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
The effect of extracorporeal shock waves on joint cartilage--an in vivo study in rabbits.
The application of extracorporeal shock waves has become a new mode of treatment for affections of the locomotor apparatus such as calcifying tendinitis, epicondylitis humeri radialis, calcaneodynia and pseudarthrosis. The treatment often takes place in the vicinity of joints. Up to now no systematic data have been published about possible side-effects on joint cartilage. ⋯ The left lateral femoral condyle of each animal was treated with 2000 shock waves of 1.2 mJ/mm2; the right condyle served as control. Macroscopical, radiological and histological analysis at 0, 3, 12 and 24 weeks after treatment showed no pathological changes in the joint cartilage. We conclude that extracorporeal shock wave treatment does not cause damage to the joint cartilage of growing rabbits.
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Arch Orthop Trauma Surg · Jan 2000
Pathology of femoral head collapse following transtrochanteric rotational osteotomy for osteonecrosis.
We investigated the pathology of femoral head collapse following transtrochanteric anterior rotational osteotomy. Six femoral heads were obtained during total hip arthroplasty some 2-12 years after osteotomy. ⋯ In newly created subchondral areas at weight-bearing sites, trabecular thickness and the number of trabecular bones had decreased, with few osteoblasts, osteoclasts, and osteocytes being present, resulting in a coarse lamellar structure of the trabecular bone. These findings suggest that transposed areas in cases of failure consist mostly of low-turnover osteoporotic lesions which could cause collapse of the femoral head.
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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.