Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Jan 1990
Modified rotational acetabular osteotomy (RAO) for advanced osteoarthritis of the hip joint in the middle-aged person. First report.
Classical methods for pelvic osteotomy, such as those of Salter, Pemberton, Chiari, and Wagner, have been developed for reconstruction of the subluxed hip joint in children and young adults. Regarding pelvic osteotomy involving a middle-aged patient, however, there are not as many operation methods to consider, and it is difficult to choose the most suitable technique for alleviating advanced osteoarthritis. Based on current practice, total hip replacement (THR) seems the accepted method, though it presents problems such as loosening, sinking, and infections; because of these factors physicians hesitate to recommend THR surgery, particularly if the patient is otherwise healthy and appears to have many good years ahead of him. ⋯ A similar osteotomy technique has been used by Eppright and Wagner. We feel that our method achieves a more favorable result for an older patient with severe osteoarthritis, since both the surgery and the follow-up rehabilitation are more comprehensive. A modified acetabular osteotomy should not be regarded as merely an alternative to total hip replacement, but as the preferred choice for hip-joint reconstruction.
-
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 ReportsIncomplete avulsion of the femoral attachment of the posterior cruciate ligament with an osteochondral fragment in a twelve-year-old boy.
Isolated avulsion of the posterior cruciate ligament from the femoral attachment of the knee as a hyperextension injury is rare. We saw a young child with an incomplete avulsion of the posterior cruciate ligament that occurred after a blow to the anterior tibial surface of a flexed knee; the child revealed a lack of knee extension due to a pinch of the osteochondral fragment connected to the anterior band of the posterior cruciate ligament in the knee joint. Arthroscopic extirpation of a fragment was undertaken.
-
Arch Orthop Trauma Surg · Jan 1990
Methods and applications of three-dimensional imaging in orthopedics.
Computed tomography is a commonly used technique for detecting pathological alterations in soft tissues and the skeleton. Three-dimensional images of the skeleton are very useful for planning surgical treatment and monitoring therapy, but unfortunately mental reconstruction of complex three-dimensional anatomical structures from conventional tomography is very difficult. This article describes a process by which automated analysis of the regions of interest in the computed tomographic (CT) images yields the contours of the surfaces which can be presented pseudo-three-dimensionally using Phong's lighting model and Gouraud's shading methods. Three applications in the areas of orthopedics and neurosurgery demonstrate the efficacy of the method.
-
Arch Orthop Trauma Surg · Jan 1990
Femoral shaft perforation at arthroplasty: to treat or not to treat.
Femoral shaft perforation at total hip arthroplasty is a complication that is being noted more frequently, and it is often associated with femoral shaft fracture below the prosthesis. This study examines the anatomic and biomechanical effects of femoral shaft perforation at arthroplasty, and the effects of supporting the perforated bone with Partridge plates and bands. ⋯ Testing the bone models to failure in tensile mode showed that the perforations weakened the bone and that the Partridge plates and bands decreased the weakening effects of the perforation. The strengthening effect of the Partridge plates and bands on the bone with a perforation, allied with the presence of an internal splint in the event of a fracture through the perforation, suggests the benefit of using Partridge plates and bands if a cortical perforation is found at arthroplasty and revision is not feasible.