Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2001
Hypoxia-inducible factor-1 activation and cyclo-oxygenase-2 induction are early reperfusion-independent inflammatory events in hemorrhagic shock.
Hemorrhagic shock (HS) initiates an inflammatory response that includes increased expression of inducible nitric oxide synthase (iNOS) and production of prostaglandins. Induction of iNOS during the ischemic phase of HS may involve the activation of the hypoxia-inducible factor-1 (HIF-1). ⋯ The lungs of rats subjected to HS demonstrated a twofold increase in HIF-1 activation (P < 0.01) and a 7.4-fold increase in expression of COX-2 mRNA (P < 0.01) compared with sham controls. The upregulation of iNOS and COX-2 during ischemia are two important early response genes that promote the inflammatory response and may contribute to organ damage through the rapid and exaggerated production of nitric oxide and prostaglandins.
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Arch Orthop Trauma Surg · Jan 2001
Surgical treatment of tibial plateau fracture in elderly patients.
This retrospective study involves 22 patients with displaced tibial plateau fractures who were treated surgically from July 1993 to April 1996. All the patients were over 60 years old (mean 66.3 years old, range 61-80 years). All of the patients were treated by open reduction and internal fixation with AO/ASIF buttress plates (Synthes, Bochum, Switzerland). ⋯ Two patients needed occasional medical treatment for residual knee joint pain. Only two patients needed canes for assistance during walking due to old age and minor stroke. The results justify surgical treatment for displaced tibial plateau fractures in elderly patients.
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We present a case of lunate dislocation with total disruption of all ligaments and, consequently, nutrient vessels. The injury was handled by fusion of the lunate with the scaphoid, capitate and triquetrum. This 'anchor fusion' has led to a very good long-term result.
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Arch Orthop Trauma Surg · Jan 2001
Case ReportsIrreducible open dorsal dislocation of the proximal interphalangeal joint.
Dislocations of the proximal interphalangeal joint rarely present a problem in reduction. We report a case of dorsal dislocation in which attempts at reduction by manipulation were not successful. A probable mechanism is discussed. In most cases of such injury, the flexor tendons should be elevated by a probe to allow replacement of the head of the proximal phalanx.
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Arch Orthop Trauma Surg · Jan 2001
The value of desoxypyridinoline in the diagnostics of loosened arthroplasty.
According to several reports in the last few years, desoxypyridinoline (Dpd) in urine increases significantly in cases of loosened arthroplasty. Therefore, this marker was suggested as useful in the diagnostics of implant loosening. In this study, the level of Dpd was determined in 69 patients with arthroplasty of the hip or the knee joint. ⋯ In conclusion there was no significant increase in Dpd in patients with implant loosening compared with the control group. Furthermore, older patients often suffer from diseases causing increased bone resorption that may falsify the test results. We cannot confirm that Dpd is helpful in the diagnostics and screening of implant loosening.