Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2005
Case ReportsIntraspinal metalloma resulting in late paraparesis.
The metal-related complications caused by orthopedic implants have long been a concern, but these problems have been considered mostly in the field of arthroplasty or internal fixation of fractures. The recent prevalence of spinal instrumentation has evoked a similar concern among spine surgeons. Here, we present a case of intraspinal metallosis adjacent to the pedicular hook occurring after treatment of vertebral fracture by posterior spinal instrumentation and fusion, and causing paraparesis at the 3rd postoperative year. ⋯ Crevice and fretting corrosion are results at the junctions of rod-screw, rod-hook, transverse connector rod and other connector rods in modular spinal implants. Adequate usage of transpedicular screws may inhibit the occurrence of such a complication. For this reason, further studies are necessary to increase metallic corrosive resistance to inhibit crevice and fretting corrosion.
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Arch Orthop Trauma Surg · Jul 2005
Benefits of postoperative shed blood reinfusion in patients undergoing unilateral total knee replacement.
In patients undergoing total knee replacement (TKR), most of the measured blood loss occurs during the postoperative period, and 30-50% of these patients receive allogeneic blood transfusion (ABT). For this reason, the salvage and return of unwashed filtered shed blood (USB) from postoperative drainage may represent an alternative to ABT in these patients. We have, therefore, evaluated the clinical utility of USB return in TKR patients, with a special focus on patients with mild anaemia. ⋯ Return of USB after TKR seems to shorten the hospital stay and effectively reduce postoperative requirements for ABT, especially in patients with preoperative Hb > or = 13 g/dL. For patients with preoperative Hb < 13 g/dL, although the return of USB also decreased the requirements for ABT, a further reduction will probably be obtained with the addition of another blood-saving method.
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Arch Orthop Trauma Surg · Jul 2005
Review Case ReportsA case of trigger finger following partial laceration of flexor digitorum superficialis and review of the literature.
Trigger finger is a common condition, and the usual cause is stenosing tenosynovitis. Trigger finger caused by trauma is extremely rare. We examined a patient in whom an apparently trivial laceration caused partial laceration of the flexor tendon, leading to trigger finger. ⋯ We also review nine previously reported cases. When triggering occurs after an injury near the base of a finger, partial laceration of the flexor tendon should be kept in mind as the cause. Ultrasonography may be valuable for the diagnosis.
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Arch Orthop Trauma Surg · Jul 2005
Palmar locking plate for treatment of unstable dorsal dislocated distal radius fractures.
This study investigates the clinical and radiological results of open reduction and internal fixation of unstable distal radial fractures using a palmar placed interlocking plate system with no substitutes for treatment of the dorsal metaphyseal fracture void. ⋯ The treatment of unstable, dorsally dislocated, distal radius fractures AO types A3, C1 and C2, with a palmar placed 2.4 mm interlocking plate system and without additional treatment of the metaphyseal defects showed good radiological and functional results with minimal loss of reduction.
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Arch Orthop Trauma Surg · Jul 2005
Therapy with gentamicin-PMMA beads, gentamicin-collagen sponge, and cefazolin for experimental osteomyelitis due to Staphylococcus aureus in rats.
In spite of new surgical techniques and recently developed antibiotics, there is no satisfactory solution for the treatment of chronic posttraumatic osteomyelitis. The introduction of local antibiotic treatment with gentamicin-PMMA beads according to Klemm has provided new stimuli for the treatment of chronic osteomyelitis. With the development of collagen as an absorbable carrier substance, the disadvantages of the rigid carrier system became evident. Due to the varying surgical techniques and different forms of adjuvant therapy, it is difficult to assess therapeutic methods and compare different studies. Therefore, it seemed appropriate to study the effect of local treatment with different antibiotic carriers in the setting of an animal study. ⋯ Each of the treatment modalities resulted in a significant therapeutic effect. Due to its ability to quickly release large amounts of gentamicin, the flexible gentamicin-containing collagen sponge proved to be superior to the rigid PMMA system. Although the gentamicin-containing collagen sponge provided high antibiotic concentration at the site of implantation, an additive effect was attained when combined with systemic antibiotic treatment.