Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2001
Comparative StudyRupture of the patellar tendon: a review of 68 cases and a retrospective study of 29 ruptures comparing two methods of augmentation.
Rupture of the patellar tendon is a rare injury requiring acute repair to reestablish knee extensor continuity and to allow early motion. Different pathomechanisms have been postulated, and multiple techniques for repair have been described in the literature. Firstly, the current study reviews the epidemiology, pathomechanism, and risk factors. ⋯ To avoid reoperation for removal of the cerclage wire, a PDS cord can be used. The infection rate seems to be higher in the PDS group. A larger prospective study group is necessary to determine whether this phenomenon can be reproduced.
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Arch Orthop Trauma Surg · Nov 2001
Comparative Study Clinical TrialBlood loss in anterior cruciate ligament (ACL) reconstruction with and without intercondylar notchplasty: does it affect the clinical outcome?
Blood loss is associated with any surgical procedure and should be reduced wherever possible. It was our impression that notchplasty adds to the amount of postoperative bleeding after anterior cruciate ligament (ACL) reconstruction. With posterior placement of the tibial tunnel, notchplasty is optional in many cases. ⋯ The serum hematocrit (Hct) decrease was 9.7% in group I and 7.4% in group II (p < 0.001). At 12 months after surgery, the IKDC and Lysholm score evaluations and the KT-1000 arthrometer measurements revealed no clinical differences between the notchplasty and non-notchplasty groups. Despite a 30% increase in blood loss, notchplasty has been shown to be a useful procedure to prevent graft impingement without negative side-effects.
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Arch Orthop Trauma Surg · Nov 2001
Comparative StudyPathomorphological and quantitative bacteriological findings in various forms of primary surgery on gunshot wounds of extremities.
It is well-known that 'wound excision' is essential in the primary treatment of wounds in war, particularly thorough debridement of the devitalized tissues around the path of a penetrating projectile. Nowadays, the gunshot wounds in peacetime have become prevalent. Instead of the traditional method of 'wound excision' (excision), we used the method of 'incision and drainage' (incision) in the primary surgery of these gunshot wounds of extremities. ⋯ Also, there was no difference in healing time; the wounds in both groups had healed by 19.2-21.4 days. Microscopic examination revealed a little normal muscle tissue in the necrotic zone of the incision group which might augment the repair process. These results suggest that there are no differences in the effectiveness in preventing infection between the two methods. 'Incision' might be superior to 'excision' for the management of the gunshot wounds of extremities in peacetime, as it involves a simple operation and there are advantages for tissue healing.
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Arch Orthop Trauma Surg · Nov 2001
Time-related changes of collected shed blood in autologous retransfusion after total knee arthroplasty.
A prospective study was done to determine the changes in blood quality parameters of collected drainage blood in retransfusion systems at 6 and 12 h after surgery to verify whether the blood was still suitable for retransfusion purposes for an additional 6 postoperative hours beyond the so far accepted first 6-h time window after surgery. Eighty-one patients received retransfusion within the first 6 h immediately following total knee arthroplasty. Additionally, drainage blood was collected for another 6 h using the same retransfusion system. ⋯ Interleukin-6 concentration increased from 6,500 to 46,500 ng l(-1) (p < 0.001). In this study, we found no relevant difference in most of the drainage blood quality parameters between the first 6-h collection period and the second 6-h collection with regard to its suitability for autologous retransfusion except higher interleukin-6 levels. Due to the higher interleukin concentration, a possible increase in febrile reactions should be taken into account during retransfusion.
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Arch Orthop Trauma Surg · Nov 2001
Case ReportsNatural history of paediatric intervertebral disc calcification.
This case report concerns a 5-year-old boy who had intervertebral disc calcification with involvement of two disc spaces and herniation of nucleus pulposus in one. The patient's symptoms resolved completely in a week with conservative measures. At the 4-year follow-up, the child was symptom-free and in full health, the herniation of nucleus pulposus had resolved completely, and calcification had disappeared in one of the disc spaces. Although the cause of this disorder is uncertain, the course is benign and self-limiting, it seldom requires surgical intervention, and the natural history is one of resolution and complete resorption of the calcification.