Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1999
Loss of correction after lateral closing wedge high tibial osteotomy--a human cadaver study.
In 12 human cadaver tibiae, osteotomies were carried out at two levels (2 and 3 cm from the distal joint line) with three different wedges (5 degrees, 10 degrees, 15 degrees) to evaluate the influence of displacement of the osteotomy fragments on areas of cortical contact. In undisplaced osteotomies (medical cortical edges superposed) cortical contact areas formed 28% (level 2 cm) and 40.5% (level 3 cm) of the cortical circumference of the proximal fragments (NS). Wedge angles and levels of osteotomy displayed no statistical differences. ⋯ Displacing the distal fragment laterally, medial cortical contact is lost, and weight-bearing leads to revarisation as cancellous bone sustains only 3 MPa, and the measured compressive stresses at the medial edge amounted to 6 MPa on average. Displacing the distal fragment medially leads to a decrease of total cortical contact, too, but at the medial edge of the osteotomy cortical contact areas are still present. As a result of the study, postoperative weight-bearing without additional plaster cast fixation is recommended only in cases with undisplaced fragments.
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Arch Orthop Trauma Surg · Jan 1999
Posterior rotational osteotomy for the treatment of femoral head osteonecrosis.
Posterior rotational osteotomy in 46 hips of 39 patients with femoral head osteonecrosis was reviewed radiographically and clinically after 2-12 years of follow-up (mean 5 years). The age of the patients at the time of surgery ranged from 18 to 60 years, with a mean of 35 years. There were 18 women and 21 men. ⋯ These results suggest that posterior rotational osteotomy is effective in delaying the progression of degeneration for large necrotic lesions, especially in young patients. Extent of rotation is limited to 150 deg because of limitations of bone quality. The indications should be refined further, and longer term follow-up is necessary.
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Arch Orthop Trauma Surg · Jan 1999
Comparative StudyEffects of essential amino acids and lactose on bony fractures and defects in rabbits: a preliminary histomorphometric study.
An experimental study was performed in order to test the possibility of improving bone repair with the administration of a drug (Calciofix, Farmaceutici Damor SpA, Naples, Italy) containing essential amino acids and lactose. Fifty rabbits were submitted to an open transversal fracture of the left fibula and to a right femoral condyle defect. They were left untreated or treated daily with the drug orally and were divided into subgroups depending on the experimental time: 15, 30, 40, 50, 60 days. ⋯ Secondly, after 15 days the defect area was significantly smaller in treated animals than in the untreated ones (P < 0.01). At 30 and 40 days, respectively, significant differences existed between the two subgroups in connective tissue and mature bone percentages (P < 0.01 and P < 0.001). Our results seem to demonstrate that the drug significantly accelerates the rate of bone formation in fractures and bone defects in rabbits.
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Arch Orthop Trauma Surg · Jan 1999
Rotational acetabular osteotomy for the treatment of dysplastic hips with end-stage osteoarthrosis--a biological alternative to total hip arthroplasty?
We evaluated the results of rotational acetabular osteotomy (RAO) for the treatment of dysplastic hips with end-stage osteoarthrosis. Sixteen patients, aged 15-45 years at the time of surgery, were reviewed at a mean follow-up of 8 years (range 3-17 years). ⋯ A subsequent total hip arthroplasty, however, was done within 2 years after RAO in two other patients who had had large bone cysts in the femoral head and acetabulum. We suggest that RAO may be the procedure of choice for selected young patients, especially teenage patients, to postpone total hip arthroplasty.
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Arch Orthop Trauma Surg · Jan 1999
Case ReportsPopliteal cyst accompanied by an intra-articular cartilage lesion in a child.
The case of an 11-year-old girl presenting with a symptomatic popliteal cyst is described. There was no previous knee trauma nor could any inflammation be found. ⋯ Whereas in adults popliteal cysts are generally accompanied by intra-articular lesions, the presence of a concomitant intraarticular lesion in children is an extremely rare finding. We conclude that intraarticular lesions in the presence of popliteal cysts might have been underestimated as most of the studies regarding popliteal cysts in children were undertaken before the advent of arthroscopy, ultrasound, or MRI.