Archives of orthopaedic and trauma surgery
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Kienböck's disease with onset after 50 years of age was studied. Of 127 patients with Kineböck's disease seen over the past 30 years, the cases of 15 (12 female, 3 male) were analyzed. The average age of onset was 58.3 years. ⋯ Moreover, it was noteworthy that the variance among aged controls (group C) was higher than among the young controls (group D). The metacarpal index of the patients with aged-onset Kienböck's disease was markedly lower than that of the young. Considering the increase of ulnar variance with age, the persistence of minus variance and the presence of osteoporosis might make the lunate bone susceptible to injury.
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Arch Orthop Trauma Surg · Jan 1990
"Physiological osteoporosis" and "osteoblast insufficiency" in old age. Comparative radiological-morphometric and statistical studies on the spongy bone of lumbar and cervical vertebral bodies.
To investigate the expectation of general insufficiency of osteoblasts with increasing age, we studied autotopsy material from 105 deceased persons of both sexes who had died between 16 and 91 years and in whom clinically manifest diseases of the bone had been excluded. Quantitative morphometric examination of the structure of the spongy bone of the 3rd-5th lumbar vertebral bodies (LVBs) and of the 5th-7th cervical vertebral bodies (CVBs) was carried out in frontal and sagittal planes, the parameters analysed being volumetric density (Vv), surface density (Sv) and specific surface area (S/V), and the results were subjected to statistical evaluation. The results showed that in the three LVBs, Vv, Sv and S/V behave in a similar manner, Vv and Sv decreasing after the age of 50 years by more than one-third while S/V remains constant throughout life. ⋯ This differing behavior of the spongy bone in the two regions of the spinal column is an expression of the different characteristic loading forces in each regions: LVB loading is predominantly static, CVB loading mainly dynamic. Thus, from the functional point of view, what is known as "physiological osteoporosis due to ageing" is nothing more than adaptation by an ageing bone to physical activity, reflecting--like the bone of the young adult--the current loading of the cancellous bone by the actions of the musculoskeletal system. Since such physical activity is often age-related, the performance of the osteoblasts does not depend upon age per se, but merely on the remaining functional adaptive capacities of the ageing organism as whole.
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Arch Orthop Trauma Surg · Jan 1990
Fracture incidence and bone mineral density of the distal radius in Japanese children.
The incidence of fractures of the distal radius in Japanese persons under 20 years of age was determined, and the bone mineral density of the radius was measured in 236 healthy Japanese children. The peak incidence of fractures occurred at 13 years of age (807 per 100,000) in boys and at 11 (300 per 100,000) in girls. ⋯ The age at the peak incidence of fractures thus coincided with the age at which the metaphyseal/diaphyseal density ratio was lowest. Thus, it is suggested that low bone mineral density at the metaphysis may be the cause of the high incidence of these fractures in adolescence.
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Arch Orthop Trauma Surg · Jan 1990
Diagnosis of bone and joint infection by leucocyte scintigraphy. A comparative study with 99mTc-HMPAO-labelled leucocytes, 99mTc-labelled antigranulocyte antibodies and 99mTc-labelled nanocolloid.
Fifty-five patients with 60 suspected infections of bones or joints were studied with 99mTc-hexamethylpropyleneaminooxine- (HMPAO-) labelled leucocytes and 99mTc-labelled antigranulocyte antibodies, in part supplemented with 99mTc-labelled nanocolloid. The findings using the different procedures were in good agreement. ⋯ Spondylitis usually shows as non-specific cold lesions. A subtraction technique with computer assisted analysis of HMPAO and nanocolloid scans provides a more precise diagnosis of this condition.
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Arch Orthop Trauma Surg · Jan 1990
Vascularized pedicled bone graft into the femoral head--treatment of aseptic necrosis of the femoral head.
Revitalization of the femoral head in cases of aseptic necrosis was attempted in 13 hips of 11 patients 15-33 years of age. The necrotic bone was replaced by a vascularized pedicular iliac bone graft and free cancellous transplants. The results after an average follow-up of 53 months are satisfying in some cases. The surgical technique used is simple and applicable when a vascularized bone graft is needed in the hip region.