Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2000
Comparative StudySubtrochanteric corrective osteotomy for the endoprosthetic treatment of high hip dislocation. Treatment and mid-term results with a cementless straight stem.
Total hip arthroplasty is problematical in the case of high dislocation. To reposition the hip, a femoral shortening osteotomy is necessary in order to prevent damage to the neurovascular structures. This paper describes the implantation of a cementless straight stem in 15 patients using a simple technique with a simultaneous, derotating and shortening osteotomy. ⋯ Fourteen patients had good or very good results in the Merle d'Aubigne score after a median of 4.3 (range 2-5.6) years of follow-up. The surgical technique described enables the initial stable fixation of a standard prosthesis without additional osteosynthesis. Additional advantages include a shorter duration of surgery, a lower complication rate and a more rapid consolidation of the osteotomy.
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Arch Orthop Trauma Surg · Jan 2000
Case ReportsIsolated palmar dislocation of the fifth carpometacarpal joint diagnosed by stress X-rays.
Isolated palmar ulnar dislocation of the fifth carpometacarpal (CMC) joint is a rare injury which often yields only subtle radiographic findings that may be easily overlooked, especially when there is no associated fracture. We reported a case of an isolated palmar dislocation of the fifth CMC joint, diagnosed correctly by means of simple stress X-rays (traction and axial compression stress views). This method proved to be useful and needs no special equipment.
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Arch Orthop Trauma Surg · Jan 2000
Comparative StudyAnterior cruciate ligament augmentation under arthroscopy. A minimum 2-year follow-up in 40 patients.
We present a new surgical technique of anterior cruciate ligament (ACL) augmentation using autogenous hamstring tendons or allogenic fascia lata under arthroscopy for patients in whom considerable ACL remnants with mechanoreceptors are preserved. We review the clinical results of 40 patients who underwent this ACL augmentation, as assessed by manual instability tests, KT-2000 knee arthrometer, Lysholm and Gillquist score, joint position sense and magnetic resonance imaging (MRI), and compare them with those of ACL reconstruction. The side-to-side differences of anterior displacement measured by the KT-2000 knee arthrometer at 30 lbs, an average of 5.3 +/- 2.6 mm preoperatively, was significantly improved to an average of 0.7 +/- 1.8 mm in the augmentation group, while an average of 6.0 +/- 2.4 mm was improved to 1.8 +/- 2.1 mm in the reconstruction group. ⋯ Thus, as for the KT-2000 knee arthrometer, the ACL augmentation group showed significantly better anteroposterior stability and terminal stiffness than the ACL reconstruction group. The final inaccuracy of joint position sense of the augmentation group was 0.7 degrees +/- 0.7 degrees, while that of the reconstruction group was 1.7 degrees +/- 1.2 degrees indicating a significant difference (P < 0.05). This study demonstrates that ACL augmentation, which can preserve ACL remnants with mechanoreceptors, is superior to ACL reconstruction from the viewpoint of position sense and joint stability.
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We report a case of a nerve sheath ganglion of the ulnar nerve at the canal of Guyon. This case involved a ganglion which was confined to the epineurium of the ulnar nerve. and it was completely excised without any damage to the nerve fiber. A nerve-sheath ganglion is rare, but it should be considered in the differential diagnosis of any tumor which is causing neural disturbance.
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Arch Orthop Trauma Surg · Jan 2000
Case ReportsCarpal tunnel syndrome caused by an idiopathic calcified mass.
This is a case report of carpal tunnel syndrome caused by an idiopathic calcareous lesion within the carpal canal. The median nerve was trapped between the transverse carpal ligament and the calcified mass. The mass was predominantly composed of calcium phosphate. Surgical release of the transverse carpal ligament and removal of the calcareous mass relieved the symptoms.