Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1998
Comparative StudyGraded exchange reaming and nailing of non-unions. Strength and mineralisation in rat femoral bone.
The effect of graded exchange reaming and intramedullary nailing on a non-union model in the rat femur was studied by clinical, radiological, bone mineralisation and biomechanical methods. A standardised procedure was first developed to create a non-union that did not heal and in which non-union developed consistently. In 30 male Wistar rats a standardised osteotomy was produced in the left femur diaphysis. ⋯ In the intervention groups radiographs showed various degrees of union. Mechanical testing showed that the fracture energy was significantly higher in group 2.0 than in group 1.6. The finding that extensive exchange reaming and nailing seems favourable in non-unions of diaphyseal fractures compared with modest reaming may have clinical implications.
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Arch Orthop Trauma Surg · Jan 1998
Case ReportsExtraskeletal Ewing's sarcoma mimicking traumatic hematoma.
We describe the clinical course of a 16-year-old baseball player with a history of recurrent hematoma of the thigh. The lesion was aspirated percutaneously several times and curetted under the diagnosis of traumatic hematoma. ⋯ He died of multiple metastases. With recurrent hematoma in the soft tissue, neoplastic lesions should be ruled out.
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Arch Orthop Trauma Surg · Jan 1998
Measurement of skeletal flow with positron emission tomography and 18F-fluoride in femoral head osteonecrosis.
Positron emission tomography (PET) with 18F-fluoride was utilized to determine the regional blood flow to the femoral head in early osteonecrosis. Five patients with a history of unilateral hip trauma and a normal contralateral side were selected. ⋯ A minimum flow of 0.04 ml/min/ml was measured in one patient whose affected femoral head healed conservatively. Our preliminary study indicates that this type of highly technical investigation appears feasible in clinical practice and permits prediction of the outcome depending upon regional skeletal flow measurements in vivo.
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Arch Orthop Trauma Surg · Jan 1998
Clinical TrialPreservation of anterior cruciate ligament in total knee arthroplasty.
Few prostheses allow preservation of the anterior cruciate ligament (ACL) during total knee replacement. We report a short-term, prospective, open study of 32 ACL-retaining and 93 ACL-replacing total knee replacements and compare the respective outcomes of both prosthesis types with a follow-up time of 2-3 years. Mean operative time, complication or revision rates did not differ, nor did the early and late clinical and radiological evaluations. ⋯ The clinical and functional results were neither improved nor worsened for ACL-retaining prostheses. There is thus no advantage, but also no inconvenience, in retaining the ACL according to short- to mid-term results of a gliding posterior cruciate ligament (PCL)-retaining prosthesis with ACL-replacement design. The possibility of an improved long-term outcome of an ACL-retaining prosthesis should be investigated further.
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Arch Orthop Trauma Surg · Jan 1998
Case ReportsBilateral pathological femoral neck fractures secondary to ectopic parathyroid adenoma.
A rare case of bilateral pathological femoral neck fractures secondary to ectopic parathyroid adenoma is reported. Both hip fractures were treated with closed reduction and internal fixation. The right hip fracture healed uneventfully, whereas the left hip fracture developed non-union that required subtrochanteric osteotomy and internal fixation and eventually healed. Neither hip developed avascular necrosis.