Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1991
An analysis of the results of transferring the musculocutaneous nerve onto the median nerve in tetraplegics.
Following injuries of the cervical spinal cord at the common level with C6 neurological level sparing, abduction of the shoulder and elbow flexion remain active. The flexors of the elbow are controlled by the musculocutaneous nerve formed mainly from C5 and C6 fibers, the motor cells of which are usually located above the level of the spinal lesion. ⋯ In 32 patients this has restored simple grasping function of the hand, increasing the patients' independence. The operation is particularly indicated in cases of complete lesion of the spinal cord at the C6-C7 level in young people, and for best results should be performed with in the first few months after trauma.
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Back school is behavior training for the prevention and treatment of back problems arising from faulty body posture and muscular dysfunction. This paper describes the conception and evaluation of a back school program for patients with vertebral fractures. ⋯ The effectiveness of the program was measured by a knowledge test and a behavior test. The results suggest that this back school is an effective addition to conventional concept using physiotherapy exclusively.
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A Thomas splint of traditional design was fitted with measuring devices and examined for its hip-relieving effect during varying activities. It was shown that there is no complete weight relief of the hip joint with this orthosis. ⋯ In regard to the hip joint, the Thomas splint is a device that reduces weight but does not entirely remove it. The results proved to be practically independent of the fitting of the orthosis and of the kind of activity.
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Arch Orthop Trauma Surg · Jan 1991
Post-traumatic radioulnar synostosis after forearm fracture osteosynthesis.
One hundred sixty-seven forearm fractures treated with plate osteosynthesis were analyzed for synostosis occurring between the radius and the ulna. Eleven cases (6.6%) were found, in 7 of which both bones of the forearm had been fractured, while the other 4 were cases of isolated radial or ulnar fracture. Overall there were 89 cases of fracture of both bones; of the 65 cases treated utilizing the two-incision approach, cross-union was seen in only 1, while in a comparable group (12 cases) in which the fractures were stabilized using the Boyd approach, there were 5 synostoses. ⋯ Among 40 isolated radial fractures, 2 radioulnar synostoses occurred, one in an open fracture and the other after fixation via the Boyd approach. These results emphasize the importance of using two approaches for fractures of both forearm bones. The highest risk of post-osteosynthetic synostosis appears to be in fractures of the proximal third of both radius and ulna.
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Arch Orthop Trauma Surg · Jan 1991
Functional restitution after lower leg fractures. A long-term follow-up.
Twenty-five patients with fractures of the lower leg treated by closed reduction and plaster fixation were examined an average of 7 years and 8 months after trauma. The end result was assessed according to the following: (1) The patient's own opinion; (2) clinical examination including comparing range of motion in knee and ankle in the fractured and non-fractured leg, leg length discrepancy, malrotation of the injured extremity and muscle force analysis; (3) radiological examination. All fractures had healed after a mean of 13.4 weeks. ⋯ Only eight patients had remaining radiological displacement, in only one of which it was severe. The slight remaining malpositionings did not influence the final functional result. The muscle force analysis showed that fractures caused by high-energy trauma also brought permanent reduction of muscular strength to the fractured extremity.