Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1991
Case ReportsPseudoarthrosis of the ulna in neurofibromatosis. A report of four cases.
Four children suffering from neurofibromatosis with ulnar pseudarthrosis and progressive reabsorption of the middle and distal thirds of the ulna are reported. None had any pain or sensory loss, but all had progressive deformity of the forearm. ⋯ Non-operative management was decided on in the patient with slow ulna reabsorption. The creation of a one-bone forearm is more likely to produce sound union, thus avoiding the need for further operations, while conservative management should be reserved for patients with a slowly progressive condition.
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We present an assessment of 200 patellar fractures treated mostly (175) by partial patellectomy. In 23 cases in which the quadriceps mechanism was 75% intact (MRC power approximately 4), the fractures were treated conservatively, with an overall acceptable result. The operative series with an average follow-up of 3 years has shown 80.3% excellent to good results. A classification of fractures of the patella, based on the anatomical fracture line and quadriceps functional loss as recorded in 690 case histories, is suggested.
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Arch Orthop Trauma Surg · Jan 1991
Randomized Controlled Trial Clinical TrialHematomas and subcutaneous suture techniques in total hip replacement. An ultrasound study.
Thirty-five patients undergoing total hip replacement due to primary arthrosis were randomized into two groups. In one group each subcutaneous suture included a stitch in the fascia; in the other group the fascia was not included in the suture. Ultrasonography examination showed no significant difference in the number of subcutaneous hematomas in each group. ⋯ Three patients had a clinical diagnosis of hematoma and in only one of these did ultrasonography support the diagnosis. It appears that the clinical diagnosis of hematomas, even subcutaneous hematomas, is unreliable. Careful hemostasis is recommended.
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Arch Orthop Trauma Surg · Jan 1991
Case ReportsSports-related two-plane fractures of the distal tibia. Report of two cases.
Two cases of sports-related two-plane fractures of the distal tibia, their operative treatment and the result of therapy after hardware removal are reported. The incidence and mechanism of this type of fracture in adolescents are shown as well as the indication for surgical reconstruction depending on the gap in the joint surface of the distal tibia.
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An isolated fracture of the first rib is rare. Stress fractures of the first rib have previously been reported in various sports and the mechanism of fractures of the first rib has been well documented. ⋯ No reported case of stress fracture of the first rib in a weightlifter has hitherto been available. This paper describes such a case for the first time.