Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1990
Review Case ReportsOsteochondritis dissecans of the lateral tibial condyle. Report of a new case and review of the literature.
Osteochondritis dissecans (OD) of the lateral tibial condyle is a rare condition. A review of the literature revealed only nine cases in seven patients. We report about a new case. ⋯ Our case supports this theory. Although comparative roentgenograms of the left knee, taken because of complaints in the right one, were interpreted to be normal, retrospective analysis clearly revealed the lateral intercondylar eminence of the left knee to have been irregular many years before the onset of symptoms. Association with a classical OD in the contralateral knee is striking in most of the reported cases.
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The load axis of the curved proximal femur lies not inside but outside the bone. Therefore, high bending forces are acting, the medial cortex absorbing pressure and the lateral cortex absorbs tension. ⋯ This dilemma is compensated by a wave plate with bone graft: the compression forces are redirected to the lateral cortex, and the plate is again subjected to tension. Furthermore, since the plate stands away from the bone, it does not disturb the blood supply at the fracture site and thus bone healing.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsCorrection of clubfoot relapse using Ilizarov's apparatus in children 8-15 years old.
Treatment of relapsed or neglected clubfeet between the age of 8-15 years is at present unsatisfactory. Correction by triple arthrodesis with wedge osteotomies is not possible before the end of skeletal maturation. This caused us to use Ilizarov's external fixator, which made it possible to correct all components of clubfoot simultaneously by continuous guided distraction. ⋯ A plantigrade foot was achieved in all cases. All patients were able to wear ready-made shoes. Complications were some slight and two severe pin track infections, temporary edema, and two relapses successfully treated by means of second procedures.
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According to one principle of surgery, the transplantation of vital tissue is the best method of reconstructing a defect. Because of absent immunologic reactions, high osteogenic potency, and preserved stability, transplantation of autogenous bone shows the best results. Necrosis of transplanted bone, leading inevitably to absorption and remodeling of the graft, can be avoided if microsurgically vascularized autogenous bone segments are transferred. ⋯ Demineralized bone matrix can be used if biomechanical stability is not required. Its ability to induce osteogenesis without a major immune reaction or the risk of transmitting diseases justifies its clinical application. Further intensive research in these areas is unavoidable.
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Arch Orthop Trauma Surg · Jan 1990
Comparative StudyBone formation in porous implants of delrin and commercially pure titanium.
Clinicians have been using implants made by titanium or delrin with varying results. In this study dividable implants, bone growth chambers (BGC), of titanium and delrin were inserted into the rabbit tibia. ⋯ Results showed that bone ingrowth into titanium implants was significantly larger than into delrin implants (P less than 0.005). The possible reasons for this are discussed.