Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2000
Anterior reconstructive spinal surgery with Zielke instrumentation for metastatic malignancies of the spine.
From March 1984 to April 1996, 60 consecutive patients with spinal metastasis underwent palliative surgery by anterior corpectomy and Zielke instrumentation. Their ages ranged from 21 to 76 years (mean 54 years). Thirty-two patients had metastasis to the thoracic spine, 20 to the lumbar spine, and 8 had both thoracic and lumbar metastases. ⋯ Forty of 52 patients with severe pain obtained significant symptomatic relief for 3 months or more, and 33 of the 46 paralyzed patients gained neural improvement. Sphincter dysfunction became better in 10 patients, and none became worse. We conclude that anterior corpectomy to decompress neural encroachment with instrumental reconstruction to stabilize the collapsed spine is a good adjunctive treatment in these highly selected patients.
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We measured radiographically the interspinous distance in 50 normal children and in 50 children with congenital dislocation of the hip. The value increased proportionally with age in normal children, but not in those with congenital dislocation of the hip. Our results indicate that a bony parameter, rather than the age of the child, is suitable for the indication of lower age limit for Salter's innominate osteotomy.
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Arch Orthop Trauma Surg · Jan 2000
Natural history of unreduced congenital dislocation of the hip in adults.
The natural history of 33 patients with 43 unreduced congenital dislocations of the hip was reviewed. The average age at the first consultation was 50 years. Four were men and 29 were women. ⋯ The average dislocation index was increased in the standing more than in the lying position. In unilaterally dislocated hips the average femorotibial angles in the ipsilateral and contralateral knees to the dislocated hip were 172 and 179 deg, respectively. Lumbar degenerative scoliosis of more than 5 deg was observed in 16 patients.
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Multiple epiphyseal dysplasia (MED) is a relatively uncommon inherited disorder of epiphyseal maturation. Affected individuals may have a degree of short-limbed dwarfism, short stubby digits, and stiff or painful joints. We report two families of MED and emphasize the variations of joint involvement. ⋯ No apparent hip lesion was present. In family B, the hip joint was predominantly affected, followed by the knee and ankle joints, and the deformity was severer than that in family A. These observations suggest that MED is a group of heterogeneous disorders.
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Arch Orthop Trauma Surg · Jan 2000
Case ReportsA rare case of enthesopathy of the bicipital tuberositas of the radius.
We present a case of a patient with complaints in both elbows, due to a prominent bicipital tuberosity with an enlarged bursa, in which operative resection was successful.