Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1999
Clinical TrialFour-part posterior fracture--dislocations of the shoulder. Treatment by limited open reduction and percutaneous stabilization.
Ten patients who had been treated by limited open reduction and percutaneous stabilization for four-part posterior fracture-dislocation of the shoulder were followed-up for an average of 3.2 years postoperatively. According to the criteria of Neer, the result was excellent in nine patients, with an average Constant score of 95.7. There was one failure who showed complete avascular necrosis. All patients with excellent results had at least 1 mm of the neck portion of the head fragment intact.
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Arch Orthop Trauma Surg · Jan 1999
Case ReportsWrist pain with triangular fibrocartilage thickening.
We review the case of a patient who had wrist pain with synovial proliferation due to triangular fibrocartilage (TFC) thickening, whose pain was relieved by total TFC resection. This suggested that TFC thickening should be considered in the evaluation of patients with wrist pain.
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Arch Orthop Trauma Surg · Jan 1999
Loss of correction after lateral closing wedge high tibial osteotomy--a human cadaver study.
In 12 human cadaver tibiae, osteotomies were carried out at two levels (2 and 3 cm from the distal joint line) with three different wedges (5 degrees, 10 degrees, 15 degrees) to evaluate the influence of displacement of the osteotomy fragments on areas of cortical contact. In undisplaced osteotomies (medical cortical edges superposed) cortical contact areas formed 28% (level 2 cm) and 40.5% (level 3 cm) of the cortical circumference of the proximal fragments (NS). Wedge angles and levels of osteotomy displayed no statistical differences. ⋯ Displacing the distal fragment laterally, medial cortical contact is lost, and weight-bearing leads to revarisation as cancellous bone sustains only 3 MPa, and the measured compressive stresses at the medial edge amounted to 6 MPa on average. Displacing the distal fragment medially leads to a decrease of total cortical contact, too, but at the medial edge of the osteotomy cortical contact areas are still present. As a result of the study, postoperative weight-bearing without additional plaster cast fixation is recommended only in cases with undisplaced fragments.
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Arch Orthop Trauma Surg · Jan 1999
Metacarpophalangeal joint arthroplasty in rheumatoid arthritis: results of Swanson implants and digital joint operative arthroplasty.
We discuss 69 metacarpophalangeal (MP) implant arthroplasties performed in 30 patients with rheumatoid arthritis. The follow-up averaged 5 years. We studied 19 finger joint prostheses by Condamine, digital joint operative arthroplasty (stabilized version; DJOA) and 50 flexible silicone Swanson implants. ⋯ Secondly, adequate coaptation cannot be achieved with this prosthetic design, even in the presence of extensive soft-tissue reconstruction. Thirdly, the use of polyethylene in MP joint replacements is questionable. In contrast, the silicone Swanson implants in our series provided superior results when used as MP implants in the rheumatoid hand.
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Arch Orthop Trauma Surg · Jan 1999
Case ReportsOsteonecrosis of the femoral head associated with pregnancy.
A 31-year-old pregnant woman suddenly complained of bilateral hip pain 2 weeks before delivery. She was delivered of triplets by Caesarean section. She had been treated with human menopausal gonadotropin and human chorionic gonadotropin (hMG-hCG) before pregnancy. ⋯ She had no history of steroid therapy or alcohol abuse. Osteonecrosis of the femoral heads bilaterally associated with pregnancy was confirmed. Pathology of the femoral head showed typical empty lacunae and necrosis of the trabecula.