Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1992
Cementless prosthesis of the hip joint with "spongy metal" surface. A prospective study.
Our investigations in human specimens and animal experiments show that prostheses with a spongy metal surface can become fixed by bony ingrowth to varying degrees. After consistent clinical and radiological follow-up over 12-65 months (mean 34 months) in a prospective study of 100 consecutive patients in whom 106 cementless total hip replacements had been carried out, we were able to show that after 1 year 82% of patients were pain-free with the prosthesis fixed by bony ingrowth, 8% were pain-free with the prosthesis fixed by dense fibrous tissue and 10% were not pain-free, but did not want revision surgery. Thigh pain decreased steadily from 53% 3 months postoperatively to 6.6% 15 months after operation. We believe that, when the implantation technique is exact, a high percentage of cementless spongy metal prostheses are fixed by bony ingrowth, and that a cementless prosthesis should be implanted only in patients under 60 years of age without osteoporosis.
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Arch Orthop Trauma Surg · Jan 1992
Fracture patterns in malignant osteopetrosis (Albers-Schönberg disease).
We report the occurrence and distribution of 17 fractures in four patients with malignant, autosomal recessive osteopetrosis. The frequency of the disease in the Caucasian population is in the order of 1 per 20,000, of which the vast majority suffer from a mild autosomal dominant form. ⋯ The traumata were all caused by common accidents, usually falls. Conservative treatment was successful, with normal healing time in the four cases presented.
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Arch Orthop Trauma Surg · Jan 1992
Pathological fractures of the femur: improvement of quality of life after surgical treatment.
Radiotherapy and chemotherapy will result in an increase in the number of pathological fractures that occur, principally as a consequence of metastatic disease. These lesions are painful, especially at the level of the femur, and are apt to make invalids of the patient. If surgical intervention is applied as quickly as possible, (compound double-plate osteosynthesis or endoprosthesis), preferably before the lesion becomes a real fracture, the patient still has a chance of keeping a good, painless and well-functioning limb. ⋯ One patient is still going strong more than 35 months after surgery. Survival time was essentially dependent on the primary underlying malignant process. The results obtained have been more than reasonable: in 67% recovery of walking capacity, in 75% an effective fight against the pain.
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Arch Orthop Trauma Surg · Jan 1992
Case ReportsOpen traumatic posterior dislocation of the hip. A case report.
A case of open traumatic posterior dislocation of the hip is presented. The femoral head and neck were completely out of the skin and there were accompanying fractures of the acetabular floor, the ischial ramus and the greater trochanter. To our knowledge, such a case has not been reported previously and this, together with its interesting mechanism, has led us to report the case. It was followed for 18 months and roentgenographic and 99mtechnetium sulphur colloid scanning studies showed avascular necrosis and osteoarthritis.
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Arch Orthop Trauma Surg · Jan 1992
Remodeling of large bone defects in the treatment of space-occupying lesions. Curettage without bone graft for treating benign bone tumors.
Curettage without bone graft was performed in 17 patients with benign bone tumors and tumor-like lesions. New bone formation with uniformly increased radiodensity appeared in serial plain radiographs within 3 months after the operation. The average period before full weight could be borne on the lower extremities was 14 weeks. ⋯ The thickening of cortical bone was predominant. These data indicate that enough mechanical strength for daily activity will be recovered by bone within 4 months after curettage without any filler, although remodeling continues for over a year. It is suggested that bone graft and implantation of "biomaterials" are not necessary in patients, especially younger ones, with benign bone tumors or tumorous conditions.