Archives of orthopaedic and trauma surgery
-
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.
-
Arch Orthop Trauma Surg · Jan 1990
Comparative StudyInfluence of bone and soft-tissue operations on serum concentrations of growth hormone, somatomedin C and alkaline phosphatase.
After animal experiments suggested there was an interaction between growth hormone and bone healing, our aim in this paper was to ascertain whether there were any changes or possible interaction between the serum level of growth hormone, somatomedin C and alkaline phosphatase while a fractured bone was healing. To this end, the serum concentrations of growth hormone, somatomedin C, alkaline phosphatase and calcium were ascertained both pre- and post-operatively in two groups of patients--one with bone operations, the other with soft-tissue operations--and the results were compared. ⋯ An increase would have implied that these two hormones are directly involved in bone regeneration. There was no change in the serum level of alkaline phosphatase or calcium after either bone or soft-tissue operations.
-
Arch Orthop Trauma Surg · Jan 1990
Case ReportsA case of hip osteoarthrosis contaminated by fungi. A histological study.
A pathological study of a surgical specimen of hip osteoarthrosis presenting a superficial fungal infection (presumably Aspergillus) without any known origin is reported. Fungal penetration was mild in cartilage and fibrocartilage and more pronounced in naked cancellous bone, but it did not occur in eburnated bone or in the deep osteomedullar area. This observation indicates an unusual combination of infection and osteoarthrosis. Relationships between fungi and bone or cartilage as well as interaction between osteoarthrotic remodeling and a superimposed disease are discussed.
-
Arch Orthop Trauma Surg · Jan 1990
Total decompression of the spinal cord for combined ossification of posterior longitudinal ligament and yellow ligament in the thoracic spine.
One of the causes of hyperostosis in the spinal canal, ossification of the posterior longitudinal ligament (OPLL) combined with ossification of the yellow ligament (OYL) in the thoracic spine, can result in serious myelopathy, leading to sandwich-type compression of the spinal cord from anterior and posterior. For such cases we devised a treatment of total decompression of the spinal cord and intervertebral body fusion. This operation consists of two steps. ⋯ This pre-treatment makes removal of the OPLL anteriorly during the second stage much easier, faster, and safer. This operation is lengthy and demanding. However, based on our experience so far, it appears to be a promising surgical procedure.
-
Arch Orthop Trauma Surg · Jan 1990
Comparative StudyCalcitonin, estradiol, and hydroxyproline as parameters in the early diagnosis of involutional osteoporosis. The importance of the "second calcitonin phenomenon".
Bone metabolism was studied in a group of 92 subjects. A greater age-related decrease in calcitonin and estradiol concentrations exists in women than in men, though this difference was not significant; it was significant, however, when the values of the three different groups of women were compared. We present what we have called the second calcitonin phenomenon, that is, a highly significant difference in women between a second basal calcitonin level and the primary admission value. In the calcium infusion test, men considered to be osteoporotic showed a deceleration in the rapid loss of reserve calcitonin deposits.