Archives of orthopaedic and trauma surgery
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The growing propagation of hip-joint sonography and its increasing use as a screening method make it important to point out some potential mistakes. Good image quality, three-dimensional evaluation with real-time technique, consideration of form variants, correct estimation of angle parameters, consideration of medical history, and clinical evaluation as well as the necessity of follow-up examinations are inevitable requirements for reliable diagnostic sonography of the hip joint.
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Kienböck's disease with onset after 50 years of age was studied. Of 127 patients with Kineböck's disease seen over the past 30 years, the cases of 15 (12 female, 3 male) were analyzed. The average age of onset was 58.3 years. ⋯ Moreover, it was noteworthy that the variance among aged controls (group C) was higher than among the young controls (group D). The metacarpal index of the patients with aged-onset Kienböck's disease was markedly lower than that of the young. Considering the increase of ulnar variance with age, the persistence of minus variance and the presence of osteoporosis might make the lunate bone susceptible to injury.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsTreatment of an old infection in a total hip replacement with an interim spacer prosthesis.
When treating a septic hip-joint prosthesis with bone loss of the proximal femur secondary to osteomyelitis, we implanted a specially designed prosthesis to act as a local antibiotic and spacer between the acetabulum and femur until the infection abated. Arthroplasty could then be carried out with no trouble and there was no recurrence of infection.
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Arch Orthop Trauma Surg · Jan 1990
Traumatic soft-tissue defects of the extremities. Implications and treatment guidelines.
The presence of traumatic soft-tissue defects in the extremity indicates serious damage that may compromise the systems of motion, circulation or sensibility and therefore jeopardize functional rehabilitation. This overview highlights the significance and the various causes of soft-tissue defects, of which several types may be distinguished. Principles for the selection of various flap procedures are outlined, in accordance with the need for elevation and early motion therapy. The requirements placed on flap tissue are described, such as surface characteristics, ability to restore sensibility, cosmesis, capacity to fill voids in the depth of defects and revascularization of adjacent areas.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsA case of hip osteoarthrosis contaminated by fungi. A histological study.
A pathological study of a surgical specimen of hip osteoarthrosis presenting a superficial fungal infection (presumably Aspergillus) without any known origin is reported. Fungal penetration was mild in cartilage and fibrocartilage and more pronounced in naked cancellous bone, but it did not occur in eburnated bone or in the deep osteomedullar area. This observation indicates an unusual combination of infection and osteoarthrosis. Relationships between fungi and bone or cartilage as well as interaction between osteoarthrotic remodeling and a superimposed disease are discussed.