Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2000
Comparative StudyInnervation of nociceptors in the menisci of the knee joint: an immunohistochemical study.
Using histology, we studied the innervation of nociceptors in the medial and lateral menisci of the knee joint. Specimens examined were taken from 16 patients during arthroplasty. The patients were 6 men and 10 women, with ages ranging from 14 to 76 years (mean 56 years). ⋯ Nerve fibers positive for SP were also detected in the menisci, but were fewer in number. Their branches also were fewer, oriented radially and paralleling blood vessels. This study showed that some of the pain in cases of meniscal tear could originate in the meniscus itself, especially with peripheral tears that may be accompanied by bleeding.
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Arch Orthop Trauma Surg · Jan 2000
Comparative StudyFixation of proximal tibia fractures by a retrograde nail: a biomechanical investigation.
Surgical treatment of proximal tibial fractures requires open reduction and internal fixation. The operative exposure causes additional soft-tissue injury and reduces the blood supply to the bone. A cephalograde tibial nail should offer comparable mechanical stability without these disadvantages. ⋯ While both implants exhibited comparable stiffness under sagittal loading, the plate had a higher rotational and varus stiffness. Despite this higher stiffness, rotational displacements at the fracture gap were nearly twice as large for this implant during loading. We conclude that the retrograde nail provides similar mechanical stability to plate fixation for proximal tibial fractures, while the closed reduction and soft-tissue preservation of this new technique are definite advantages.
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Arch Orthop Trauma Surg · Jan 2000
Case ReportsOsseous lesions of the distal ulna: atypical location--unusual diagnosis. Report of three cases with similar imaging and different pathologic diagnoses.
Three cases with destructive bone lesions of the distal end of the ulna caused by different pathologic entities (Ewing's sarcoma, osteosarcoma, rheumatoid pseudotumoral synovitis) are presented, all with similar clinical and comparable x-ray and magnetic resonance imaging features. Although the distal end of the ulna may be resected without significant functional impairment, careful evaluation of treatment strategies compatible with oncologic standards is warranted.
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Arch Orthop Trauma Surg · Jan 2000
Case Reports Comparative StudyEvaluation of isolated fractures of the greater trochanter with magnetic resonance imaging.
The diagnosis of an isolated fracture of the greater trochanter can be done on routine radiographs, but this may not be the whole story. We evaluated fractures of the greater trochanter of the femur by magnetic resonance imaging (MRI). MR images were obtained within 5 days of the time of clinical presentation. ⋯ MRI showed that in seven of the eight cases, the fracture line was observed leading from the greater trochanter towards other trochanter regions. In only one case was the fracture limited to the greater trochanter and corresponded to the line observed on the standard radiographs. We suggest that in cases of greater trochanter fracture with somewhat severe symptoms, MRI should be performed in order to discover the appropriate diagnosis and treatment.
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Arch Orthop Trauma Surg · Jan 2000
Case ReportsSimultaneous anterior and posterior traumatic dislocation of the hip. A case report with review of the literature.
The presence of anterior dislocation of the hip along with contralateral posterior dislocation of the hip in the absence of other major trauma is a distinctly rare injury pattern. We report such a case resulting from a motor vehicle striking a pedestrian, along with a review of previous cases. The patient was managed nonoperatively within 6 hours of trauma with an excellent final outcome and no posttraumatic complications over a 3-year follow-up. The possible mechanism of this injury is discussed.