Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsMassive wear of a steel ball head by ceramic fragments in the polyethylene acetabular cup after revision of a total hip prosthesis with fractured ceramic ball.
The purpose of this case study of severe metallosis is to draw the attention of orthopedic surgeons to extremely serious results of this kind in the event of the fracture of the ceramic ball in a total hip prosthesis. Eleven months after implantation of a KJF hip prosthesis with an aluminum oxide ceramic ball in combination with a polyethylene acetabular cup, fracture of the ceramic ball was observed. After examining the polyethylene cup during the revision operation, the operating orthopedic surgeon merely replaced the fractured ceramic ball with a metal ball head made of stainless steel. ⋯ It is these extremely hard ceramic fragments that were responsible for the massive wear of the steel ball head, the hardness of which is approximately ten times less than that of aluminum oxide ceramic. The fracture of the ceramic ball further resulted in damage to the metal taper of the stemmed femoral component. In cases of this kind it is consequently absolutely essential to remove both the polyethylene cup and the ball head, and--if necessary--the femoral component as well.
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Arch Orthop Trauma Surg · Jan 1990
Comparative StudyThe Tikhoff-Linberg procedure for bone tumors of the proximal humerus: the classical "extensive" technique versus a modified "transglenoid" resection.
The authors report on two groups of patients (each with 12) with primary bone tumors of the humerus who underwent either a classical Tikhoff-Linberg (T-L) procedure or a modified technique by which the body of the scapula was saved. The latter procedure was an "en bloc" resection of the glenohumeral joint after an extra-capsular osteotomy of the neck of the scapula, followed by reconstruction with a modular prosthesis. ⋯ Besides producing better aesthetic and functional results, the modified technique offered the advantages of shorter anesthesia time, less blood loss, and a better anchorage of the prosthesis. The results of this study show that the proposed modification of the T-L procedure is indicated in patients with bone tumors of the proximal humerus in which invasion of the joint capsule is present without macroscopic involvement of the glenoid.
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Arch Orthop Trauma Surg · Jan 1990
Absorbable polyglycolide pins in fixation of displaced fractures of the radial head.
In a prospective study 24 patients with a displaced fracture of the radial head were treated by open reduction and internal fixation using absorbable polyglycolide pins, 2 mm in diameter. All patients admitted with fractures involving a quarter or more of the radial head, whether comminuted or not, were included in the study whenever there was a displacement of 2 mm or more between the fragments. The mean follow-up time was 28 months (range 15-43 months). ⋯ A transient inflammatory reaction around the implants occurred in two cases 8-12 weeks postoperatively. The functional end-result was classified as excellent or good in 22 patients (91%). This study indicated that successful fixation of displaced fractures of the radial head can be accomplished by using absorbable pins.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsBilateral pseudarthrosis of the femur after stress fracture.
Stress fractures of the diaphysis of the femur are very rare, particularly bilateral ones. We describe here a woman patient with bilateral pseudoarthrosis of the femoral diaphysis which was the result of a stress fracture. ⋯ The patient has been closely examined for over 30 years. Our own explanation for the beginnings of stress fracture as well as for the pseudarthrosis development are given.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsWhich X-ray views are required in juvenile ankle trauma?
Although ankle sprains are probably the most common injury in adolescent sports people, epiphyseal injuries are missed on the presumption of a ligamentous tear. The risk of damaged ligaments has been overemphasized while the potentially dangerous epiphyseolysis has been understressed. An oblique X-ray of the ankle joint is indicated prior to "stress" pictures.