Archives of orthopaedic and trauma surgery
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Multiple epiphyseal dysplasia (MED) is a relatively uncommon inherited disorder of epiphyseal maturation. Affected individuals may have a degree of short-limbed dwarfism, short stubby digits, and stiff or painful joints. We report two families of MED and emphasize the variations of joint involvement. ⋯ No apparent hip lesion was present. In family B, the hip joint was predominantly affected, followed by the knee and ankle joints, and the deformity was severer than that in family A. These observations suggest that MED is a group of heterogeneous disorders.
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The shape of the proximal segment of the femur must be taken into account when implanting femoral endoprostheses, especially those intended for cementless anchorage. Numerous femoral prostheses are available for the proximally broadly extending, "trumpet-shaped" morphology. However, the femur often has a narrow, more cylindrical configuration, as is frequently seen with dysplastic hip joints, but variants of the anatomical constitution or ethnic variants are also found. ⋯ The surgical technique is relatively straightforward, and complications are rare. The patients' subjective satisfaction is particularly remarkable. The success of the operation lies in correct preoperative planning, which ensures that the morphology of the selected femur guarantees contact between the bone cortex and the middle third of the prosthetic stem.
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The accessory navicular bone is one of the most symptomatic bones of the foot. Although it has been reported to be present in various members of the same family, there is a lack of knowledge about its inheritance in the literature. We examined three families and suggest that it has an autosomal dominant trait with incomplete penetrance.
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Arch Orthop Trauma Surg · Jan 2000
Comparative StudyManagement of the floating elbow injury in children. Simultaneous ipsilateral fractures of the elbow and forearm.
Simultaneous ipsilateral fracture of the elbow and forearm--floating elbow--is an uncommon injury. During a 7-year period we prospectively followed 12 children who presented with completely displaced supracondylar fractures of the humerus associated with a forearm fracture of the same limb. All patients underwent emergency operative reduction and percutaneous K-wire stabilisation. ⋯ Ten patients had good or excellent outcomes, and there were two fair results. The incidence of open fractures and nerve injury and the need to perform an open reduction were higher than those recorded for isolated supracondylar fractures. The floating elbow is an indicator of a high energy injury and requires aggressive operative management.
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Arch Orthop Trauma Surg · Jan 2000
Comparative StudyResults of posterior cruciate-retaining unconstrained total knee arthroplasty after proximal tibial osteotomy for osteoarthritis. A prospective cohort study.
The purpose of the study was to investigate the results of posterior cruciate ligament (PCL)-retaining total knee arthroplasty (TKA) after previous proximal closed wedge tibial osteotomy for degenerative arthritis according to the technique recommended by Coventry and Insall. Thirty-five patients with previous proximal tibial osteotomy were matched to 35 patients without previous osteotomy according to age, sex, and Knee Society patient category. TKA after osteotomy was technically more difficult, often requiring a more extensive exposure. ⋯ Knee Society scores were significantly lower in those with previous osteotomy, primarily because of decreased anteroposterior stability and pain. No significant differences were found in function scores, range of motion, or alignment. However, overall results of this PCL-retaining unconstrained TKA did not match those reported after PCL-substituting TKA.