Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2000
Transtrochanteric rotational osteotomy for osteonecrosis of the femoral head with preoperative superselective angiography.
A prospective radiologic and scintigraphic study was made of 15 joints in 12 patients who underwent transtrochanteric rotational osteotomy of the femoral head after identifying by preoperative superselective angiography which arteries should be preserved during surgery. The preoperative superselective angiography revealed that the blood supply to the femoral head was provided by the medial femoral circumflex artery in 12 joints and a branch of the internal iliac artery in 3 joints. ⋯ At the follow-up examination made after at least 2 years, there were no cases of collapse of the new femoral head weight-bearing site, and also there were no cases with a large cold area in the femoral head on the scintigram obtained 2 months postoperatively. For this operative procedure, the nutrient arteries of the femoral head should be confirmed by preoperative superselective angiography, and it is essential that these arteries be preserved during surgery.
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Arch Orthop Trauma Surg · Jan 2000
Case ReportsHuman leukocyte antigen (HLA) phenotypes in siblings with osteosarcoma.
Osteosarcoma was detected in two siblings. Their human leukocyte antigen (HLA) phenotypes were completely identical, although they were different from those of osteosarcoma patients in previous reports. ⋯ These cases suggest that genetic similarity may influence the development of osteosarcoma. Ascertainment of the HLA phenotypes in siblings with osteosarcoma might be a useful strategy to facilitate the early diagnosis of this tumor.
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Arch Orthop Trauma Surg · Jan 2000
Case ReportsOccult fractures of tibial plateau detected employing magnetic resonance imaging.
We describe two cases of spontaneous fracture at the tibial metaphysis not diagnosed by standard X-ray. In both cases, only magnetic resonance imaging supplied a precise diagnosis and allowed us to follow the evolution of the pathology. ⋯ Osteoporosis was noted in all cases. Hypothetically, similar pathological situations could be present without being diagnosed since they are not always detected by standard X-rays.
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Arch Orthop Trauma Surg · Jan 2000
Case ReportsBone remodelling in humeral arthroplasty: follow-up using CT imaging and finite element modeling--an in vivo case study.
Little material is available in the literature about remodelling of the human humerus after implantation of a shoulder hemiarthroplasty. A 73-year-old patient was examined by CT 4 years after implantation of a right shoulder hemiarthroplasty, and the bone density as represented by Hounsfield values was compared with the contralateral side. Additionally, a three-dimensional finite-element model was generated from the image data and analysed. ⋯ Distally from the prosthesis, high stresses were found. On the control side, a more homogeneous stress distribution was noted. The results could be explained by bone resorption around the prosthesis caused by stress shielding; this hypothesis has to be confirmed by future studies.