Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1992
Training in basic microsurgical techniques without experiments involving animals.
Until recently, anaesthetised rats have been the usual material employed for learning basic microvascular and microneurosurgical techniques. However, ethical considerations, the costs involved and legislation controlling experiments with animals allow training in microsurgery for extended periods of time at a few medical centres only. This paper reports on our experience of an alternative training programme largely conducted without using live animals. ⋯ Mono-, oligo- and polyfascicular nerves, structurally similar to the configurations found in human extremities, are found in pig legs. The ever-increasing importance of microsurgery in modern medicine requires more and more surgeons and orthopaedists to familiarize themselves with these techniques. The model we propose for teaching and training substantially facilitate such further professional training in an efficient way, and at the same time allows a substantial reduction in the number of experiments conducted on animals.
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Arch Orthop Trauma Surg · Jan 1992
Relationship between the pivot shift and the configuration of the lateral tibial plateau.
Twenty patients with a chronic anterior cruciate ligament tear were studied. First they were interviewed on the preoperative history of unexpected giving way (pivot shift), then they were tested for clinical pivot shift sign, and last, the configuration of the lateral tibial plateau was studied using magnetic resonance imaging. ⋯ Interestingly, there was also a link between the instability history and the configuration of the lateral tibial plateau (P = 0.0021), and, further, between the clinical pivot shift sign and the configuration of the lateral tibial plateau (P = 0.0002). The variation in the shape of the convexity of the lateral tibial plateau seems to be associated with the symptoms and prognosis of the patients with rupture of the anterior cruciate ligament.
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Arch Orthop Trauma Surg · Jan 1992
Simple bone cysts. A review of 59 cases with special reference to their treatment.
In a retrospective study, 21 simple bone cysts (SBC) treated by curettage (with or without bone grafting) are compared to 20 SBC treated by intralesional injections of methylprednisolone. Curettage led to 43% favourable results and 29% recurrences. ⋯ In our experience, curettage and hydroxyapatite grafting led to 100% complete healing (only 2 cases). We recommend intralesional methylprednisolone injections because the method is easy, effective and safe.
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Arch Orthop Trauma Surg · Jan 1992
Case ReportsBilateral scapular fractures secondary to electrical shock.
Fractures of the scapula are rare injuries. Usually the scapula requires a high-energy impact to sustain a fracture. Various fractures have been noted as a result of convulsive seizures. We report bilateral scapular fractures caused by electric shock and discuss their pathomechanical origin.
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Arch Orthop Trauma Surg · Jan 1992
Case ReportsTraumatic scapulothoracic dissociation. A case report.
A rare case of scapulothoracic dissociation which was not diagnosed initially is reported. Vascular injuries associated with this injury are potentially life threatening. ⋯ Emergency subclavian arteriography is essential to assess the vascular status. A high index of suspicion has to be maintained so that this dangerous injury is not overlooked.