Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1999
Case ReportsMesenchymal chondrosarcoma associated with Goldenhar's syndrome.
Goldenhar's syndrome is characterised by bony abnormalities of the face, jaw and vertebral column. We report the first case of the development of a primary malignant neoplasm (mesenchymal chondrosarcoma) initially misdiagnosed as a meningioma, occurring in association with this syndrome.
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Arch Orthop Trauma Surg · Jan 1999
Comparative StudySusceptibility to local infection in biological internal fixation. Experimental study of open vs minimally invasive plate osteosynthesis in rabbits.
Resistance to local infection after fracture fixation with plate osteosynthesis may be influenced by the implantation technique. It is known that the extent of the surgical approach to the bone can compromise the local defence capacity. ⋯ The infection rate for the open surgical technique was 38.5% and that for the MIPO technique, 25%. This difference is not statistically significant (P > 0.05) suggesting that resistance to local infection associated with the MIPO method is at least equivalent to the open approach for plate osteosynthesis.
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Arch Orthop Trauma Surg · Jan 1999
Comparative StudyPrimary stability of different implants used in conjunction with high tibial osteotomy.
High tibial osteotomy in the varus knee has been successfully performed for a long time. Several newer operation techniques have been established in recent years. We tested the primary stability of several of these techniques in vitro. ⋯ If the medial cortex is transected intraoperatively in lateral osteosynthesis, an additional medial implant is necessary to ensure sufficient primary stability. For practical reasons it was necessary to neglect the contribution of the soft tissues around the knee, although all implants were tested under the same conditions. Care should thus be taken when interpreting the results of this study in a clinical setting.
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Arch Orthop Trauma Surg · Jan 1999
Immune responses to osteoarticular allografts of the knee--cytokine studies.
Immunological behaviour in correlation with bone allograft survival was studied in peripheral blood and synovial fluid from seven patients who had undergone large bone resection and allograft transplantation of the knee. Plasma and synovial fluid samples for cytokine measurements [interleukin (IL-1beta, IL-6) and tumour necrosis factor alpha (TNF-alpha)] were drawn from peripheral blood for diagnostic arthrocentesis. ⋯ These findings show that soluble products of T-cell, macrophage and osteoblast origin, produced as a response to the bone-graft antigens, might be responsible for the bone resorption seen in our material. The elevated IL-1beta and TNF-alpha levels detected support this statement.
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Although various operative procedures have been applied for advanced or terminal osteoarthritis of the hip joints in relatively young patients, the long-term results are controversial. Since 1974, we have performed the triple-cup arthroplasty developed by Aoki in 110 patients who were comparatively young. The triple-cup assembly is composed of stainless-steel outer and inner cups between which a high density polyethylene cup is incorporated, so that there are basically four mobile surfaces, but the major movement is actually taking place between the outer cup and the plastic cup [8]. ⋯ The femoral head in the cup was often covered with a layer of fibrous tissue. We could utilize the femoral head as a bone graft, even though the residual volume of bone varied in each case. The result of revision surgeries after the triple-cup arthroplasty was good clinically and radiographically at last follow-up.