Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Oct 2001
ReviewUltrasonography as a diagnostic modality in Osgood-Schlatter disease. A clinical study and review of the literature.
Sonographic examination of the knee has been proposed by several authors in the past as a simple and reliable method to diagnose Osgood-Schlatter disease (OSD). Ultrasound was used to compare the knees of 25 boys and 10 girls with typical OSD with 35 symptom-free knees of an aged-matched group of children. Based on recorded data, patients were categorized (one affected knee in each individual) according to the classification system proposed by De Flaviis et al. in 1989. ⋯ This distribution of cases was found to be statistically similar to the initial findings reported by De Flaviis and colleagues. This study therefore supports the validity and reproducibility of their classification method for the ultrasonographic evaluation of children with OSD. This is only the first step, and further assessment of this classification is still required to elucidate its clinical as well as its prognostic value.
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Arch Orthop Trauma Surg · Oct 2001
Biomechanical evaluation of hip joint after Salter innominate osteotomy: a long-term follow-up study.
The biomechanical state of the hip after a Salter innominate osteotomy was investigated by using the radiographic data of 38 operated and 21 contralateral nonoperated hips from our archives. The centre-edge angle of Wiberg was determined from the radiographs taken shortly after the operation. From the radiographs of the latest follow-up (7-13 years after the operation), we also determined the peak value of contact hip joint stress normalized by the body weight, and the functional angle of the weight-bearing area. ⋯ We found that the centre-edge angle increases on average during the follow-up time in the operated hips as well as in the contralateral nonoperated hips, but the average increase is smaller in the former. It is shown that an unfavorable stress distribution is connected to the decrease of the centre-edge angle over time. Finally, we found a weak positive correlation between the centre-edge angle shortly after the operation and the functional angle of the weight-bearing area at the of the latest follow-up.
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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.
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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.
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Arch Orthop Trauma Surg · Oct 2001
Risk factors for long-term treatment of whiplash injury in Japan: analysis of 400 cases.
We studied the risk factors for long-term treatment of 400 patients with whiplash injury in Japan. Most of the patients were injured in rear-end car collisions, but none had cervical bone lesions or spinal cord or root lesions. We evaluated the following risk factors: sex, age, degree of vehicle damage, and admission or non-admission to the hospital. ⋯ Damage to more than half of the car was associated with a longer treatment. Patients who were admitted to the hospital need treatment longer than the non-admission group. Thus, age over 30 years, a large amount of damage to the vehicle, and admission to the hospital are predictors of long-term treatment for whiplash injury in Japan.