Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1991
Biomechanical analysis of the dynamic hip screw in the treatment of intertrochanteric fractures.
A prospective study was performed in 148 elderly patients (over 60 years old) whose intertrochanteric fractures were caused by moderate trauma. The patients were treated with dynamic hip screws and followed up for at least 2 years (average 34 months). The lag screw was placed as the biomechanical analysis favored. ⋯ The authors conclude that a lag screw should ideally be placed inferiorly toward the medial margin in the frontal plane and centrally in the sagittal plane. The length of the lag screw should be such as to extend from 1.0 cm beneath the subchondral bone to the lateral femoral cortex. At least four cortical screws (piercing the cortex at eight points) should be inserted on the distal femoral fragment.
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Arch Orthop Trauma Surg · Jan 1991
Cementless Gustilo-Kyle and BIAS total hip arthroplasty: 2- to 5-year results.
We conducted extensive radiographic and clinical examination of 58 cementless total hip arthroplasties. Forty BIAS femoral stems had heads made of Co-base F 75 alloy and 18 Gustilo-Kyle femoral stems had Ti6A14V alloy heads. The cross-sectional geometry and location of the porous coating pads of the two stem types was identical, the BIAS component being slightly shorter. ⋯ All unstable components which did not suffer intraoperative fracture had also acetabular wear of more than 1 mm. The only case with endosteal erosion was seen in a patient with an unstable implant displaying the most extensive wear. Nonparametric statistical analysis showed that the patients with Ti6A14V/polyethylene bearing surfaces had a statistically significantly higher extent of wear and a statistically significant higher incidence of femoral component loosening than patients with CrCoMo/polyethylene bearing surfaces.
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Arch Orthop Trauma Surg · Jan 1991
Case ReportsMaffucci's syndrome combined with dedifferentiated chondrosarcoma.
We report a rare case of Maffucci's syndrome combined with dedifferentiated chondrosarcoma in the right shoulder girdle developing from pre-existing enchondroma. In this case, magnetic resonance imaging was useful in diagnosing dedifferentiated chondrosarcoma before surgery. ⋯ Further, the dedifferentiated tumor had three mesenchymal elements: osteosarcoma, malignant fibrous histiocytoma, and fibrosarcoma. This histological heterogenicity may be due to mesodermal dysplasia of Maffucci's syndrome.
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Arch Orthop Trauma Surg · Jan 1991
Long-term results after implantation of McKee-Farrar total hip prostheses.
From 1973 to 1976, McKee-Farrar total hip arthroplasties were performed in the Orthopaedics Department at the Centre of Pulmology. In the present study, only patients with a complete record of radiological changes at the bone/implant or bone/cement interface were evaluated. ⋯ The design of the metal cup with metal studs at the outer surface has a favourable effect on the stability of the implant/cement combination: loosening at the implant/cement interface did not occur in any of these cases and there were few cement fractures. In spite of the metal-to-metal combination, abrasion is slight and there is no danger of metallosis.