Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1990
The value of intramedullary reaming in the treatment of chronic osteomyelitis of long bones.
Between 1985 and 1990 25 patients with chronic osteomyelitis (osteitis) of long bones were treated by intramedullary reaming. In most cases the aetiology of the osteomyelitis was posttraumatic. 22 of these patients who had undergone intramedullary reaming at least 6 months ago were evaluated. ⋯ One patient produced a little extraosseous sequestrum 3 months after the operation but since then has had no recurrence. The purpose of this study is to propose intramedullary reaming as an excellent treatment for chronic osteomyelitis of long bones and show the pathophysiological background that led to this modality.
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Arch Orthop Trauma Surg · Jan 1990
Comparative StudySignificance of postoperative stability for bony reparation of comminuted fractures. An experimental study.
The significance of postoperative mechanical stability to bone repair of comminuted fractures was investigated in an animal experimental study comparing four commonly employed operative methods of fracture stabilization: 1. Plate osteosynthesis combined with lag screw fixation; 2. Bridging plate osteosynthesis; 3. ⋯ As fracture model, a triple wedge osteotomy of the right sheep tibia was used. In regard to biomechanical strength, the method which gave best postoperative stability, plate osteosynthesis in combination with interfragmentary lag screws, did not result in the best bone repair. In this experimental setup, stabilization by bridging methods, inducing bone healing by secondary intention, gave better bone regeneration in the experimental fractures.
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Arch Orthop Trauma Surg · Jan 1990
Clinical TrialLimb lengthening and three-dimensional deformity corrections. A retrospective clinical study.
Different methods of limb lengthening as used at the Orthopedic Surgery Clinic of the Medical School, University of Zagreb, are compared. The results of operations performed between 1979 and 1989 on 111 patients are presented. These patients were subjected to surgery aimed at length equalization of limbs and/or correction of three-dimensional deformities. ⋯ These advantages manifest themselves in a reduced number of operations, lower incidence of infection and improved bone regeneration. It is preferable to perform corticotomy at the metaphysis site because of its optimum blood supply and its higher potential for osteogenesis. With corticotomy performed at the diaphysis site, satisfactory results were observed in only one-third of the cases.
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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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Temporary impairment of blood supply has been suggested to cause bone remodeling. The degradation of cells and matrix and the attraction of resorbing cells were examined in this study. ⋯ Both supernatant from the aged bone specimens and ground bone particles exhibited significant chemotactic activity that was specifically attracting monocytes. It is suggested that soluble bone matrix proteins or degeneration products liberated during ischemic damage to cortical bone initiate the resorptive process.