Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1999
Large-dose ascorbic acid administration suppresses the development of arthritis in adjuvant-infected rats.
We performed animal experiments to test the hypothesis that active oxygen species (AOS) play a major role in adjuvant-induced arthritis in rats and to determine whether large-dose ascorbic acid administration would suppress the development of arthritis, reducing the level of damaging AOS in the same animal model. Arthritis was induced in male Lewis rats by adjuvant injection into the base of the tail. Ascorbic acid at doses of 0.5, 1.0, and 2.0 g/kg body weight (BW) was injected intraperitoneally twice each week for 3 weeks (9 rats per group). ⋯ The increases in SOD activities produced by the adjuvant injection were significantly reduced in both the synovium and the RBC at ascorbic acid doses of 1.0 and 2.0 g/kg BW. In conclusion, large-dose ascorbic acid administration reduced the increases in hind paw inflammatory edema, arthritis in the extremities, and infiltration of the inflammatory cells into the synovial tissue in the adjuvant-induced arthritis rats. Since these anti-arthritic effects were associated with a decrease in SOD activities in both the synovium and RBC, the decrease in SOD activity could be one of the mechanisms underlying the suppressive effects of large-dose ascorbic acid on the development of arthritis in this animal model, inhibiting the damaging AOS.
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Arch Orthop Trauma Surg · Jan 1999
Self-locking tension band technique. A new perspective in tension band wiring.
After experiencing some complications with the AO modified tension band technique, we have made a small modification to prevent proximal migration of the Kirschner wires. In this modification, the proximal ends of the wires are bent to form a loop and the cerclage wire passed through them. In this way, Kirschner wires and cerclage wire lock each other, preventing migration. ⋯ Fracture union occurred in 8 weeks (mean). We did not see any postoperative complications or implant failures. Rigid fixation allows early mobilization which quickly restores functional status.
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From January 1992 to May 1997, 46 distal humeral fractures were treated by open reduction and internal fixation. Among these, 30 were intra-articular, which were managed by the transolecranal approach, routine ulnar nerve transposition, 3.5-mm dual-plate fixation and early active mobilisation. We encountered 2% non-union, 2.2% fixation failure, 11.1% nerve complications, 28.2% overall heterotopic ossification and 11.1% poor range-of-motion rates.
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Arch Orthop Trauma Surg · Jan 1999
Weight-based heparin dosing is more effective in the treatment of postoperative deep vein thrombosis.
Rapid clinical diagnosis and adequate treatment are the major determinants of successful therapy of deep vein thrombosis (DVT). In the initial treatment of DVT, heparin is the anticoagulant of choice. Appropriate heparin dosing is of major interest concerning the onset of therapeutic anticoagulation and, thus, the clinical outcome of the patients. ⋯ In group one (patients treated with the weight-based heparin nomogram) the therapeutic range (partial thromboplastin time 1.5-2.3 times the control) was reached on average within 24 h (75% of the patients); 95% of the patients reached the therapeutic range within 48 h. In group two (patients treated with the standard heparin nomogram) the therapeutic range was reached on average within 48 h (60%; 30% of the patients reached the therapeutic range within 24 h). The used weight-based heparin nomogram has proved to be effective, safe and superior to one based on standard practice concerning the time elapsed between initial heparin therapy and achieving the therapeutic range for intravenous anticoagulation.
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Arch Orthop Trauma Surg · Jan 1999
Dynamic neutralisation of the lumbar spine confirmed on a new lumbar spine simulator in vitro.
A new dynamic neutralisation system for lumbar spine segments has been developed and tested on four cadaveric lumbar spines. Segments L4/5 (3 cases) and L3/4 (1 case) were tested on a new lumbar spine simulator which allowed the simultaneous application of bending moments, compressive and shear loads. The average applied loads were 18.3 Nm flexion moment, 2296 N compressive and 458 N anterior shear load for flexion, and 12.5 Nm extension moment, 667 N compressive and 74 N posterior shear load for extension. ⋯ The endplate centres as well as the centre of the screw heads were taken as reference points, identified by orthogonally taken radiographs. The dynamic neutralisation system described reduces bending angles and horizontal translations, but it expands vertical translations. The bulging of the posterior annulus is also reduced.