Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2001
Fracture-dislocations of the elbow joint--strategy for treatment and results.
Between January 1993 and December 1996, 41 patients with fracture dislocation of the elbow joint were treated in our department. In 28 patients (median age 46 years, range 15-77 years; 16 male, 12 female), a clinical and radiological follow-up was obtained after median 34 months (range 12-59 months). In addition to the humero-ulnar dislocation, isolated fractures were present in 13 patients and combined fractures in 15 (all with involvement of the radial head). ⋯ Poor results were primarily caused by extensive initial soft-tissue damage, delayed definitive surgical therapy, and ectopic heterotopic ossification. In contrast, fracture localization and degree of arthrosis were not of significant importance for the final outcome. In fracture dislocations, the goal is a primary definitive surgical treatment aiming for early postoperative physiotherapy.
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Arch Orthop Trauma Surg · Jan 2001
Case ReportsFlexor digitorum longus accessorius in the club foot of an infant with Nager syndrome.
The case of a male infant is reported who had club foot on the right side and pes adductus on the left side in combination with acrofacial dysostosis; he also demonstrated preaxial anomalies of the upper limbs indicative of Nager syndrome. In addition, an unusual aberrant muscle was discovered during surgical correction of the right club foot.
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Arch Orthop Trauma Surg · Jan 2001
Comparative StudyCorrection of kyphotic deformity before and after transection of the anterior longitudinal ligament--a cadaver study.
With a custom-made measuring unit, two separate experiments, involving six and five cadaveric torsos with intact rib cages and sternums, respectively, were carried out to determine the effect of the transection of the anterior longitudinal ligament with and without osteodiscectomy and its influence on the thoracic kyphosis. The open or thoracoscopically assisted anterior release, as part of the operative treatment of scoliosis or kyphosis, usually consists of a transection of the anterior longitudinal ligament (ALL) and an additional discectomy. A complete osteodiscectomy, however, is not always possible with a minimally invasive approach. ⋯ In comparison, the additional osteodiscectomy led to a further average increase of only 2 degrees per level. The measurements performed on human cadavers showed that the isolated transection of the ALL leads to a sufficient anterior release of the thoracic spine, allowing a correction of the kyphotic deformity. The release with a concomitant osteodiscectomy represents a more time-consuming and more invasive procedure resulting in only a slightly greater amelioration of the sagittal Cobb angle, while being associated with a greater patient morbidity.
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Arch Orthop Trauma Surg · Jan 2001
Case ReportsOsteoid osteoma of olecranon process of ulna in subchondral location.
We present a case of a 15-year-old girl with osteoid osteoma in an unusual subchondral localization of the olecranon. Unspecific complaints and minimal X-ray findings at the onset of the disease led to an incorrect diagnosis and more than 2 years of inefficient treatment.
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Arch Orthop Trauma Surg · Jan 2001
Effect of preoperative chemotherapy on the outcome of surgical treatment of vertebral tuberculosis: retrospective analysis of 434 cases.
A retrospective analysis of 434 patients with vertebral tuberculosis who were treated surgically was performed with special reference to the preoperative duration of chemotherapy. Of these, 376 underwent 4 weeks of a chemotherapy regimen with isoniazid, rifampin and ethamburol, and in 2 re-activation of the disease was observed. The remaining 58 underwent operation for neurological impairment with 6-18 h of the same chemotherapy regimen, and in no case did re-activation occur. These results suggest a shorter duration of chemotherapy may be utilised in all patients undergoing surgical treatment for vertebral tuberculosis, providing a thorough debridement is performed, leaving no necrotic or infected tissue behind.