Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1992
Case ReportsUse of a posterior calf fasciocutaneous flap with distal pedicle to reconstruct a huge ankle defect.
A distally based posterior calf fasciocutaneous flap was successfully used to reconstruct a major ankle defect with exposed bones and joints. The flap, which reaches easily this region, can also be used as a free flap for coverage of heel and ankle when the forefoot is not involved in the injury.
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Arch Orthop Trauma Surg · Jan 1992
The modified Mayo procedure combined with basal valgus osteotomy of the first metatarsal for severe hallux valgus.
The modified Mayo procedure corrects valgus deformity of the great toe secondary to osteoarthritis in the first metatarsophalangeal joint. Basal osteotomy of the first metatarsal to correct metatarsus primus varus and to maintain correction of the valgus deformity may be performed simultaneously. We retrospectively reviewed the results in 55 of 70 feet treated by this combined procedure. ⋯ The results were either very good or good in 82%, moderate in 14%, and poor in 4%. Our technique of basal osteotomy of the first metatarsal is a simple and effective procedure to correct metatarsus primus varus and may restore the distal transverse arch. It should be considered as a possible method of treatment when the intermetatarsal angle is greater than 10 degrees.
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Arch Orthop Trauma Surg · Jan 1992
Physiopathology of the knee joint after distal iliotibial band transfer.
In an experimental study of 14 cadaver knee joints, the pressure load on the joint surface after distal iliotibial band transfer was measured using Fuji Prescale foils. With an intact anterior cruciate ligament, increases of up to 153% for the average pressure load and of 225% for the total pressure in the lateral compartment were found in relation to the fixation point chosen. At point P3--slightly dorsal to the insertion of the lateral collateral ligament--the area loaded with maximum pressure increased to six-fold. ⋯ After transection of the anterior cruciate ligament and iliotibial band transfer at the "over-the-top" point, a significant shift of pressure towards the medial compartment was seen, while the lateral pressure load decreased. Medially, the area loaded with peak pressure remained constant, while the corresponding area in the lateral joint space showed a highly significant decrease to nearly one-third of normal. After additional bilateral meniscectomy this tendency was even more pronounced.(ABSTRACT TRUNCATED AT 250 WORDS)
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Arch Orthop Trauma Surg · Jan 1992
Radiographic assessment of cup migration in bipolar hip arthroplasty: intra-observer and interobserver errors and tolerance limits.
Statistical methods were used to calculate the possible observer error in measuring cup migration in bipolar hip arthroplasty from follow-up radiographs. Finding the "tolerance limits" by such methods helped in assigning the true significance of any observed change.
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The muscles and tendons of the rotator cuff of 37 fixed cadaver shoulder joints were dissected. In ten shoulder joints devoid of gross pathological lesions it was found that the supraspinatus muscle was inserted at two points--mainly into the major tubercle and partly into the lesser tubercle of the humerus. In one case of six, an additional insertion clearly occurred in a shoulder joint with rotator cuff tear.