Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1989
Case ReportsNeurofibromatosis with spinal paralysis due to arteriovenous fistula.
A case of neurofibromatosis with spinal paralysis due to arteriovenous fistula is reported. Preoperatively, the appropriate diagnosis was missed because angiography had not been performed. Postoperative angiography disclosed that an arteriovenous fistula formed a tumor-like mass, and that a part of the mass had invaded the spinal canal, compressing the spinal cord. It is concluded that the possibility of an arteriovenous fistula should be kept in mind in neurofibromatosis patients with spinal cord symptoms.
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Arch Orthop Trauma Surg · Jan 1989
Factors associated with heterotopic bone formation following total hip replacement.
In order to delineate groups of patients suitable for treatment to prevent heterotopic bone formation (HBF) following total hip replacement, 99 patients were examined to evaluate predisposing factors. One year after surgery, HBF was found in 73% of the patients. ⋯ Previous ipsilateral hip surgery did not increase the risk of HBF. Although not significant, all patients who developed heterotopic bone after previous ipsi- or contralateral hip surgery showed HBF of the same or even a higher grade after the present replacement.
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Arch Orthop Trauma Surg · Jan 1989
Leg-length inequality has poor correlation with lumbar scoliosis. A radiological study of 100 patients with chronic low-back pain.
Leg-length inequality and its hypothetical consequences, pelvic tilt and lumbar scoliosis, were measured in 100 young or middle-aged adults suffering from chronic low-back pain. Leg-length inequality had a good correlation with the pelvic tilt assessed from the iliac crests, a moderate correlation with the sacral tilt, but a poor correlation with the lumbar scoliosis. ⋯ Thus, there is a gradually decreasing correlation between the posture parameters when moving from the hips up to the lumbar spine. We conclude that before a radiologically observed leg-length inequality be considered as the cause of low-back pain, an erect-posture radiograph of the whole pelvis and lumbar spine is essential, in order to assess an existing pelvic tilt and scoliosis.
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Arch Orthop Trauma Surg · Jan 1989
Limb-preserving operations in the treatment of malignant bone tumors.
Limb-preserving resections require very careful indications; in particular, the criteria of oncologic radicality must be strictly considered. The functional results can be improved compared with those of ablative surgery, while the rate of relapse-free survival is the same. Surgical therapy for metastases of bone tumors should be performed by simple and safe procedures which allow for quick rehabilitation. The most important limb-preserving methods of operation in the treatment of primary and secondary malignant bone tumors are discussed and a few examples are presented.
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Arch Orthop Trauma Surg · Jan 1988
Pharmacokinetics of methylmethacrylate monomer during total hip replacement in man.
The concentration of methylmethacrylate monomer (MMA) in the blood stream after implantation of the components of 15 total hip prostheses using bone cement was determined in the pulmonary artery, the radial artery, and the superior vena cava after cement application, and correlated with the observed drop in blood pressure and the increase in the pulmonary arterial pressure. In all samples MMA was found. The values ranged from 0.02 micrograms/ml to 59 micrograms/ml. ⋯ The pulmonary arterial mean pressure increased from 18 to 20 mmHg during the first 10 min. Although in some patients a drop in blood pressure started at the same time as MMA reached maximum values, high concentrations did not result in a greater effect on the circulatory parameters. Statistical analysis by the Spearman test revealed no correlation between MMA concentrations and the decrease in blood pressure or the increase in the pulmonary arterial pressure.