Archives of orthopaedic and trauma surgery
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The spontaneous degeneration of the human rotator cuff seems to have mechanical and nutritive causes. Until now it was not known whether other species without an acromion had a vascularization of the rotator tendons which is similar to that of man. ⋯ Most important is the fact that the supraspinatus tendon shows an area of hypovascularity close to its insertion. Thus, the dog may be used for experimental purposes relating to the rotator cuff.
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Arch Orthop Trauma Surg · Jan 1990
Traumatic soft-tissue defects of the extremities. Implications and treatment guidelines.
The presence of traumatic soft-tissue defects in the extremity indicates serious damage that may compromise the systems of motion, circulation or sensibility and therefore jeopardize functional rehabilitation. This overview highlights the significance and the various causes of soft-tissue defects, of which several types may be distinguished. Principles for the selection of various flap procedures are outlined, in accordance with the need for elevation and early motion therapy. The requirements placed on flap tissue are described, such as surface characteristics, ability to restore sensibility, cosmesis, capacity to fill voids in the depth of defects and revascularization of adjacent areas.
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The instability of atlanto-axial subluxation remains a challenging problem in patients with rheumatoid arthritis. In order to preserve as much function of the cervical spine as possible, inclusion of the occiput into the fusion should exclusively be performed when there is a radiologically or clinically manifest pathological condition of the atlanto-occipital joint or marked upward migration of the dens axis. ⋯ This article presents a retrospective analysis of the clinical and radiological results of occipito-cervical fusion in 26 patients with rheumatoid arthritis using a modified Brattström technique. The complications encountered were mainly due to the use of wire fixation, reinforcement using bone cement and insufficient reduction of atlanto-axial subluxation.
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Twenty-nine patients were examined by magnetic resonance imaging for various lesions of the spine. The results of these scans were compared with those of plain radiographs, computertomographs, and radionuclide bone scans. ⋯ Characteristic changes of the signal patterns for inflammatory and tumorous lesions were not observed. The differentiation of these lesions will presently continue to have to be based on morphological criteria.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsTreatment of an old infection in a total hip replacement with an interim spacer prosthesis.
When treating a septic hip-joint prosthesis with bone loss of the proximal femur secondary to osteomyelitis, we implanted a specially designed prosthesis to act as a local antibiotic and spacer between the acetabulum and femur until the infection abated. Arthroplasty could then be carried out with no trouble and there was no recurrence of infection.