Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2001
ReviewImmobilisation for acute ankle sprain. A systematic review.
The variation of practice with respect to the treatment of the acutely sprained ankle suggests a lack of evidence-based management strategies for this problem. The objective of this review was to assess the effectiveness of the various methods of immobilisation for acute ankle sprain. An electronic database search was conducted using MEDLINE, EMBASE, BIOSIS, CINAHL, Cochrane Controlled Trial Register and Current Contents. ⋯ Sensitivity analysis showed that a non-concealed treatment allocation did not influence the statistical significance of the overall results. Based on our results, functional treatment currently seems a more appropriate treatment and should be encouraged. Concerning effectiveness, immobilisation, if necessary, should be restricted to certain patients and for short time periods.
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Arch Orthop Trauma Surg · Jul 2001
ReviewNine-year results of Müller cemented titanium Straight Stems in total hip replacement.
At the Orthopaedic Department of the University of Basel, a total of 540 cemented Müller titanium alloy (Ti6Al7Nb) Straight Stems were inserted between 1989 and 1993. A cohort of 120 consecutive patients (66 women, 54 men) with 126 prostheses operated on between March and December 1989 were followed clinically and radiologically in a prospective manner for a mean observation time of 9.1 years. In all cases, the Müller titanium alloy Straight Stem was combined with the senior author's (E. ⋯ Our results do not confirm the high rate of osteolysis and revisions with the Müller titanium alloy Straight Stem presented by some other institutions. The verdict on a specific endoprosthetic implant must be made by combined assessment of the design, the implant surface condition, the material, the cement, the cementing procedure and the operative technique. The statement made in earlier publications that cemented titanium alloy should not be used as a femoral stem prosthesis should be reconsidered.
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Arch Orthop Trauma Surg · Jan 2001
ReviewA review of halo vest treatment of upper cervical spine injuries.
Thirty-five relevant studies involving in total 682 patients with 709 different types of injuries were evaluated in a review to determine the outcomes after immobilisation in a halo vest for various injuries to the upper cervical spine between 1962 and 1998. Studies were analysed according to the type of injury pattern and in terms of the treatment outcomes following primary treatment with a halo vest. The following types of injuries were evaluated: odontoid fractures (n = 420), hangman's fractures (n = 172), other axis fractures (n = 75), Jefferson fractures (n = 26), C1 arch fractures (n = 9), atlantooccipital (n = 2) and atlantoaxial dislocations (n = 5). ⋯ A halo vest can be recommended for patients with isolated Jefferson fractures, hangman's fractures, odontoid type III and type II fractures, with a low dislocation rate. The results of treatment with a halo vest were unsatisfactory with regard to combined injuries with an odontoid type II fracture. An overall healing rate of 86%, however, allows one to conclude that this treatment continues to be a good alternative to operative stabilisation of bone injuries to the upper cervical spine.
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Arch Orthop Trauma Surg · Jan 2000
Review Case ReportsFailure of osteosynthesis and prosthetic joint infection due to Mycobacterium tuberculosis following a subtrochanteric fracture: a case report and review of the literature.
We report a patient with a subtrochanteric fracture, for whom internal fixation failed and a prosthetic joint replacement was complicated by a local reactivation of a Mycobacterium tuberculosis infection. After hip replacement with revision and adequate medical therapy, a full recovery was attained without the necessity of removing the artificial joint.
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Arch Orthop Trauma Surg · Jan 2000
Review Case ReportsIsolated dislocation of the hamate bone. Case report and review of the literature.
A case of isolated dislocation of the hamate bone is reported. Mechanism of the injury and treatment are described including a review of the literature.