Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1990
Vascularized pedicled bone graft into the femoral head--treatment of aseptic necrosis of the femoral head.
Revitalization of the femoral head in cases of aseptic necrosis was attempted in 13 hips of 11 patients 15-33 years of age. The necrotic bone was replaced by a vascularized pedicular iliac bone graft and free cancellous transplants. The results after an average follow-up of 53 months are satisfying in some cases. The surgical technique used is simple and applicable when a vascularized bone graft is needed in the hip region.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsBilateral congenital pseudarthrosis of the clavicle.
A case of bilateral congenital pseudarthrosis of the clavicle in a baby boy is described. The patient is fully asymptomatic, and no functional impairment is present. This is probably only the seventh case described of this rare congenital anomaly.
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A case is reported of spontaneous rupture of the biceps femoris muscle, a hitherto undescribed condition. A characteristic history is discussed and a new clinical sign described.
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The spontaneous degeneration of the human rotator cuff seems to have mechanical and nutritive causes. Until now it was not known whether other species without an acromion had a vascularization of the rotator tendons which is similar to that of man. ⋯ Most important is the fact that the supraspinatus tendon shows an area of hypovascularity close to its insertion. Thus, the dog may be used for experimental purposes relating to the rotator cuff.
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Arch Orthop Trauma Surg · Jan 1990
Comparative StudyComparison between straight- and curved-stem Müller femoral prostheses. 5- to 10-year results of 545 total hip replacements.
Between 1977 and 1982, 545 cemented femoral prostheses were implanted, in combination with a noncoated cementless polyethylene acetabular component (RM cup). Three hundred and eighty-one straight-stem and 76 curved-stem Müller femoral components were implanted, as well as 88 collared components with a 130-mm stem and a 130 degrees neck-shaft angle, derived from a long-stem steel prosthesis. Survivorship analysis of revisions for aseptic loosening at 10 years revealed 97% straight-stem survival, 91.6% curved-stem survival, and 88.3% 130 degrees stem survival. "Survival" curves were also constructed for radiological loosening, and the survival rates (patients without radiological evidence of loosening) were 69.8%, 78.8%, and 63.1% respectively at 10 years. ⋯ This resulted in less calcar resorption, but there was a higher rate of stem loosening. Acetabular loosening and associated wear products appear to be responsible for calcar resorption, and stress shielding of the calcar appears to be of minor importance in the pathogenesis of aseptic stem loosening. Better cementing techniques have improved survivorship of the curved-stem prosthesis, and early fears of high rates of radiological loosening with the straight stem have not been substantiated.