Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1992
Epiphyseal chondroblastoma of bone. Long-term effects on skeletal growth and articular function in 15 cases treated surgically.
The authors describe the long-term sequelae of chondroblastoma in 15 patients with open growth plates, whose age at operation ranged from 8 to 15 years. At follow-up, the youngest patient was 21 and the oldest 48 years old. Upper limb length discrepancy ranging from 2 cm to 10 cm was present in the four patients who had a proximal humeral epiphyseal location; in three of them, the range of motion of the shoulder was also limited and X-rays showed marked irregularities of the humeral head. ⋯ One patient with proximal tibial epiphyseal involvement also had mild genu valgum. Radiographic osteoarthritis was present only in the trapeziometacarpal joint of a patient in whom the first metacarpal bone affected by the tumor was replaced by a free fibular graft. The abnormalities observed did not cause important functional loss in either the everyday or the working activities of any of our patients.
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In the pelvic region three major compartments (gluteus medius-minimus compartment, gluteus maximus compartment, and iliopsoas compartment) can be distinguished from the smaller compartment of the tensor fasciae latae muscle. Pelvic compartment syndromes are rare. A clear history of trauma is often lacking. ⋯ The mean follow-up of the four other patients was 29 months (7-48 months). Three of these four patients revealed a decrease of gluteal muscle volume. Ergometric tests showed a decrease in gluteal muscle force in all patients.
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Arch Orthop Trauma Surg · Jan 1992
Types I and III procollagen extension peptides in serum respond to fracture in humans.
Markers of types I and III collagen turnover were measured in serial blood samples in 16 patients with a Colles' fracture. The collagen markers were the carboxy-terminal extension peptide of type I procollagen (PICP) and the amino-terminal extension peptide of type III procollagen (PIIINP). Significant increases were found of PIIINP within 1 week and of PICP within 2 weeks. ⋯ Osteocalcin, a serum marker of osteoblast activity, increased within 1 week and levelled off after 9 months. Correlations between the change in osteocalcin and those in PICP and PIIINP, respectively, were weak. These new biochemical markers may prove relevant as non-invasive markers of normal and pathological fracture healing in humans.
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Arch Orthop Trauma Surg · Jan 1992
Case ReportsAn unusual stress fracture of the fibula in a long-distance runner.
A stress fracture of the proximal fibula in a young long-distance runner is reported. Such fractures are rare. The literature is reviewed and diagnosis and treatment are discussed.
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Arch Orthop Trauma Surg · Jan 1992
The natural course of osteoarthritis of the hip due to subluxation or acetabular dysplasia.
In 59 patients, 86 hips with subluxation or hip dysplasia were examined to determine the natural course of the condition and select suitable treatment. Thirty-three percent of the joints (13/39 hips) developed early osteoarthritis from pre-osteoarthritis within an average term of 9.2 years, while the remaining, sixty-six percent (31/47 hips) developed advanced-stage osteoarthritis from early osteoarthritis within an average term of 7.8 years. ⋯ In pre-osteoarthritis, centre-edge angle, slope of the acetabular roof, acetabular head index, acetabular depth ratio and Japanese Orthopaedic Association (JOA) hip score were significant predictors, while in early osteoarthritis, a broken Shenton's line, cranial joint space and JOA score were significant. On the basis of multiple parameters, formulas for predicting development in patients with pre-osteoarthritis, those with early osteoarthritis, and all patients together were established, with an accuracy of 87%, 71%, and 68%, respectively.