Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Jan 1990
Comparative StudyBlood levels of active metabolites of vitamin D3 in fracture repair in humans. A preliminary report.
Blood levels of the active metabolites of vitamin D3, 25-hydroxycholecalciferol [25(OH)D3], 1,25-dihydroxycholecalciferol [1,25(OH)2D3] and 24,25-dihydroxycholecalciferol [24,25(OH)2D3] were determined in seven patients. Two subjects suffered from delayed union of tibial fractures; one showed a delayed union after a proximal tibial osteotomy; one patient suffered from bilateral femoral neck fractures, of which one failed to unite and the other united late; two patients had multiple fractures that united normally; and one patient exhibited staged bilateral femoral neck fractures whose occurrence was separated by a short interval and which united without undue delay. ⋯ A decrease in 1,25(OH)2D3 levels was noted in only two patients. We postulate that these changes reflect the consumption of these metabolites during healing at the fracture site.
-
Arch Orthop Trauma Surg · Jan 1990
Biomechanics of the interlocking nail. A study of the proximal interlock.
Conventional interlocking nails for the femur use an inclined proximal interlocking screw; the AO/ASIF universal interlocking nail utilizes a transverse interlocking screw which is anchored in cortical bone. The transverse position of the screw allows one to employ the nail for either the right or left side. The yield strength of the thinner diameter transverse screw, (thread 4.5 mm. core 3.0 mm) was compared with that of the Grosse-Kempf nail oblique screw (thread 6.3 mm, core 4.5 mm) by testing in cadaver femora to evaluate the risk of fatigue failure. ⋯ Taking the highest load without plastic deformation as a criterion, the mechanical strength of the two screws was evaluated for each fracture situation. The thinner but shorter transverse interlocking screw demonstrated higher strength (4500 N vs. 3000 N; P less than or equal to 0.02) than the thicker inclined screw in the diaphyseal and the subtrochanteric fracture situation (2300 N vs. 1100 N; P less than or equal to 0.06). The biomechanical test showed the transverse screw to have sufficient and superior strength.
-
The locked or unlocked intramedullary nail is considered today in most institutions the first choice for stabilisation of the majority of closed diaphyseal fractures of the femur and tibia. In 1st and 2nd degree open fractures of the tibia, the unreamed locked nail may perhaps become the preferred implant. ⋯ The plate and external fixator will remain indicated in most fractures with meta- and epiphyseal extension as well as in situations in which the intraoperative fluoroscopy is not available. Our experience with the new AO universal femur and tibia nails are being reported.
-
Arch Orthop Trauma Surg · Jan 1990
Case ReportsTibial hypo-/aplasia with preaxial syn- and polydactyly.
Tibial hypo-/aplasia with preaxial syn- and polydactyly is a rare autosomal dominant condition. Fewer than 20 cases have so far been described. One is presented here.
-
Arch Orthop Trauma Surg · Jan 1990
Ultrasonographic detection of foreign bodies in soft tissue. A human cadaver study.
The usefulness of ultrasound in the detection of foreign bodies was examined in a blind study in human cadavers using glass, plastic and wood as foreign bodies. Of 65 foreign bodies placed in 102 cicatrices, 58 were found using a 5 MHz transducer. The sensitivity was 89% and the specificity 93% making ultrasound a useful clinical tool for this purpose.