Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2000
Scaphoid nonunion treated by open reduction, anterior inlay bone grafting, and Kirschner-wire fixation.
Forty-three patients with ununited fractures of the scaphoid were treated by open reduction, anterior inlay bone grafting and Kirschner wire fixation. All but one achieved bone union. The one failure was successfully treated with a second anterior inlay bone grafting procedure. ⋯ Preoperatively, carpal instability was present in 25 patients. In these cases, carpal alignment demonstrated by the radiolunate and scapholunate angle was improved significantly after surgery: the radiolunate angle from 15 degrees before surgery to 2 degrees after surgery, and the scapholunate angle from 67 degrees to 54 degrees, respectively. Pain, restricted motion of the wrist, and the grip strength were improved after surgery.
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The accessory navicular bone is one of the most symptomatic bones of the foot. Although it has been reported to be present in various members of the same family, there is a lack of knowledge about its inheritance in the literature. We examined three families and suggest that it has an autosomal dominant trait with incomplete penetrance.
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Arch Orthop Trauma Surg · Jan 2000
Mechanical properties of a rat patellar tendon stress-shielded in situ.
The effects of stress deprivation on the mechanical properties of the patellar tendon (PT) were studied using 14 albino rats. The PT was stress-shielded with cerclages on one side, while the contralateral patellar tendon served as a sham-operated control. After 10 weeks, paired load-strain as well as load-relaxation experiments were performed (11 and 3 specimen pairs, respectively). ⋯ The time constant significantly decreased in the stress-shielded specimens under 5 N loads, which may be considered 'physiological'. Tissue remodeling might explain the observed changes in the viscoelastic behaviour of the stress-shielded tendons. Loading, even in the physiological range of normal daily activity, may lead to an elongation of previously stress-shielded tendons or ligaments and consequently alter the behaviour of a joint.
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Arch Orthop Trauma Surg · Jan 2000
Randomized Controlled Trial Comparative Study Clinical TrialThe treatment of pulled elbow: a prospective randomized study.
To evaluate the effectiveness in decreasing recurrence of cast application after manual reduction of pulled elbow. Sixty-four children with pulled elbow were randomized into two treatment groups: Group A underwent manipulative reduction followed by splinting the elbow in a flexed and supinated position for 2 days; group B underwent manipulative reduction only. ⋯ Four (13%) of 31 patients in group B had a pulled elbow 2-5 days later. Immobilizing the elbow for 2 days after manipulative reduction improves the success of treatment of a pulled elbow.
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Arch Orthop Trauma Surg · Jan 2000
Randomized Controlled Trial Comparative Study Clinical TrialThe incidence of thrombosis in high tibial osteotomies with and without the use of a tourniquet.
In a prospective randomised study, 65 high tibial osteotomies were performed in cases of varus osteoarthritis of the knee, and the incidence of thrombosis with and without the use of a tourniquet was studied. With an average incidence of thrombosis of 10.8%, no statistically significant differences between these two groups were seen.