Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1998
Review Case ReportsComplete dorsal dislocation of the metacarpophalangeal joint of the thumb.
In the pathology of simple complete dislocation involving the metacarpophalangeal joint of the thumb, whether or not the palmar plate is interposed within the joint is controversial. Nine cases of complete dorsal dislocation of the joint were reviewed, and cadaver dissection was performed to study the pathology of this injury. Eight of the nine patients were seen within 4 days of injury and treated successfully by closed manipulation. ⋯ We were able to reproduce the pathological anatomy of the dislocation, wedging of the palmar plate in the joint of the cadaver. In this cadaver and in all clinical cases, radiographs showed a complete dislocation with an increased distance between the palmar edge of the base of the proximal phalanx and the metacarpal head, indicating an interposition of the palmar plate. Our study suggests that in simple complete dislocations of this joint, the palmar plate is interposed between the displaced bones.
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Arch Orthop Trauma Surg · Jan 1998
Review Case ReportsFracture of the axis after dome-like cervical laminoplasty.
We describe a case of fracture of the axial neural arch that occurred after a dome-like cervical laminoplasty and caused dural compression. Cervical laminoplasty with dome-like laminoplasty of the axis was performed on a patient with cervical myelopathy due to ossification of the posterior longitudinal ligament extending from C2 to C6. ⋯ After total axial laminectomy, permanent neurological improvement was obtained. Our experience suggests that care should be taken to avoid an excessive dome-like laminoplasty and that the possibility of axial fracture should be borne in mind.
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Arch Orthop Trauma Surg · Jan 1998
Review Case ReportsAspiration of intraspinal synovial cyst: recurrence after temporal improvement.
Intraspinal synovial cyst primarily occurs in the lumbar spine and may cause back pain and compression nerve disturbance. Percutaneous aspiration has been recommended as an alternative to surgery in three cases. We report on two patients who improved after aspiration of gelatinous material and steroid injection but whose cyst recurred within a short period of time. ⋯ These two types are indistinguishable on computed tomography or magnetic resonance imaging. The results of all patients whose aspirated material was gelatinous were unsuccessful, including our cases. Thus, the outcome may depend on the pathology of the cyst.
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Arch Orthop Trauma Surg · Jan 1995
ReviewInfections and immunological hazards of allogeneic bone transplantation.
Allogeneic transplantation of human cancellous and cortical bone is a controversially discussed concept in trauma and orthopaedic surgery. Biological and immunological arguments support transplantation of autologous material whenever this is technically possible. On the other hand, synthetic alloplastic materials for bone substitution are available free of immunological and hygienic hazards. ⋯ Bone transplantation is performed without vital indication in nearly every case. Thus an optimum of hygienic security has to be claimed for recipients of allogeneic bone. The "Munich model" for bone transplantation is presented and discussed.
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Man-made bone implant materials as substitutes for autogenic spongiosa transplantation are reviewed, specifically materials made from collagen. The intra- and extracellular biosynthesis of collagen is described. Manufacture, properties and indications of sterile Collagen-fleece, a well proven surgical biomaterial prepared from porcine collagen, is presented. Further research led to the development of a new bone-replacement material called Collapat.