Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1989
ReviewPost-traumatic osteomyelitis. Pathophysiology and management.
Osteomyelitis is one of the most severe complications that can arise following operative treatment of bone. It requires a long-term treatment. The patient can never be sure that it heals completely. ⋯ Stabilization is achieved by means of an external fixator. Once the fracture area has been cleaned, cancellous bone grafting is done once, twice, or even more frequently. For wound closure it is necessary to rotate muscle groups, to cover the bone with dermatomic skin, or to use microvascular flaps.(ABSTRACT TRUNCATED AT 250 WORDS)
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Arch Orthop Trauma Surg · Jan 1989
ReviewIncisional hernia through iliac crest defects. A report of three cases with a review of the literature.
Although the iliac crest is the most common site from which autogenous bone grafts are obtained, complications are surprisingly rare. One of these is incisional hernia through the resulting bony defect. ⋯ Elective repair of such hernias is advisable in order to avoid such complications. Attention to primary closure of bony iliac defects when complete is mandatory to prevent the occurrence of incisional hernia.
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Arch Orthop Trauma Surg · Jan 1989
Case ReportsNeurofibromatosis with spinal paralysis due to arteriovenous fistula.
A case of neurofibromatosis with spinal paralysis due to arteriovenous fistula is reported. Preoperatively, the appropriate diagnosis was missed because angiography had not been performed. Postoperative angiography disclosed that an arteriovenous fistula formed a tumor-like mass, and that a part of the mass had invaded the spinal canal, compressing the spinal cord. It is concluded that the possibility of an arteriovenous fistula should be kept in mind in neurofibromatosis patients with spinal cord symptoms.
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Arch Orthop Trauma Surg · Jan 1989
Leg-length inequality has poor correlation with lumbar scoliosis. A radiological study of 100 patients with chronic low-back pain.
Leg-length inequality and its hypothetical consequences, pelvic tilt and lumbar scoliosis, were measured in 100 young or middle-aged adults suffering from chronic low-back pain. Leg-length inequality had a good correlation with the pelvic tilt assessed from the iliac crests, a moderate correlation with the sacral tilt, but a poor correlation with the lumbar scoliosis. ⋯ Thus, there is a gradually decreasing correlation between the posture parameters when moving from the hips up to the lumbar spine. We conclude that before a radiologically observed leg-length inequality be considered as the cause of low-back pain, an erect-posture radiograph of the whole pelvis and lumbar spine is essential, in order to assess an existing pelvic tilt and scoliosis.
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Arch Orthop Trauma Surg · Jan 1989
Limb-preserving operations in the treatment of malignant bone tumors.
Limb-preserving resections require very careful indications; in particular, the criteria of oncologic radicality must be strictly considered. The functional results can be improved compared with those of ablative surgery, while the rate of relapse-free survival is the same. Surgical therapy for metastases of bone tumors should be performed by simple and safe procedures which allow for quick rehabilitation. The most important limb-preserving methods of operation in the treatment of primary and secondary malignant bone tumors are discussed and a few examples are presented.