Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Oct 2008
Revascularisation during fracture healing with soft tissue injury.
The purpose of our study was to quantitatively assess changes in the revascularisation process in the fracture gap and in adjacent regions during the course of healing of diaphyseal fractures with and without closed soft tissue injury. ⋯ Our results indicate that damage severe soft tissue does not adversely affect the fracture healing process. Furthermore, the present findings suggest that a partly destroyed bone-soft tissue interaction resulting in only a temporary and slight reduction of the extraosseous blood supply might have no deteriorating effect on fracture healing outcome. A possible delay in healing is not observed during the first 4 weeks. Therefore, soft tissue damage without destruction of the bone-soft tissue interface is likely to have only a limited effect on fracture healing.
-
Arch Orthop Trauma Surg · Oct 2008
Case ReportsElephantiasis nostras verrucosa complicated with chronic tibial osteomyelitis.
Elephantiasis nostras verrucosa represents an infrequent clinical entity with cutaneous changes characterized by dermal fibrosis, hyperkeratotic verrucous and papillamotous lesions resulting from chronic non-filarial lymphedema secondary to infections, surgeries, tumor obstruction, radiation, congestive heart failure, and obesity. Although recurrent streptococcal lymphangitis is believed to play a critical role in the origin of elephantiasis nostras verrucosa, the exact pathogenesis of the disorder is not yet clear. Therapeutic efforts should aim to reduce lymph stasis, which will also lead to improvement of the cutaneous changes but unfortunately there is no specific treatment for advanced cases. In this report, we present a patient who was treated by below knee amputation as a result of elephantiasis nostras verrucosa complicated with chronic tibial osteomyelitis.
-
Arch Orthop Trauma Surg · Oct 2008
Primary reconstruction with digital ray transposition after resection of malignant tumor.
Hand reconstruction after wide resection of digital malignant tumors is still very challenging. The technique of adjacent digital ray transposition has been used for digital defects arising from trauma, but few papers have focused on reconstruction following resection of malignant tumors of the finger. The indications, complications and functional outcomes with this approach are discussed. ⋯ Primary reconstruction with digital ray transposition produces acceptable functional outcomes after resection of malignant tumor. This procedure is best indicated for central single ray amputation but sometimes is associated with esthetical problems.
-
This study involves the results of open elbow arthrolysis performed on a series of patients having fixed joint contracture. ⋯ The importance of this study is that the patients have fixed deformities and a long follow-up time. Severely stiff elbow is one of the main indications of open arthrolysis in the patients without muscle atrophy. We suggest sequential arthrolysis as an effective way to obtain good range of motion especially in severe stiff elbows as well as to maintain the ligamantous stability of the elbow joint.