Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Jan 2000
Case ReportsOccult fractures of tibial plateau detected employing magnetic resonance imaging.
We describe two cases of spontaneous fracture at the tibial metaphysis not diagnosed by standard X-ray. In both cases, only magnetic resonance imaging supplied a precise diagnosis and allowed us to follow the evolution of the pathology. ⋯ Osteoporosis was noted in all cases. Hypothetically, similar pathological situations could be present without being diagnosed since they are not always detected by standard X-rays.
-
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.
-
Arch Orthop Trauma Surg · Jan 2000
Case ReportsOperative treatment of destructive spondyloarthropathy of the lumbar spine in a patient on chronic dialysis.
We present a patient with end-stage renal disease treated by chronic dialysis, in whom progressive destructive spondyloarthropathy of the lumbar spine was successfully managed by fusion with internal fixation, resulting in relief of pain and restoration of activity.
-
Arch Orthop Trauma Surg · Jan 2000
Case ReportsOsseous overgrowth after post-traumatic amputation of the lower extremity in childhood.
Severe accidents in children may cause extreme destruction of the lower extremities. In some cases, there is no possibility to preserve the limbs. Initially, a weight-bearing stump cannot be achieved after amputation due to unstable local and soft tissue conditions. ⋯ Unfortunately, surgical revisions have to be performed quite often. To avoid several surgical corrections, an initial stump-capping with autologous material from the injured limb can be performed. Thus, the number of secondary procedures may be reduced drastically.
-
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.