Archives of orthopaedic and trauma surgery
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Man-made bone implant materials as substitutes for autogenic spongiosa transplantation are reviewed, specifically materials made from collagen. The intra- and extracellular biosynthesis of collagen is described. Manufacture, properties and indications of sterile Collagen-fleece, a well proven surgical biomaterial prepared from porcine collagen, is presented. Further research led to the development of a new bone-replacement material called Collapat.
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Arch Orthop Trauma Surg · Jan 1992
Randomized Controlled Trial Multicenter Study Clinical TrialPrevention of deep vein thrombosis with low molecular-weight heparin in patients undergoing total hip replacement. A randomized trial. The German Hip Arthroplasty Trial (GHAT) Group.
In a double-blind, randomized multicentre trial, the efficacy and safety of two regimens for the prevention of postoperative venous thrombo-embolism, low-molecular-weight heparin (LMWH) CY 216 and unfractionated heparin (UH), were compared in 341 patients undergoing elective total hip replacement. A group of 169 patients received one subcutaneous injection of 48 mg (approximately 10,000 anti-Xa IC units) LMWH and two placebo injections per day and 172 patients received a fixed dose of 5000 IU UH t.i.d. Deep vein thrombosis was assessed by bilateral phlebography on day 14 +/- 1 after surgery. ⋯ The safety of the treatments, as assessed by the incidence of major haemorrhage, intra- and postoperative blood loss, transfusion requirements, haemoglobin drop and frequency of wound haematomata, was similar in the two groups. It is concluded that prophylaxis of postoperative thrombo-embolism in hip surgery with one subcutaneous injection (48 mg) of LMWH CY 216 is as effective and as safe as prevention with fixed low-dose heparin (5000 IU t.i.d.). A tendency to reduced rates of pulmonary embolism (3.6% vs. 1.2%) and proximal deep vein thrombosis (19% vs. 10.3%) was observed in favour of LMWH CY 216.
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Arch Orthop Trauma Surg · Jan 1992
Randomized Controlled Trial Clinical TrialSlotted versus non-slotted locked intramedullary nailing for femoral shaft fractures.
Experimentally, two slotted nails, the Grosse-Kempf nail and the AO/ASIF universal femoral nail, were compared to the non-slotted Grosse-Kempf nail and control bone using a cadaver femoral osteotomy. The stiffnesses and strengths of the osteotomies fixed with slotted nails in 10-30 degrees torsion were 6-8% and the values of non-slotted nails 40% of control bone. The maximal moments were 14-18% and 48%, respectively. ⋯ Four complications in the slotted nail group and three in the non-slotted nail group were considered to be independent of the choice of nail and did not affect the end result. Three splinterings of the distal fragment, one resulting in a change of the osteosynthesis implant to a condylar plate, were considered to result from the high stiffness of the non-slotted nail. Osteosynthesis of femoral shaft fractures using slotted nails has not resulted in healing disturbances, which could be accounted for by the high torsional elasticity of the nail; there seems to be no indication for high-stiffness nails in femoral fractures.
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Arch Orthop Trauma Surg · Jan 1992
Three- to five-year results with the cementless Harris-Galante acetabular component used in hybrid total hip arthroplasty.
In this paper we present our 3- to 5-year results after hybrid total hip replacement using the cementless porous coated Harris-Galante acetabular component and the cemented Griss femoral component in 39 patients with 40 implantations. Postoperatively, mild to moderate pain was experienced by 16.1% of patients, mostly following hard activity. A slight to moderate limp occurred in 24.2%. ⋯ The postoperative range of motion was increased in 93.9%. Radiographically, none of the acetabular or femoral components had to be classified as unstable. Only one acetabular component displayed complete (i.e., along all interface zones) radiolucency and was therefore classified as possibly unstable.
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Arch Orthop Trauma Surg · Jan 1992
Case ReportsTraumatic hemipelvectomy. A case report and comments on associated injuries.
The twenty-fifth reported case of survival following traumatic hemipelvectomy is presented. Our patient is the fourth female survivor and the second who escaped associated injuries to either the genito-urinary system or the rectum.