Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1990
Clinical TrialLimb lengthening and three-dimensional deformity corrections. A retrospective clinical study.
Different methods of limb lengthening as used at the Orthopedic Surgery Clinic of the Medical School, University of Zagreb, are compared. The results of operations performed between 1979 and 1989 on 111 patients are presented. These patients were subjected to surgery aimed at length equalization of limbs and/or correction of three-dimensional deformities. ⋯ These advantages manifest themselves in a reduced number of operations, lower incidence of infection and improved bone regeneration. It is preferable to perform corticotomy at the metaphysis site because of its optimum blood supply and its higher potential for osteogenesis. With corticotomy performed at the diaphysis site, satisfactory results were observed in only one-third of the cases.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsTransient palsy of hip abductors after a fall on the buttocks.
A fall on the buttocks caused monolateral transient palsy of the hip abductors in two patients. Palsy could be ascribed to acute entrapment of the superior gluteal nerve between the piriformis muscle and the incisura ischiadica major.
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Arch Orthop Trauma Surg · Jan 1990
Prognosis of primary anterior shoulder dislocation in young adults.
From 1982 to 1987, 194 patients with 196 primary traumatic anterior shoulder dislocations were treated in our hospital. One hundred and sixty-six patients with 168 shoulder dislocations (87%) were available for study at follow-up an average of 4 years after treatment. The most important prognostic factor in relation to recurrence was the age of the patient at the time of the primary dislocation. ⋯ Athletes in this age group had no worse a prognosis as to recurrence than non-athletes. A fracture of the greater tuberosity improved the prognosis significantly (P less than 0.01). Neither the presence of a Hill-Sachs lesion nor the period of immobilization influenced the recurrence rate in patients aged 30 years and younger.
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Arch Orthop Trauma Surg · Jan 1990
Comparative StudyDiagnostic value of serum tumor markers in skeletal metastasis of carcinomas.
Levels of serum tumor markers including tissue polypeptide antigen (TPA), CA 15-3, CA 19-9, squamous cell carcinoma antigen, carcinoembryonic antigen, alpha-fetoprotein, and PAP were measured in 26 patients with bone metastasis and in 9 patients with primary bone tumors. More than one markers was elevated in 19 of the 26 patients with bone metastasis, although there was no elevation of the markers in 3 patients with renal cell carcinoma. TPA was the most sensitive marker in the diagnosis of metastasis. ⋯ On the other hand, there was a slight elevation of the markers observed in two of the nine patients with primary bone lesions. Serum tumor markers are useful in the diagnosis of bone metastasis to differentiate it from primary bone lesions. Especially in solitary bone lesions, serum markers may be the only way to make a differential diagnosis between the two.
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Arch Orthop Trauma Surg · Jan 1990
New aspects of lumbar disc disease. MR imaging and histological findings.
Magnetic resonance imaging (MRI) and plain X-ray and CT studies were performed in patients with a history of lumbar back pain due to spinal disc disease. Spin-echo pulse sequences (SE), phase-contrast techniques (partial saturation sequences with delayed readout, PS), and fat-suppressing inversion recovery sequences (STIR) were employed. In 74 of 325 patients, PS and STIR images displayed vertebral marrow changes adjacent to the end-plates of the affected segments. ⋯ In six patients histological diagnosis showed substitution of hematopoietic marrow by fatty tissue, cartilaginous particles, degeneration of fat cells, and an increase in extracellular fluid with different components. The etiology is still unclear, but a correlation with lumbar disc disease is demonstrated. These vertebral marrow changes were best displayed with STIR and phase-contrast MR sequences, both providing contrast changes superior to T2-weighted SE techniques.