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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Diagnostic and clinical features of the frozen shoulder syndrome and the Sudeck syndrome are similar in many aspects. Radioisotope bone scan shows an increased uptake in affected areas in both diseases, while native radiographs show a progressive demineralisation. ⋯ In the immobilised control group with degenerative changes of the rotator cuff, calcifying tendinitis and shoulder instability (n = 12) and in the group of healthy probands (n = 20), the difference between the affected and non-affected side (left and right humerus of the healthy probands) was only more than 21% in one case each. There are several references in the literature that assume frozen shoulder to be an algoneurodystrophic process; our observations support this hypothesis, possibly leading to earlier diagnoses and extended therapeutic management.
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We present the outcome of a mould arthroplasty implanted for a congenital hip dysplasia in 1955 to revise a previous cup arthroplasty. This type of prosthesis, which has been developed on the basis of the concept of Smith-Peterson, by Prof. Marino-Zuco in Rome in the early 1940s, showed excellent results and was widely used until the advent of Charnley low-friction arthroplasty.
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Arch Orthop Trauma Surg · Jan 2000
Case ReportsLocalization, detection and guided removal of soft tissue in the hands using sonography.
Penetrating wounds and lacerations are frequent pathologies treated in the emergency room. The management of hand trauma represents a large part of the work in any surgical practice. Although X-rays are routinely taken, numerous foreign bodies remain undetected, and the wounds are just locally debrided and the lacerations sutured. ⋯ Usually, in response to continued pain, an ultrasound investigation is ordered, and the pathology becomes apparent. A number of examples are briefly described in order to highlight the present inadequacies. It is suggested that hospital administrators consider the need to provide ultrasonographic services as an integral facility of the emergency room.
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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.