Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1990
Kinematics of the patellofemoral joint. Investigations on a computer model with reference to patellar fractures.
Patellofemoral kinematics were studied on a computer model. The articulating point of the patella moves from distal to proximal during flexion, until the quadriceps tendon starts to turn around the femur tendo-femoral gliding. The pattern of patellofemoral movement consists of a gliding and rolling component, the latter at its maximum at the beginning of flexion. ⋯ The distal part of the patella is the part with mechanical stress at all angles of flexion. The conclusions to be drawn for treatment are that fractures within the proximal and central part of the patella need a very high stability of internal fixation, the distal part of the patella less so. Postoperative treatment must take into account the changing contact area, because the peak stress is always at the contact area.
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To realize the new concept of biological internal fixation the limited contact dynamic compression plate was developed. It minimizes vascular damage to the plated bone segment. It should lead to a more versatile and efficient application of internal fixation using plates.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsTreatment of fractures of the humeral capitulum using fibrin sealant.
Three patients with fresh displaced fractures of the capitulum humeri were treated by the fibrin sealant method, without additional internal fixation. At follow-up, between 1 1/2 and 4 1/2 years after surgery, clinical results were very good. Fibrin sealant has many advantages over traditional osteosynthesis techniques and is therefore recommended as an effective method for treating such serious but uncommon fractures of the elbow joint.
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Arch Orthop Trauma Surg · Jan 1990
Comparative StudyBone formation in porous implants of delrin and commercially pure titanium.
Clinicians have been using implants made by titanium or delrin with varying results. In this study dividable implants, bone growth chambers (BGC), of titanium and delrin were inserted into the rabbit tibia. ⋯ Results showed that bone ingrowth into titanium implants was significantly larger than into delrin implants (P less than 0.005). The possible reasons for this are discussed.
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Arch Orthop Trauma Surg · Jan 1990
Clinical TrialLimb lengthening and three-dimensional deformity corrections. A retrospective clinical study.
Different methods of limb lengthening as used at the Orthopedic Surgery Clinic of the Medical School, University of Zagreb, are compared. The results of operations performed between 1979 and 1989 on 111 patients are presented. These patients were subjected to surgery aimed at length equalization of limbs and/or correction of three-dimensional deformities. ⋯ These advantages manifest themselves in a reduced number of operations, lower incidence of infection and improved bone regeneration. It is preferable to perform corticotomy at the metaphysis site because of its optimum blood supply and its higher potential for osteogenesis. With corticotomy performed at the diaphysis site, satisfactory results were observed in only one-third of the cases.