Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1999
Postoperative ossifications of the shoulder. Incidence and clinical impact.
Periarticular ossifications of the shoulder after surgery have been described since the beginning of the century. Risk factors and the clinical impact of heterotopic bone formation have been discussed controversially. After open surgery on the shoulder, 131 patients (rotator cuff repair n = 106, acromioplasty n = 25) were included in a retrospective study if pre- and postoperative X-rays were available. ⋯ As significant risk factors for the formation of heterotopic bone, the existence of osteoarthritis and the duration and complexity of the procedure could be cited. The appearance of periarticular ossifications after surgery of the shoulder seems to be of minor clinical impact. Severe cases with major functional deficits should and can be prevented by a fast and atraumatic operation technique.
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Arch Orthop Trauma Surg · Jan 1999
Self-locking tension band technique. A new perspective in tension band wiring.
After experiencing some complications with the AO modified tension band technique, we have made a small modification to prevent proximal migration of the Kirschner wires. In this modification, the proximal ends of the wires are bent to form a loop and the cerclage wire passed through them. In this way, Kirschner wires and cerclage wire lock each other, preventing migration. ⋯ Fracture union occurred in 8 weeks (mean). We did not see any postoperative complications or implant failures. Rigid fixation allows early mobilization which quickly restores functional status.
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Arch Orthop Trauma Surg · Jan 1999
High tibial osteotomy: factors influencing the duration of satisfactory function.
In 94 patients 112 knees were examined after high tibial osteotomy for varus and valgus gonarthrosis. Preoperatively, there were 71 varus and 23 valgus deformities. The mean follow-up period was 9.0 years (range 2-21 years). ⋯ The data were subjected to multivariate statistical analysis in which three of four evaluated risk factors were found to be associated with the duration of pain-free survival: certain preoperative injuries, preoperative meniscopathies and a deterioration of the stage of arthrosis (P < 0.05). There was no significance for weight in excess of 10% above the normal body mass index (BMI) limits. However, in a Kaplan-Meier survival analysis this parameter could be determined as a significant factor for a reduced pain-free survival interval (P < 0.05): patients with a BMI of more than 10% above normal limits had a pain-free period of 5.07 years, whereas those with a BMI of less than 10% had a pain-free period of 7.80 years.
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Arch Orthop Trauma Surg · Jan 1999
Shear strength of the cement metal interface--an experimental study.
The shear strength of the cement-metal interface using rods with different surface treatments and a clinical standardized cementing technique was studied. Under "dry" conditions, a low interface shear strength can be obtained with polished and smooth CoCrMo surfaces (peak-to-valley height Rt: 1 microm, average 0.2 MPa; 5 microm, 0.38 MPa). Grit-blasted and polymethylmethacrylate (PMMA)-precoated surfaces achieved higher values (PMMA precoat: average 5.16 MPa; CoCrMo peak-to-valley height Rt: 20 microm, average 8.61 MPa: 60 microm, average 7.8 MPa). ⋯ A microscopic analysis of cross-sections revealed gap formations at the cement-metal interface to varying degrees (1-16 microm). PMMA-precoated rods rarely showed any gap formation at all. The above-mentioned gap formation was seen independently of the porosity at the cement-metal interface and corresponds to the clinical and postmortem observed debonding of the interface.
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Arch Orthop Trauma Surg · Jan 1999
Functional results after partial pelvic resection in Ewing's sarcoma of the ilium.
Ewing's sarcoma of the pelvis has an unfavourable prognosis. The clinical and functional results of 7 patients who had a Ewing's sarcoma of the pelvis stage IIB were reviewed. All patients received multiple-agent chemotherapy pre- and postoperatively (modified T6 and T2 protocol according to Rosen) and underwent local resection of the pelvic tumour. ⋯ All were free of disease and had neither local recurrence nor metastases. In five patients the functional results were rated as "good" or "excellent". The good results depend mainly on the reconstruction of the pelvic girdle and its mechanical stability.