Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1999
Case ReportsStability and alignment of the cervical spine of hemodialyzed patients treated by canal-expansive laminoplasty.
In this present study, four hemodialyzed patients with cervical myelopathy treated by canal-expansive laminoplasty are reported. The average duration of hemodialysis was 18 years, and the average follow-up was 16 months. Early results show maintenance of sagittal alignment and reduction of instability of the cervical spine with no progression of the destructive spondyloarthritis.
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Hip dislocation has long been one of the major complications after total hip arthroplasty (THA). From 1980 to 1994, we performed 2728 THAs (including primary and revision cases). There were 97 hips (3. 6%) with the complication of dislocation, 62 of which were followed up for at least 2 years (mean 5.3 years; range 2-12 years). ⋯ The success rate for the first attempt at closed reduction for the treatment of dislocation was 41%; the success rate decreased gradually with the number of attempts. For the recurrent dislocation group, bracing for 4-6 weeks with training was recommended for the postural type and bracing for 3 months with muscle training for the soft-tissue imbalance type. Only 15% of the dislocated hips needed re-operation, and most of the patients resolved the problem after being informed and undergoing muscle training.
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Arch Orthop Trauma Surg · Jan 1999
Clinical TrialComplex cemented revision using polished stem and morselized allograft. Minimum 5-years' follow-up.
The aim of this study was to evaluate the results of complex hip revision using a cemented, collarless and polished femoral stem design (CPT, Zimmer, Warsaw, In.) within a tightly impacted morselized allograft. We have now been using the impaction grafting technique in combination with the CPT stem (Zimmer) for 10 years in complex cases of severe bone loss. In this study we have elected to report only those patients who have been revised at least once before revision using the impaction grafting technique. ⋯ The subsidence was nonprogressive, and no subsidence occurred after the 1st year. The Charnley, D'Aubigne, Postel scoring (maximum 6 points) for pain improved from 2.2 points preoperatively to 4.4 postoperatively, function from 2.3 to 4.3, and movement from 2.3 to 4.1. In conclusion, the concept of impaction grafting in THR revision in our study has so far proven to be successful with good clinical results at 5 years despite the relatively high early subsidence of the femoral component.
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Arch Orthop Trauma Surg · Jan 1999
Case ReportsClosed cervical spine trauma associated with bilateral vertebral artery injuries.
Bilateral vertebral artery injuries in closed cervical spine injuries are uncommon, but early recognition and treatment are important to prevent neurological deterioration. A case of bilateral vertebral injuries in a 35-year-old motor vehicle accident victim is presented, and the current literature is reviewed.
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Arch Orthop Trauma Surg · Jan 1999
Comparative StudyLower limb amputations during 3 years in Hungary.
We reviewed nationwide hospital data of amputations during 3 years to provide a comparison with similar data gathered about 20 years ago. Data were provided by the National Medical Records Centre and processed by our personally developed programmes. The cause of amputation was most often vascular disease, amputees were usually elderly, and the large majority of amputation surgery was carried out on the lower limb. ⋯ Mortality parameters remarkably exceed those of foreign countries. Although the data accuracy is compromised, there are still ways of exploiting the data in favour of quality improvement of care, e.g. improve transtibial amputation rate, reduce mortality. The publication of data can be of benchmarking importance for hospitals by enabling them to compare their own results with those of other hospitals, as well as to develop and improve performance.