Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1998
Comparative StudyEffects of nail rigidity on fracture healing. Strength and mineralisation in rat femoral bone.
The present study was undertaken to assess the effects of the rigidity of nails on the healing of fractures as evaluated by mechanical strength and rate of bone mineralisation. Ten rats supplied biomechanical data at the start of the experiment and another 100 rats were randomly assigned to 5 groups. In 20 rats no intervention was performed, and they served as a reference group of normal values. ⋯ This study demonstrates that diaphyseal fractures treated with titanium nails with a bending rigidity similar to the intact femur have a higher maximum bending load and fracture energy at 12 weeks than both rigidly or softly nailed fractures. BMD in the callus region was also highest after titanium nailing at 12 weeks. BMD in the distal diaphysis and total femur indicates that the degree of stiffness of the nails have little influence on total bone mineralisation at 12 weeks.
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Arch Orthop Trauma Surg · Jan 1998
Comparative StudyBiocompatibility of silicon carbide in colony formation test in vitro. A promising new ceramic THR implant coating material.
We studied the possible use of silicon carbide (SiC) as a ceramic coating material of titanium-based total hip replacement (THR) implants. The idea is to prevent wear debris formation from the soft titanium surface. ⋯ The present cytotoxicity test using JCRB0603 cells showed that 5 microns SiC particles inhibited colony outgrowth by one-third (67% + 10% vs control), while SiC-coated pins did not cause any inhibition and acted similarly to uncoated titanium pins. The results support the hypothesis that SiC is a promising ceramic THR implant coating material.
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Arch Orthop Trauma Surg · Jan 1998
Value of posterior cruciate ligament index in the diagnosis of anterior cruciate ligament injuries.
Assessment of the diagnostic value of the posterior cruciate ligament index (PCL index) for injuries of the anterior cruciate ligament (ACL) was done. Magnetic resonance imaging (MRI) and knee joint arthroscopy of 170 patients were evaluated. The shortest distance between the femoral and tibial attachment of PCL (x) and the distance from that line to the tip of the arc marked by the PCL (y) on the sagittal plane images were measured. ⋯ In 30 patients in whom arthroscopy showed total ACL rupture, the mean PCL index was 2.88 +/- 0.74, and in 10 patients with ACL partial rupture, 3.09 +/- 0.23. The conclusion is that injury to the ACL changes the PCL index markedly. In diagnostically unreliable MR images, deterioration of the PCL index could help in the diagnosis of ACL injury.
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Arch Orthop Trauma Surg · Jan 1998
Magnetic resonance imaging in lateral epicondylitis of the elbow.
The purpose of the study was to determine the changes that might be detected using magnetic resonance imaging (MRI) on patients with chronic lateral epicondylitis of the elbow and to judge its value concerning the clinical treatment. Thirty-four patients with chronic lateral epicondylitis were included in a prospective study. All individuals underwent MRI of the elbow on a 0.2-T dedicated system. ⋯ In a further 11 cases, the morphology and signal intensity were normal. The histopathological analysis of 6 surgical cases confirmed the preoperative MRI findings by showing either focal fibrous degenerative tendon tissue or microruptures of collagenous fibres. MRI in patients with chronic lateral epicondylitis can help to differentiate the disease and may be of use in clinical management, preoperative planning, and in the evaluation of the degree of degeneration at the common extensor tendon insertion.
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The aim of this study was to evaluate the changes of biochemical markers during fracture healing in patients with osteoporosis. The study included 26 patients; 9 underwent hip hemiarthroplasty (mean age +/- SD: 71.0 +/- 10.2 years, group EN) for femoral neck fractures. 7 underwent osteosynthesis (75.3 +/- 8.2 years, group OS) for trochanteric fractures, and 10 subjects had spinal compression fractures (68.2 +/- 12.0 years, group CO). No operative procedures were performed in group CO. ⋯ No biochemical markers changed significantly in group CO. In conclusion, bone resorption was accelerated at an early stage due to acute osteonecrosis or bed rest, followed by bone formation due to callus or mechanical stress later on. As far as bone resorption markers are concerned, 24 weeks are enough to eliminate the effect of fracture.