Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1991
ReviewPathological fractures and lytic bone lesion of the femoral neck associated with beta 2-microglobulin amyloid deposition in long-term dialysis patients.
A correlation is demonstrated between chronic hemodialysis using cuprophane membranes (mean duration: 13 years) and pathological fractures (n = 7 in 6 patients) after lytic bone deposits of beta 2-microglobulin amyloid (n = 13 patients). The characteristic symptom complex includes painful impingement syndrome of the shoulder, carpal tunnel syndrome, painful hip and recurrent knee effusions. ⋯ Due to reduced regeneration capacity in amyloid bone lesions the resulting surgical therapy should aim at total joint replacement or augmented osteo synthesis. Definitive operative treatment should be aspired even in the absence of manifest fractures, as the natural course of the disease is characterized by progression of the bone destruction and a continuous pain syndrome.
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Arch Orthop Trauma Surg · Jan 1991
Randomized Controlled Trial Clinical TrialEffect of high-dose corticosteroids on the incidence of deep vein thrombosis after total hip replacement.
Fifty patients receiving uncemented total hip prostheses were examined by venography of the legs on the 2nd postoperative day. The patients were randomly divided into two groups, a non-steroid group (n = 26) and a steroid group (n = 24). Both groups received dextran thrombo-prophylaxis. ⋯ All patients were followed up clinically and plethysmographically up to 12 months after surgery. Distally located asymptomatic DVT were not given specific treatment. The postoperative course was uneventful except for one patient in each group who developed clinically, apparent DVT more than 3 weeks after operation, although the initial venographic studies were normal.
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Arch Orthop Trauma Surg · Jan 1991
Case ReportsMalignant fibrous histiocytoma in the course of chronic osteomyelitis.
Malignant fibrous histiocytoma (MFH) was found in the femur of a 28-year-old man who had suffered from chronic osteomyelitis. The patient had undergone surgery for a valgus knee deformity and the procedure was complicated by chronic osteomyelitis which lasted for 12 years. ⋯ The patient died 4 months later. Histopathological and immunohistochemical examinations indicated the diagnosis of MFH.
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Arch Orthop Trauma Surg · Jan 1991
Influence of immobilization on autograft healing in the knee joint. A preliminary study in a sheep knee PCL model.
The influence of immobilization on patellar tendon autograft healing was investigated in 12 sheep with replaced posterior cruciate ligaments of the knee (PCLs). In one group achillotomy immobilized the operated knee joint. In another group initial reduced weight-bearing was obtained by hanging the sheep in a special trapeze. ⋯ The best data were observed in the no-protection group. This study demonstrates the negative effect of immobilization on autograft healing in a sheep PCL model. Even early in the healing process tissue may be extremely sensitive to stress and strain.
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Arch Orthop Trauma Surg · Jan 1991
Review Case ReportsTraumatic dislocation of the hip in young children.
Traumatic dislocation of the hip joint is an uncommon injury in children. The present report on this traumatic emergency is based on the authors' own observations of three cases and a review of the literature. ⋯ The crucial therapeutic intervention to avoid this serious complication seems to be immediate, usually closed, reduction under general anaesthesia. A management protocol is presented.