Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1991
Long-term results of tibial plafond fractures treated with open reduction and internal fixation.
In this study a series of 41 consecutive cases of operatively treated fractures of the tibial plafond was retrospectively analysed. The fractures were classified into types I (9.75%), II (41.5%) and III (48.75%) as defined by Rüedi. The 10-year average follow-up revealed 66% good and 24% fair objective results overall. ⋯ With adequate open reduction and internal fixation, satisfactory results can be obtained in severe tibial plafond fractures. Meticulous soft tissue care and handling at surgery are important. Various fixation devices may need to be incorporated to ensure optimal soft tissue status for fracture healing.
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Thirty injuries involving the proximal tibial epiphysis were treated during a period of 28 years. The epiphysis was displaced in 16 cases (53%). ⋯ Three of the six patients with unsatisfactory outcome had a discrepancy in leg length of more than 2.5 cm after concomitant ipsilateral fracture of the femur or the tibia. One patient had a positive 3-cm anterior drawer sign, one patient had a 10 degree valgus deformity of the tibia, and one had to undergo above-knee-amputation because of delayed diagnosis of the vascular lesion.
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The value of MRI and CT in the diagnosis of soft-tissue tumors was investigated in a prospective study of 25 patients. MRI and CT give a true reflection of the tumor dimensions. ⋯ If both techniques are available, then MRI is to be preferred in view of the better spatial orientation and sharper contrast it offers between the tumor and adjacent structures. If only CT is available, then an adequate image can generally be obtained with this technique too.
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Arch Orthop Trauma Surg · Jan 1991
Orthopaedic treatment in tibial diaphyseal fractures. Risk factors affecting union.
A retrospective of 216 tibial fractures treated orthopedically was carried out. The aim was to analyze a set of clinicobiological parameters that owing to their assumed action on the physiological model of consolidation can be considered as risk factors to be taken into account in all kinds of orthopedic treatment, because they may lead to a lengthening of the normal consolidation time of the fracture. The variables analyzed were the following: type of immobilization, causative agent of the fracture, location of the focus of the fibular fracture, initial displacement, degree of conminution, type of wound, type of fracture, appearance of radiologically observable callus, commencement of weight-bearing, post-fracture hematoma, secondary displacement, and infection of soft tissues. In the particular case of immobilization by an ischiopedic plaster cast, the following parameters showed a greater degree of prognostic significance: initial displacement, secondary displacement, and age.
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Arch Orthop Trauma Surg · Jan 1991
Medial approach open reduction for congenital dislocation of the hip using the Ferguson procedure. A review of 31 hips.
Between January 1979 and October 1984, 31 congenitally dislocated hips in 19 patients were treated using open reduction via the medial approach, as described by Ferguson, at the Ankara University Faculty of Medicine. Patient age at operation ranged from 3 to 33 months (mean 12.1 months). ⋯ Avascular necrosis of the femoral head was observed in 9.7% and slight, transient ischaemic radiographic changes of the femoral head in 22.6% of the hips; 25.8% of the hips have already undergone or are due to undergo subsequent surgery due to an insufficient radiographic result. The medial approach was found to be a reliable procedure for infants who have not had extensive previous conservative treatment and who are between 7 and 18 months of age.