Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2000
Case ReportsSimultaneous double interphalangeal dislocation in one finger.
Isolated dislocation of the proximal or distal interphalangeal joint of a finger is common, but simultaneous dislocation of both joints is rare. Three cases of simultaneous dislocations of both interphalangeal joints in the same finger are reported. Closed reduction was easily achieved in all cases.
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Arch Orthop Trauma Surg · Jan 2000
Cemented femoral impaction bone grafting for severe osteolysis in revision hip arthroplasty. Good results at 4-year follow-up of 10 patients.
Ten hips underwent impaction bone grafting with cement as revision of the femoral stem for severe osteolysis. At clinical follow-up of a median of 4 years (range 3.0-4.6 years) there were no failures. The median Harris hip score increased from 53 to 80, and pain score from 25 to 40. ⋯ All of the 9 patients with radiographical follow-up of more than 1 year showed trabecular remodelling, 7 of whom had signs of cortical repair. Subsidence was a median of 2 mm, with the maximum subsidence being 5 mm. The results appeared clinically stable after 4 years with radiographic reconstitution of the bone stock.
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Arch Orthop Trauma Surg · Jan 2000
Open reduction and internal fixation in flexion-distraction injuries to the lower spine in children and adolescents involved in traffic accidents as car occupants. A report and literature review.
Flexion-distraction injuries of the spine are reported after traffic accidents in individuals wearing only lap seatbelts. We examine here this type of injury in one child and two adolescents who all were seated in the rear seat of cars involved in traffic accidents. All of the children were wearing regular three-point safety belts not adjusted to children. ⋯ Flexion-distraction injuries in individuals with an immature skeleton, wearing standard three-point safety belts, have not been reported in the literature. The pathomechanism of the lesion in the lower spine may well involve damage to the intestines, particularly at the junction between the mobile intra-abdominal and the fixed retroperitoneal part of the gut. Reduction and stable fixation preserve the anatomy of the lower spine, while unstable fixation methods do not secure reduction sufficiently to allow early mobilisation.
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Arch Orthop Trauma Surg · Jan 2000
The influence of obesity on perioperative morbidity and mortality in revision total hip arthroplasty.
The significance of obesity as a risk factor for postoperative complications was determined in a consecutive series of 229 cases of revision total hip replacement. The body mass index (BMI) was used as an objective measure to classify the patients. ⋯ The results of our study demonstrate a clear association between obesity and operative time, whereas no statistically significant relationships were observed between obesity and the other parameters. We conclude that obesity does not have any significant influence on perioperative morbidity and mortality but is clearly related to operation time and, therefore, to higher costs per operation.
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Arch Orthop Trauma Surg · Jan 2000
Case ReportsBone remodelling in humeral arthroplasty: follow-up using CT imaging and finite element modeling--an in vivo case study.
Little material is available in the literature about remodelling of the human humerus after implantation of a shoulder hemiarthroplasty. A 73-year-old patient was examined by CT 4 years after implantation of a right shoulder hemiarthroplasty, and the bone density as represented by Hounsfield values was compared with the contralateral side. Additionally, a three-dimensional finite-element model was generated from the image data and analysed. ⋯ Distally from the prosthesis, high stresses were found. On the control side, a more homogeneous stress distribution was noted. The results could be explained by bone resorption around the prosthesis caused by stress shielding; this hypothesis has to be confirmed by future studies.