Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1993
Comparative StudyQuantitative stress radiography for diagnosis of anterior cruciate ligament deficiency. Comparison between manual and instrumental techniques and between methods with knee flexed at 20 degrees and at 90 degrees.
A portable stress-applying device for stress radiography was developed for daily clinical use. Using this device, stress radiography for the diagnosis of the anterior cruciate ligament (ACL) deficiency was performed with the knee flexed at 20 degrees and at 90 degrees. A 100-N force was chosen as a standardized stress. ⋯ When stress radiography with the knee flexed at 20 degrees and that at 90 degrees were compared, the former was more reliable than the latter. As the manual technique is compromised by a lack of standardization in applied force, a mechanical device is required in quantitative stress radiography. The reliability of stress radiography with the knee flexed at 20 degrees is considered high enough to warrant dispensing with further stress radiography with the knee flexed at 90 degrees for diagnosing ACL deficiency.
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Arch Orthop Trauma Surg · Jan 1993
Case ReportsPubic-type dislocation of the hip combined with fracture of the ipsilateral greater trochanter. A case report.
Traumatic anterior dislocation of the hip is a relatively uncommon injury, and when it does occur it is frequently combined with osteochondral fracture of the femoral head or the acetabulum. Anterior dislocation of the hip with an associated fracture of the ipsilateral greater trochanter is extremely rare. This paper presents a case of this rare type of injury and clarifies the mechanism of the injury using a cadaver specimen.
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Arch Orthop Trauma Surg · Jan 1993
Pathogenesis and prophylaxis of circulatory reactions during total hip replacement.
Circulatory reactions such as a drop in blood pressure, bradycardia, cardiac arrest, and even intraoperative death after insertion of the stem are well known events during total hip replacement. The present paper reports bone marrow intravasation after rise of intramedullary pressure in the femoral cavity during insertion of hip prostheses, demonstrated by intraoperative transesophageal echocardiography. In an animal study, the ultrasound echoes were identified as "mixed emboli" consisting of a core of bone marrow surrounded by thrombus. ⋯ In the second series, the drop in blood pressure did not occur. In conclusion, it was demonstrated that effective venting of the bone marrow cavity by a bore hole, and avoidance of compression of the bone-marrow-filled distal femoral cavity by using a plug, results in effective prevention of circulatory reactions: no drop in blood pressure occurred. The use of an intramedullary plug is discussed and recommended.
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Arch Orthop Trauma Surg · Jan 1993
Clodronate increases the calcium content in fracture callus. An experimental study in rats.
Eighty-eight rats underwent intramedullary pin fixation and fracture of both tibiae. Half of the animals were given clodronate 50 mg/kg s.c. weekly. Clodronate treatment did not affect the growth of fibrocartilage or the endochondral and membranous new bone formation. ⋯ Calluses were remodeled to lamellar bone in both groups. However, although the total area invaded by mineralized tissue in callus remained unaffected by the drug, the areas of hematopoietic bone marrow tissue within mineralized callus were observed to be markedly smaller in clodronate-treated animals than in controls. The calluses in the clodronate group were significantly heavier and contained more calcium at 2 months after fracture than those in the controls.
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Arch Orthop Trauma Surg · Jan 1993
Irreducible isolated dislocation of the radial head in a skeletally mature teenager. A case report.
Isolated dislocation of the radial head is an uncommon injury. This injury has been reported in children; in the skeletally mature it is extremely rare. An irreducible dislocation has been previously reported in a young child, but no case has to date been reported in an adult. The present case is reported to demonstrate this rare injury and to suggest a possible explanation for the cause of the irreducibility.