Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1990
The value of intramedullary reaming in the treatment of chronic osteomyelitis of long bones.
Between 1985 and 1990 25 patients with chronic osteomyelitis (osteitis) of long bones were treated by intramedullary reaming. In most cases the aetiology of the osteomyelitis was posttraumatic. 22 of these patients who had undergone intramedullary reaming at least 6 months ago were evaluated. ⋯ One patient produced a little extraosseous sequestrum 3 months after the operation but since then has had no recurrence. The purpose of this study is to propose intramedullary reaming as an excellent treatment for chronic osteomyelitis of long bones and show the pathophysiological background that led to this modality.
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Arch Orthop Trauma Surg · Jan 1990
Comparative StudyDiagnostic value of serum tumor markers in skeletal metastasis of carcinomas.
Levels of serum tumor markers including tissue polypeptide antigen (TPA), CA 15-3, CA 19-9, squamous cell carcinoma antigen, carcinoembryonic antigen, alpha-fetoprotein, and PAP were measured in 26 patients with bone metastasis and in 9 patients with primary bone tumors. More than one markers was elevated in 19 of the 26 patients with bone metastasis, although there was no elevation of the markers in 3 patients with renal cell carcinoma. TPA was the most sensitive marker in the diagnosis of metastasis. ⋯ On the other hand, there was a slight elevation of the markers observed in two of the nine patients with primary bone lesions. Serum tumor markers are useful in the diagnosis of bone metastasis to differentiate it from primary bone lesions. Especially in solitary bone lesions, serum markers may be the only way to make a differential diagnosis between the two.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsFragmentation of methylmethacrylate: a cause of late failure of total hip replacement. A case report.
Extensive localized bone lysis in the femur following implantation of a metal-on-metal total hip prosthesis was observed. Fragmentation of the cement occurred 10 years after implantation. Histologic and ultrastructural features of macrophages are consistent with the hypothesis that particles from the acrylic resin were the factors stimulating the macrophagic reaction. Both mechanical factors and changes of the physico-chemical properties of the cement may have an etiologic role.
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Arch Orthop Trauma Surg · Jan 1990
Prognosis of primary anterior shoulder dislocation in young adults.
From 1982 to 1987, 194 patients with 196 primary traumatic anterior shoulder dislocations were treated in our hospital. One hundred and sixty-six patients with 168 shoulder dislocations (87%) were available for study at follow-up an average of 4 years after treatment. The most important prognostic factor in relation to recurrence was the age of the patient at the time of the primary dislocation. ⋯ Athletes in this age group had no worse a prognosis as to recurrence than non-athletes. A fracture of the greater tuberosity improved the prognosis significantly (P less than 0.01). Neither the presence of a Hill-Sachs lesion nor the period of immobilization influenced the recurrence rate in patients aged 30 years and younger.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsTransient palsy of hip abductors after a fall on the buttocks.
A fall on the buttocks caused monolateral transient palsy of the hip abductors in two patients. Palsy could be ascribed to acute entrapment of the superior gluteal nerve between the piriformis muscle and the incisura ischiadica major.