Archives of orthopaedic and trauma surgery
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In view of the increased numbers of vertebrogenic complaints in society today, the authors investigated the clinical and morphological relations involved in these conditions. Histological techniques and the scanning electron microscope were used to examine the different structures of the spine under conditions of tensile overload. ⋯ The authors found that the insertion of collagen fibres in cartilage or bone in the regions overloaded by tensile forces is identical to that found in epicondylitis in other locations. Such enthesopathies in the spinal region may form a major component of back pain states, and special therapy should be employed for them.
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Arch Orthop Trauma Surg · Jan 1991
Reconstruction of the anterior cruciate ligament alone in the treatment of a combined instability with complete rupture of the medial collateral ligament. A prospective study.
In a prospective study, 14 patients with a complete rupture of both the anterior cruciate ligament (ACL) and the medial collateral ligament (MCL) were treated by reconstruction of the ACL alone. The torn MCL was not addressed. The initial instability was documented clinically and by stress radiographs (20 kp) taken under anaesthesia. ⋯ Follow-up examination at an average of 14 months demonstrated excellent results in 11 cases, good in 2 cases, and fair in 1 case. With the exception of one residual anterior tibial translation of 8 mm, all knees showed almost normal stability in the frontal and sagittal plane, with full range of motion. These result confirm that ACL reconstruction utilizing the patellar tendon alone is sufficient in the treatment of combined instability due to ACL and MCL injuries.
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Arch Orthop Trauma Surg · Jan 1991
Case ReportsTibia valga after fracture: documentation of mechanism.
Tibia valga following fracture in the proximal metaphysis of the tibia in children was previously attributed to various mechanisms. This case report offers an additional explanation based on bone scintigraphy 10 months after injury. Decreased radionuclide uptake at the lateral proximal tibial physis without evidence of increased uptake on the medial side suggests that a Salter type V injury to the lateral growth plate can occur in conjunction with a medial metaphyseal fracture, resulting in the development of tibia valga.
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An extremely rare case of giant cell tumour of the proximal end of the ulna, which was clinically aggressive but histologically benign, is reported in a 28-year-old man. The tumor was excised in en bloc but patient died 8 months after surgery. To the best of our knowledge, this is the first reported case from South East Asia and the second available in the English-language literature. It therefore warrants report.
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Arch Orthop Trauma Surg · Jan 1991
Anterior ankle pain in sports medicine: aetiology and indications for arthroscopy.
Persistent pain and swelling in the anterior part of the upper ankle are encountered very frequently in sports traumatology. Classically, in the patient with a long history of typical anterior ankle pain there is no instability, but pinching effects, a sense of impingement, blocking and a feeling of unsteadiness combined with a certain restriction of movement due to the pathology. By analogy with the anatomical structures, various pathologic changes can lead to the classic clinical symptoms: adhesions, cicatrices, meniscoid-type lesions, osteophytes with synovitis, folds, fibrotic subcutaneous fatty tissue, free arthroliths, osteochondral lesions and arthrotic changes. ⋯ Arthroscopic interventions were carried out in a total of 21 patients, with follow-up times between 6 and 36 months. About two-thirds of all the patients showed good or very good results, while in one-third the results were unsatisfactory, mainly because of degenerative changes. An precise diagnosis is essential, but the significance of a pathologic change as the cause of symptoms can be problematical.