Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1990
Total decompression of the spinal cord for combined ossification of posterior longitudinal ligament and yellow ligament in the thoracic spine.
One of the causes of hyperostosis in the spinal canal, ossification of the posterior longitudinal ligament (OPLL) combined with ossification of the yellow ligament (OYL) in the thoracic spine, can result in serious myelopathy, leading to sandwich-type compression of the spinal cord from anterior and posterior. For such cases we devised a treatment of total decompression of the spinal cord and intervertebral body fusion. This operation consists of two steps. ⋯ This pre-treatment makes removal of the OPLL anteriorly during the second stage much easier, faster, and safer. This operation is lengthy and demanding. However, based on our experience so far, it appears to be a promising surgical procedure.
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Arch Orthop Trauma Surg · Jan 1990
The importance of functional magnetic resonance imaging (MRI) in the planning of stabilizing operations on the cervical spine in rheumatoid patients.
Chronic inflammatory diseases, such as chronic polyarthritis or spondylarthritis ankylopoietica, can occasionally lead to vertebral instabilities of the occipitoatlantal or atlantoaxial level, requiring some form of stabilizing operation. By means of functional magnetic resonance imaging, i.e., with the cervical spine at its maximal range of flexion and extension, performed on 11 patients suffering from an instability at the above level, it was possible to demonstrate not only the extent of synovial tissue, but also how this sometimes excessive soft-tissue growth hinders an adequate reduction of the subluxated vertebrae. The importance of this investigation lies in the fact that the necessary operation can be planned appropriately. As such, three patients required a decompressing operation entailing resection of the posterior arch of the atlas, widening of the foremen magnum, or both.
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Pigmented villonodular synovitis is a benign disease of the synovial membrane of joints, tendon sheaths, or bursae, which nevertheless can cause marked local destruction. Its diagnosis is often delayed because complaints and symptoms are nonspecific. Familiarity with the disease may ensure an earlier diagnosis and consequently early onset of therapy, which may prevent serious damage. ⋯ Findings possibly suggestive of pigmented villonodular synovitis include hemarthrosis, soft tissue swelling, radiological evidence of cyst formation at a distance from the weight-bearing area of a joint, an increased triglyceride concentration, and a positive bone scan. A normal appearance on arthroscopy does not rule out the disease. Therapeutic results are better in the localized than in the diffuse form of the disease.
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Arch Orthop Trauma Surg · Jan 1990
The polymorphonuclear leukocyte: has it a role in fracture healing?
The aim of the present study was to assess whether the presence of polymorphonuclear leukocytes in the first stage of fracture repair was of any importance. In anesthetized male Wistar rats, a transverse osteotomy was performed at midshaft in one femur and immediately stabilized by an intramedullary Kirschner nail. The animals were allowed unprotected weight bearing immediately. ⋯ There were no differences in the amount of callus measured or in radiological healing. However, there was a significantly higher bending moment in femurs from animals treated with ANS than in those given NSS (P less than 0.02). No differences were observed in rigidity or total energy absorption.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsWhich X-ray views are required in juvenile ankle trauma?
Although ankle sprains are probably the most common injury in adolescent sports people, epiphyseal injuries are missed on the presumption of a ligamentous tear. The risk of damaged ligaments has been overemphasized while the potentially dangerous epiphyseolysis has been understressed. An oblique X-ray of the ankle joint is indicated prior to "stress" pictures.