Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Oct 2001
Avascular necrosis of femoral head after gamma-nailing for unstable intertrochanteric fractures.
We reported on 7 cases of avascular necrosis of the femoral head after treatment of an unstable intertrochanteric fracture with the Asian Pacific gamma-nail. The incidence was about 1.16% (7 of 604) in our series. ⋯ Avascular necrosis was found about 6 months to 3 years after the initial operation, and all the fractures were solidly united at the final diagnosis. The possible etiologies were initial high energy trauma and combining basal neck fracture and iatrogenic damage of the blood supply to the femoral head.
-
Arch Orthop Trauma Surg · Oct 2001
Risk factors for heterotopic ossification in total hip arthroplasty.
This study prospectively evaluated 928 patients with 1318 primary total hip replacements for heterotopic ossification (HO). The mean clinical and radiological follow-up was 2.5 years (range 1.5-3.6 years). HO was noted in 44.6% of all total hips replaced. ⋯ The following factors showed a significantly increased risk of HO: hypertrophic osteoarthritis, HO after contralateral total hip replacement, trochanteric osteotomy, lateral or anterolateral approach, previous hip surgery, subtrochanteric femoral osteotomy, and male gender (p < 0.05 in chi-square analysis of independence and multivariable analysis). Patients with rheumatoid arthritis showed less HO. A combination of any of these factors resulted in a significant increase in the risk of developing HO.
-
Arch Orthop Trauma Surg · Oct 2001
Transpedicular decancellation osteotomy in the treatment of peridural fibrosis.
From 1992 to 1997 a series of 12 multiply operated (averaging 2.5 previous operations) patients with recurrent peridural fibrosis and postlaminectomy kyphosis underwent surgery at our clinic. The surgery was designed to restore the physiological lordosis and relax tethered cord and epidural veins by transpedicular decancellation osteotomy at a vertebra other than the vertebra with peridural fibrosis. This paper presents the long-term functional outcome of these 12 patients. ⋯ All symptoms and the pain due to peridural fibrosis disappeared in the early postoperative period. Patients had tower disability and pain scores at their early and long-term follow-ups (follow-up period 24-74 months, mean 36.3 months). For patients with failed medical therapy for peridural fibrosis accompanied by lumbar kyphosis or hypolordosis, transpedicular decancellation osteotomy should be the surgical treatment of choice.
-
Arch Orthop Trauma Surg · Oct 2001
The post-discectomy syndrome. Aetiology, diagnosis, treatment, prevention.
The post-discectomy syndrome (PDS) is a common diagnosis in patients with problems following a disc operation. The different causes of PDS make the establishment of the correct diagnosis and its corresponding efficient treatment difficult. ⋯ The following paper aims to specify PDS according to its aetiology, diagnosis, treatment and prevention. The diagnosis should be made efficiently, so that the patient can receive prompt adequate therapy.