Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1992
The influence of metal backing in unicompartmental tibial component fixation. An in vivo roentgen stereophotogrammetric analysis of micromotion.
The fixation of the tibial component in 36 patients with conventionally cemented unicompartmental knee arthroplasties for femorotibial gonarthrosis was studied using roentgen stereophotogrammetric analysis (RSA). Twenty-four tibial components were all-polyethylene while 12 were metal-backed. The follow-up was for 6 years. ⋯ A strong correlation was found between the extension of the radiolucent line and the migration. Otherwise, neither demographic, clinical, nor radiographic data correlated with the RSA results. In this study metal backing did not have any influence on prosthetic fixation as measured by RSA.
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Arch Orthop Trauma Surg · Jan 1991
ReviewIndications for and results of operative treatment of spondylitis and spondylodiscitis.
We present a retrospective follow-up study of 24 patients with spondylitis or spondylodiscitis whose treatment included surgical intervention. Tuberculous spondylitis was diagnosed in 14 patients and 10 suffered from non-specific spondylitis. The average age of the patients was 50.2 years and average follow-up was 3 years. ⋯ We recommend radical debridement and spinal fusion through a ventral approach in patients with destruction of the ventral vertebral body, progressive neurological impairment, septicaemia and antibiotic-resistant, symptomatic infections of the spine. In the elderly patient, even in reduced states of health, early surgical intervention can be particularly valuable. Although surgical intervention should be reserved for specific indications, we were able to document favourable results in all 24 patients treated with debridement and spinal fusion.
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Arch Orthop Trauma Surg · Jan 1991
Case ReportsMalignant fibrous histiocytoma in the course of chronic osteomyelitis.
Malignant fibrous histiocytoma (MFH) was found in the femur of a 28-year-old man who had suffered from chronic osteomyelitis. The patient had undergone surgery for a valgus knee deformity and the procedure was complicated by chronic osteomyelitis which lasted for 12 years. ⋯ The patient died 4 months later. Histopathological and immunohistochemical examinations indicated the diagnosis of MFH.
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Arch Orthop Trauma Surg · Jan 1991
ReviewKnee ligament injuries combined with ipsilateral tibial and femoral diaphyseal fractures: the "floating knee".
The incidence of rupture of the knee ligaments was retrospectively studied in 47 patients with ipsilateral fractures of the femoral and tibial diaphyseal shaft. Fifteen patients proved to have an instability of the knee at the time of follow up. Disruption of the knee ligaments had not been recognised initially. ⋯ After stabilisation of both fractures in these cases, the knee ligaments had been repaired; at re-examination these patients had no complaints and their knees were perfectly stable. In view of the high incidence of missed cases, the possibility of disruption of the knee ligaments should be considered in all patients with fractures of both the femoral and tibial shaft. Meticulous examination of the knee at the time of injury is strongly advocated.
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The neurilemoma (benign schwannoma) is a benign tumor which arises from the Schwann cells of the peripheral nerves. In an intraosseous localization it is a very rare lesion, only forty cases being reported in the literature, and only two of these with the tumor located in the femur. This paper reports on a patient with a large neurilemoma in the lower part of the left femur.