Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Jan 1999
Case ReportsTransoral missile removal from the anterior C1 region following transpharyngeal missile wound.
We present a successful treatment result in a rare case of low velocity missile transpharyngeal wound to the upper cervical area in a 33-year-old man. There are very few reports concerning related cases, with some disagreement regarding their treatment. The retained missile was successfully removed from the anterior region of the C1 vertebra through a transoral-transpharyngeal approach using the explosive transpharyngeal wound sustained. ⋯ The early soft-tissue debridement, missile removal, pharyngeal closure without wound drainage and broad-spectrum antibiotic coverage resulted in an uneventful postoperative course and good long-term outcome. Early surgery is important to prevent complications in such cases. However, the prophylactic tracheostomy, wound drainage and applying of a nasogastric tube could be left to the surgeon's judgment based on the individual patient's respiratory status, intraoperative findings and wound contamination/colonization.
-
Arch Orthop Trauma Surg · Jan 1999
Comparative StudySimulator trials to determine the wear of the combination aluminium oxide ceramic-carbon fibre reinforced plastic (CFRP) used as an insert in a hip socket.
Hip simulator trials were conducted to determine the initial wear between alumina femoral heads and carbon fibre reinforced plastic (CFRP, CAPROMAN) insert in a titanium socket. A force of 2500 N and a frequency of 0.857 H were applied. ⋯ After 1 million cycles, the additional changes were less than 1 microm. Based on an examination of retrieved implants (wear rate: 6.1 microm/year) and based on the simulator results, the combination alumina-CFRP inserts could be approved for total hip replacement.
-
Arch Orthop Trauma Surg · Jan 1999
Clinical Trial Controlled Clinical TrialPatellar motion analyzed by kinematic and dynamic axial magnetic resonance imaging in patients with anterior knee pain syndrome.
Ten consecutive patients (12 knees), all women, with anterior knee pain syndrome participated in the study. The patellofemoral joints were examined with the knee in 0 degrees, 10 degrees, 20 degrees, and 30 degrees of flexion. At each knee position, kinematic and dynamic, an axial magnetic resonance (MR) image was used to focus on the sagittal plane, followed by an axial image focused through the middle of the patella. ⋯ There were no statistically significant differences of SA between the groups, regardless of muscle contraction or flexion angle. At 30 degrees of flexion, muscle contraction increased CA and decreased PTA. In our opinion, imaging in the first 30 degrees of flexion with thigh muscle contraction is necessary for a correct diagnosis.
-
Arch Orthop Trauma Surg · Jan 1999
Case ReportsAcute arterial occlusion associated with total knee arthroplasty.
Acute arterial occlusion is a rare but limb-threatening complication in total knee arthroplasty. Most of the previously reported cases of this complication required surgical intervention. ⋯ The case is also indicative of the etiology and the optimal prevention of this complication. In a patient with advanced arteriosclerosis, as indicated by vascular calcification around the knee or in the abdomen, knee arthroplasty should be performed without a tourniquet, and intra-operative manipulation should be done cautiously because of the potential for intimal disruption.
-
Arch Orthop Trauma Surg · Jan 1999
Case ReportsReconstructive treatment of sclerosing osteomyelitis of the entire femur of 30 years' duration with avoidance of segmental resection.
We describe the successful operative treatment of a patient with chronic sclerosing osteomyelitis of the femur in which en bloc resection was avoided. Therapy consisted of combined endoscopic, computed tomography and bone scan-guided fenestration and intramedullary reaming, with removal of all sclerotic zones and normalization of the cortical thickness. An adequate supply of oxygen to the area was ensured by improved vascularisation and the application of hydrogen peroxide. At the medium term follow-up no recurrence was seen, and hip and knee function was normal.