Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2001
Case ReportsThe 5-year survival following the marginal resection of a primary leiomyosarcoma of the distal femur and a stump fracture.
In this case, we present a 5-year follow-up of a 3-fault-affected primary leiomyosarcoma of the distal femur (spontaneous fracture treated by osteosynthesis; marginal resection; stump fracture after adequate trauma) with an extended local recurrence but without metastasis.
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Arch Orthop Trauma Surg · Sep 2001
Case ReportsSkeletal cystic angiomatosis with severe hip joint deformation resembling massive osteolysis.
An aggressive destruction pattern resulting in joint deformation has not been described in skeletal cystic angiomatosis (SCA) so far. We present the case of a 6-year-old boy with such findings strongly resembling Gorham's disease (massive osteolysis). Since the prognosis of the latter entity tends to be less favorable than in SCA, particularly SCA without extraskeletal involvement, careful differentiation of both disorders appears to be important.
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This 10-year retrospective review of spinal injuries at a destination ski resort was done to determine the incidence and type of spinal and neurologic injury associated with alpine winter sports. Spinal injury patterns and outcomes in skiers and snowboarders over a period of 11 seasons at a destination resort were studied. One-fourth of cervical injuries were associated with a temporary neurologic deficit. ⋯ There was approximately one significant spinal injury every 100,000 skier-days, and only 9% of spinal injuries required surgery. The incidence of death or associated permanent neurologic deficit is low (approximately one per two million skier-days). Skiing and snowboarding have a low incidence of significant spinal trauma.
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Arch Orthop Trauma Surg · Sep 2001
Magnetic resonance arthrography of the acetabular labrum: value of radial reconstructions.
The intention was to compare the sensitivity and specificity of radial planes with oblique coronal and oblique axial planes for the detection of labral abnormalities of the acetabulum on magnetic resonance arthrography (MRa). Twenty cadaveric hip joints were examined by radiography and MRa. For MRa, 15 ml of a solution of iodinated contrast material and gadolinium diethylene triamine tetra-acetic acid (Gd-DTPA; 100:1) were injected under fluoroscopic guidance. ⋯ Also, 3/6 labral degenerations without detachment, 6/7 partial detachments, 2/2 complete detachments, and 1/2 flap-like labra were correctly diagnosed. MRa of the acetabular labrum using radial reconstructions is well suited to delineate the acetabular labrum and to diagnose labral detachments. Radial reconstructions allow for perpendicular display of the whole acetabular circumference and are more accurate for the diagnosis of acetabular labral lesions, when compared with oblique coronal and oblique axial reconstructions.
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Arch Orthop Trauma Surg · Sep 2001
The influence of intermittent external dynamic pressure and tension forces on the healing of an epiphyseal fracture.
In vitro studies about the regenerative capacity of chondrocytes located in the growth plate of long bones revealed a potential for reparation. A measurable advance in the understanding of the physiologic processes in the bone growth plate and their modifications after defined lesions is based on the recognition of the role of the vascular architecture. Newly formed bridging arteries crossing from the metaphysis to the epiphysis through the growth plate are thought to be responsible for the cell proliferation observed after Salter-Harris I and II lesions. ⋯ This was more clearly seen with the use of the dynamic fixator. We conclude that a temporary ischemia with a reactive hyperemia takes place, which we could document by histological analysis and MRI. These results could modify the current clinical therapy of growth plate fractures.