Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1990
New aspects of lumbar disc disease. MR imaging and histological findings.
Magnetic resonance imaging (MRI) and plain X-ray and CT studies were performed in patients with a history of lumbar back pain due to spinal disc disease. Spin-echo pulse sequences (SE), phase-contrast techniques (partial saturation sequences with delayed readout, PS), and fat-suppressing inversion recovery sequences (STIR) were employed. In 74 of 325 patients, PS and STIR images displayed vertebral marrow changes adjacent to the end-plates of the affected segments. ⋯ In six patients histological diagnosis showed substitution of hematopoietic marrow by fatty tissue, cartilaginous particles, degeneration of fat cells, and an increase in extracellular fluid with different components. The etiology is still unclear, but a correlation with lumbar disc disease is demonstrated. These vertebral marrow changes were best displayed with STIR and phase-contrast MR sequences, both providing contrast changes superior to T2-weighted SE techniques.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsArterial lesions in major knee trauma: pedal pulse a false sign of security?
In major knee trauma fractures and/or dislocations can be associated with arterial lesions. Two case reports demonstrate the difficulties in the diagnosis of intimal lesions in the popliteal artery. ⋯ The importance of prompt diagnosis and treatment is emphasized. The use of arteriography is discussed.
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Arthrography of the wrist joint as a dynamic examination aids in confirming lesions of interosseous ligaments of the triangular fibrocartilage complex and soft tissue. The results of arthrography in 185 wrists, classified according to age of patients and pathological disorders with or without trauma demonstrate mostly post-traumatic discus lesions in younger patients. ⋯ Pathological changes of biomechanics of the hand and wrist are noticed more often and consequently are treated surgically. Arthrography of the wrist joint is a valuable means of diagnostic imaging.
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Arch Orthop Trauma Surg · Jan 1990
Comparative StudyAutomated percutaneous lumbar discectomy with and without chymopapain pretreatment versus non-automated discoscopy-monitored percutaneous lumbar discectomy. An experimental study in human cadaver spines.
Percutaneous lumbar discectomy has gained growing interest during recent years as an alternative to open surgery for protrusions and non-sequestrated subligamentous intervertebral disc herniations. As a less invasive method it competes with chemonucleolysis. At least two modifications are known to date: automated percutaneous lumbar discectomy (APLD) with a 2-mm suction probe and non-automated, discoscopy-monitored percutaneous lumbar discectomy with a suction rongeur and a motor-driven shaver (NAPLD). ⋯ By contrast, the rongeur, which first cuts the material to be removed and then carries it away by suction, was much more effective. Further data to support the advantages of non-automated percutaneous nucleotomy are discussed. Pretreatment of the disc with chymopapain did not result in a higher yield of nucleus material when combined with APLD.
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Arch Orthop Trauma Surg · Jan 1990
Comparative StudyThe APS knee joint prosthesis. A review of 32 patients.
First clinical and radiographic results with a new knee joint prosthesis, implanted without cement, are reported and the characteristics of the implant (dowel fixation and special instrumentation) presented. The first series of 35 joints with a follow-up period of 1-3 years shows excellent results. ⋯ If these two conditions are met, there is every probability of successful implantation. No problems specific to the implant have been encountered.