Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1999
Case ReportsDislocation of the proximal tibiofibular joint.A new method for fixation.
We introduce a new method for fixation of a rare, isolated, proximal tibiofibular dislocation. One third of the biceps femoris muscle tendon was used for fixation of the dislocated proximal fibular head. The fixation was achieved by using a soft threaded interference ACL screw.
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Arch Orthop Trauma Surg · Jan 1999
Serum cholesterol is elevated in patients with Achilles tendon ruptures.
Forty-one patients were analyzed after surgical treatment of Achilles tendon ruptures. The following parameters served as the outcome measure: (1) duration of wearing cast, (2) length of hospital stay, (3) outpatient treatment, (4) time of absence from work, (5) complications, (6) re-rupture rate, (7) subjective evaluation by patients, (8) scar condition, (9) ability to stand on tiptoes, (10) Thompson test, (11) movement of talocrural joint, (12) circumference data of lower extremity, (13) radiographs, (14) power measurement of the ankle (in kg), (15) ultrasound examination, (16) blood cholesterol levels, (17) scoring by Trillat's score. ⋯ Given the good results, surgical treatment of Achilles tendon ruptures is recommended, but patients of status post-Achilles tendon rupture should be checked for high cholesterol levels. In the future, controlled, prospective trials need to prove a correlation between Achilles tendon rupture and a pathological blood lipid status.
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Arch Orthop Trauma Surg · Jan 1999
Structural properties of the fibular band in congenital total absence of the fibula.
Nine children with unilateral total congenital absence of the fibula were examined by magnetic resonance imaging (MRI), and histological study of the fibular band was performed in four of them. Both examinations revealed two types of fibular band. ⋯ In type II, the band directly attached to the calcaneus without any evidence of hyaline cartilage, and the feet could be corrected only by total excision. We suggest partial excision of the band in type I and total excision in type II as the initial treatment of congenital total absence of the fibula.
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Arch Orthop Trauma Surg · Jan 1999
Comparative StudyCombined injuries of the medial collateral ligament and the anterior cruciate ligament. Early ACL reconstruction versus late ACL reconstruction.
Aim of this retrospective study is to evaluate the effect of acute and late anterior cruciate ligament (ACL) reconstruction in patients with a combined injury of the ACL and the medial collateral ligament (MCL). All MCL injuries were treated non-operatively. In 27 patients (group I) we performed early ACL reconstruction (within the first 3 weeks after injury). ⋯ The Lysholm score was significantly better in the group with late ACL reconstruction (group I: 85.3, group II: 89.9). The position on the Tegner activity scale decreased in both groups, to 5.5 in group I (preoperatively: 6.0) and to 5.6 in group II (preoperatively: 5.9). With regard to the lower rate of motion complications in the early postoperative period, the lower rate of re-arthroscopies, and the significantly better results in the Lysholm score, we prefer late ACL reconstruction in the treatment of combined injuries of the ACL and the MCL.
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Arch Orthop Trauma Surg · Jan 1999
Case ReportsOsteonecrosis of the femoral head associated with pregnancy.
A 31-year-old pregnant woman suddenly complained of bilateral hip pain 2 weeks before delivery. She was delivered of triplets by Caesarean section. She had been treated with human menopausal gonadotropin and human chorionic gonadotropin (hMG-hCG) before pregnancy. ⋯ She had no history of steroid therapy or alcohol abuse. Osteonecrosis of the femoral heads bilaterally associated with pregnancy was confirmed. Pathology of the femoral head showed typical empty lacunae and necrosis of the trabecula.