Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2001
Randomized Controlled Trial Clinical TrialLumbar micro disc surgery with and without autologous fat graft. A prospective randomized trial evaluated with reference to clinical and social factors.
Epidural scarring is one of the possible complications after lumbar disc surgery. Perineural scar tissue has been considered responsible for recurrent neurological symptoms in patients operated on for disc herniation and leads to a high rate of unsatisfactory results. In addition, postoperative scars may increase the technical difficulty and risk of subsequent procedures. ⋯ A total of 92 patients received an implantation of autologous fat graft, 94 did not. After a median of 24.2 months after their surgery, an objective examinator compared various clinical parameters and the social situation of patients in both groups without knowing the operation method used. We found no significant differences between the fat-graft group and the control group regarding either the clinical outcome or the social aspects.
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Arch Orthop Trauma Surg · Sep 2001
Case ReportsUse of vascularized pedicle iliac bone graft in the treatment of avascular necrosis of the femoral head.
A vascularized pedicle iliac bone graft was performed in patients with extensive necrosis in whom the necrotic area occupied more than two-thirds of the femoral head. The purpose of this procedure is to supply vascularity and mechanical strength to the avascular femoral head. Our series consisted of 18 hips. ⋯ Stage progression was noted in 3 of 4 joints in the group who underwent iliac bone graft alone. In the group who underwent the combined procedure, stage progression was noted in 2 of 10 joints at more than 1 year after operation. A vascularized pedicle iliac bone graft to treat avascular necrosis of the femoral head is considered promising for joint preservation.
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Arch Orthop Trauma Surg · Sep 2001
ReviewImmobilisation for acute ankle sprain. A systematic review.
The variation of practice with respect to the treatment of the acutely sprained ankle suggests a lack of evidence-based management strategies for this problem. The objective of this review was to assess the effectiveness of the various methods of immobilisation for acute ankle sprain. An electronic database search was conducted using MEDLINE, EMBASE, BIOSIS, CINAHL, Cochrane Controlled Trial Register and Current Contents. ⋯ Sensitivity analysis showed that a non-concealed treatment allocation did not influence the statistical significance of the overall results. Based on our results, functional treatment currently seems a more appropriate treatment and should be encouraged. Concerning effectiveness, immobilisation, if necessary, should be restricted to certain patients and for short time periods.
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Arch Orthop Trauma Surg · Sep 2001
Case ReportsLate detachment modular femoral component after primary total hip replacement.
Three years after total hip replacement surgery, a patient's modular femoral head separated from the stem portion of a primary total hip replacement while the patient was rising from a chair. The modular femoral head was in a polyethylene acetabular socket. ⋯ The use of modular components greatly increases the flexibility during primary or revision total hip arthroplasty, but introduces the risks of component dissociation and intraoperative errors in matching. We report an unusually late dislocation of a primary modular total hip replacement.
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Arch Orthop Trauma Surg · Sep 2001
Case ReportsImaging features of intraosseous lipomas of the calcaneus.
We report two cases of intraosseous lipoma arising in the calcaneus of a 36-year-old and a 22-year-old women complaining of heel pain. Plain radiographs and computed tomography scans revealed cystic lesions in the calcaneus triangle. ⋯ Curettage and bone grafting were performed. There was no recurrence identified on plain radiographs 2 years following the surgery.