The sensitivity was 89% and the specificity 93% making ultrasound a useful clinical tool for this purpose.
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Arch Orthop Trauma Surg · Jan 1990
Absorbable polyglycolide pins in fixation of displaced fractures of the radial head.
In a prospective study 24 patients with a displaced fracture of the radial head were treated by open reduction and internal fixation using absorbable polyglycolide pins, 2 mm in diameter. All patients admitted with fractures involving a quarter or more of the radial head, whether comminuted or not, were included in the study whenever there was a displacement of 2 mm or more between the fragments. The mean follow-up time was 28 months (range 15-43 months). ⋯ A transient inflammatory reaction around the implants occurred in two cases 8-12 weeks postoperatively. The functional end-result was classified as excellent or good in 22 patients (91%). This study indicated that successful fixation of displaced fractures of the radial head can be accomplished by using absorbable pins.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsDigital subtraction angiography in musculoskeletal tumors and other conditions.
One hundred and forty consecutive DSA examinations of various musculoskeletal diseases were analyzed with respect to the contributions and/or limits of this modern diagnostic imaging modality. Angiography remains the imaging tool of choice for many benign and malignant orthopedic conditions of bones and soft tissues, mainly when MRI is still not generally available. ⋯ DSA has the advantage of being less invasive and it also surpasses analog arteriography in better visualization of vascular patterns hidden in hyperostosis, sclerosis, and metallic shadows. Angiographic investigations, when necessary, should therefore start with DSA.
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Arch Orthop Trauma Surg · Jan 1990
Modified rotational acetabular osteotomy (RAO) for advanced osteoarthritis of the hip joint in the middle-aged person. First report.
Classical methods for pelvic osteotomy, such as those of Salter, Pemberton, Chiari, and Wagner, have been developed for reconstruction of the subluxed hip joint in children and young adults. Regarding pelvic osteotomy involving a middle-aged patient, however, there are not as many operation methods to consider, and it is difficult to choose the most suitable technique for alleviating advanced osteoarthritis. Based on current practice, total hip replacement (THR) seems the accepted method, though it presents problems such as loosening, sinking, and infections; because of these factors physicians hesitate to recommend THR surgery, particularly if the patient is otherwise healthy and appears to have many good years ahead of him. ⋯ A similar osteotomy technique has been used by Eppright and Wagner. We feel that our method achieves a more favorable result for an older patient with severe osteoarthritis, since both the surgery and the follow-up rehabilitation are more comprehensive. A modified acetabular osteotomy should not be regarded as merely an alternative to total hip replacement, but as the preferred choice for hip-joint reconstruction.