Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2000
Case ReportsCompression of the ulnar nerve in Guyon's canal by uremic tumoral calcinosis.
We describe the case of a 70-year-old woman with chronic renal failure on haemodialysis presenting with an ulnar nerve compression in Guyon's canal secondary to uremic tumoral calcinosis. Excision of calcium deposits and external neurolysis of the ulnar nerve were successfully performed. ⋯ Clinical and radiological features and therapy are discussed. Uremic tumoral calcinosis is an unusual etiology of ulnar nerve compression in Guyon's canal not previously reported in dialysis patients.
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Arch Orthop Trauma Surg · Jan 2000
Comparative StudyEffects of single-dose versus fractionated irradiation on the suppression of heterotopic bone formation--an animal model-based follow-up study in rats.
The histological and enzymatic effects of single-dose irradiation of 7 Gray (Gy) versus fractionated irradiation of 5 x 2 Gy on the suppression of heterotopic ossification were examined over a period of 60 days in adult male Wistar rats (n = 57). The standardized osteogenesis model system in rats 19, 10, 11, 16, 19] was used for this purpose. The course of developing ossifications was documented quantitatively and qualitatively by means of quantitative computed tomography/osteodensitometry and digital luminescence radiography. ⋯ Therefore, it may be concluded that the smaller degree of heterotopic ossification in the irradiated groups was due to damage of and a decrease in the number of mesenchymal stem cells at the implant site. Our results stress the necessity of instituting postoperative irradiation therapy as early as possible to prevent heterotopic ossification. In view of experimentally proven better effects, fractionated irradiation has to be preferred to a dose-equivalent single-dose radiation, especially considering the fewer side-effects noted with fractionated irradiation.
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Arch Orthop Trauma Surg · Jan 2000
Comparative StudyTeaching model for intraoperative spinal sonography in spinal fractures. An experimental study.
To improve the technique of intraoperative sonography of the spinal canal, a teaching model of the thoracolumbar spine was developed. It allows to simulate the typical spinal stenosis of a vertebral fracture and the sonographic procedure to detect and measure such a lesion. ⋯ The results could be validated in the cadaveric model. Thus, sonographic expertise acquired with the teaching model proved to be reliable in the clinical situation.
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Arch Orthop Trauma Surg · Jan 2000
Case ReportsFemoral nerve palsy in hip replacement due to pelvic cement extrusion.
We report a case in which cement protrusion into the pelvis led to a major complication. During reaming and preparation of the anterosuperior acetabulum, a bony defect resulted which made fixation of an uncemented cup impossible, and a cemented polyethylene cup was used instead. ⋯ Postoperative X-rays and CTs showed that a huge mass of bone cement protruded into the pelvis in close proximity to the iliac vessels and the femoral nerve. This probably led to nerve damage during the cement's polymerisation process due to the heat.
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A lateral closing wedge osteotomy was performed in 39 children with cubitus varus deformity resulting from a supracondylar fracture. All had a deformity of 15 degrees or more, with 5 having more than 30 degrees of varus. The osteotomy was fixed by three different methods. ⋯ We propose this method of fixation as a good alternative method to the modified French technique, especially in cases of severe cubitus varus deformity, where removal of a large wedge can produce a big step at the osteotomy site, increasing the possibility of disengagement of the stainless steel wire from the screw head. In addition, minor postoperative modifications of correction, if required, can also be performed. It also avoids a second operation for implant removal.