Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1998
Comparative StudyRadial and lumbar bone mineral density after wrist synovectomy in rheumatoid arthritis. A minimum 2-year follow-up in 10 unilaterally operated patients.
Bone mineral density (BMD) of both radii and lumbar vertebrae was measured by single-photon absorptiometry and dual X-ray absorptiometry, respectively, before and 2.1-4.8 years after a unilateral wrist synovectomy in 10 patients with rheumatoid arthritis. Radial BMD on the operated side significantly increased after synovectomy, while that on the non-operated side did not change. ⋯ The grip strength of the operated side increased significantly after synovectomy, while there were no changes in the grip strength on the non-operated side. These findings suggest that wrist synovectomy results in pain relief and improves use, thereby increasing the BMD of the operated radius.
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From 1984 to 1987, a complete, single-layered, porous-coated femoral component (Roy-Camille type) was used for primary cementless total hip replacement in 80 patients. Seventy-two patients (77 hips) with a minimal follow-up of 5 years (mean 7.2 years) were assessed clinically and radiographically. Thigh pain occurred in 4 hips. ⋯ From this study, we found that the complete, single-layered, porous-coated stem had a low loosening rate after 5 years. Bone ingrowth into the porous coating was found in most of the cases. A lower stress shielding effect in comparison with the complete, multi-layered, porous-coated prosthesis was also noted.
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A case of a patient with traumatic, simultaneous right posterior and left anterior hip dislocations without associated fractures is reported. Simultaneous asymmetric bilateral hip dislocation is very rare. The mechanism of this injury is discussed.
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Arch Orthop Trauma Surg · Jan 1998
Dislocated fractures of the talus treated with biodegradable internal fixation.
Six patients with a displaced fracture of the neck or body of the talus were treated using biodegradable screws and rods. During an average follow-up time of 24 (range, 18-31) months, there were no redisplacements nor collapses due to avascular necrosis. ⋯ The functional result was mainly dependent on the presence or absence of other injuries, being excellent in 4, good in 1 and poor in 1 patient who also had bilateral highly comminuted calcaneal fractures. Thus, biodegradable implants seem to be suitable for the fixation of displaced fractures of the talus.
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Arch Orthop Trauma Surg · Jan 1998
Comparative Study Clinical TrialComputed tomography of the spine as an important diagnostic tool in the management of war missile spinal trauma.
Twenty-two patients with spinal injury were evaluated by plain radiography immediately after hospital admission. In 14 patients whose condition was stable, we performed computed tomography (CT) scanning through the involved segments. To provide better planning before neurosurgical management, we divided the vertebral column in thirds. ⋯ Penetrating injuries with a dural lesion were present in the majority of cases, while spinal cord injury was obvious in some. They were all well visualized using spinal CT scanning. Our view is that the role of CT is essential in guiding surgical management of war missile injuries to the spine.