The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Aug 1990
Refracture after removal of a condylar plate from the distal third of the femur.
Of 103 patients who had a fracture of the distal third of the femur that was treated by open reduction and internal fixation with a condylar blade-plate, sixty-two had removal of the plate after the fracture had united. The mean interval between injury and removal of the plate was twenty-six months. Six patients (10 per cent) sustained a refracture that was unrelated to major trauma; the refracture occurred twelve to ninety-three days after removal of the plate. ⋯ The use of such screws significantly increased the risk of refracture after removal of the hardware (p less than 0.01). The refractures were treated by intramedullary nailing in five patients and by replating in one, and union was achieved in all six patients. Routine removal of a condylar blade-plate after union of a fracture of the distal third of the femur cannot be recommended, especially in the presence of supplemental fixation with interfragmentary screws.
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J Bone Joint Surg Am · Aug 1990
Total knee arthroplasty with the kinematic prosthesis. Results after five to nine years: a follow-up note.
A review of the results of 192 kinematic total knee replacements five to nine years after the operation showed that the results were still satisfactory. At the time of the review, the ages of the patients ranged from twenty-two to eighty-seven years. ⋯ Radiolucency was present around 40 per cent of the tibial components, 30 per cent of the femoral components, and 60 per cent of the patellar components, but the lines were thin and not progressive. The complications included loosening of the patellar components in five knees, one fracture of the tibial tray with loosening of the patellar component, one fracture of the patellar component, and one dislocation of the patellar component.
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J Bone Joint Surg Am · Mar 1990
Case ReportsManagement of dislocations of both ends of the clavicle.
We treated six patients who had a dislocation of both ends of the clavicle (an anterior dislocation of the sternoclavicular joint and a posterior dislocation of the acromioclavicular joint). Two patients who had fewer demands on the shoulder--an elderly woman and a woman who had had an ipsilateral amputation of the hand--did well; they had only minor symptoms after non-operative management. The other four patients (all men) had continuing pain at the acromioclavicular joint; each had a reconstruction of the joint, which resulted in a painless, full range of motion and return to normal activity. No patient had continuing pain in the sternoclavicular joint.
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J Bone Joint Surg Am · Oct 1989
Adult idiopathic scoliosis treated with Luque or Harrington rods and sublaminar wiring.
We reviewed the results of spinal arthrodesis that was performed, with sublaminar wires that were attached to either double L-shaped Luque rods or to a Harrington rod, in forty-two adults who had idiopathic scoliosis. The minimum length of follow-up was two years; the maximum, five years; and the average, three years. The average scoliosis measured 67 degrees preoperatively, was corrected to 37 degrees at operation, and was 44 degrees at the time of follow-up. ⋯ Three patients had a pseudarthrosis, which was in the lumbar area in all of them. All three patients had had only a posterior operation. No statistically significant difference in the amount of final correction was demonstrated between the subgroups.