Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1990
Nonsteroid anti-inflammatory drugs prevent the recurrence of heterotopic ossification after excision.
The prophylactic effect of nonsteroid anti-inflammatory drugs on the recurrence of high-grade periarticular heterotopic ossification after resection was studied in ten patients operated on for loosening of one or both components of a cemented total hip prosthesis. These drugs, given at a standard dosage for 1-3 weeks after surgery, prevented the recurrence of heterotopic ossification. ⋯ At follow-up 2-5 years after surgery, all patients walked well and there were no clinical or radiographs signs of loosening of the prosthetic components. It is concluded that treatment with NSAIDs following resection of periarticular heterotopic ossification prevents recurrence.
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In patients with persistent localized pain at the level of a sesamoid bone of the thumb not obviously related to trauma, sesamoidectomy gives excellent results. Often no X-ray or histological abnormalities are found, leaving the origin of pain problems still unsolved.
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Arch Orthop Trauma Surg · Jan 1990
Modified rotational acetabular osteotomy (RAO) for advanced osteoarthritis of the hip joint in the middle-aged person. First report.
Classical methods for pelvic osteotomy, such as those of Salter, Pemberton, Chiari, and Wagner, have been developed for reconstruction of the subluxed hip joint in children and young adults. Regarding pelvic osteotomy involving a middle-aged patient, however, there are not as many operation methods to consider, and it is difficult to choose the most suitable technique for alleviating advanced osteoarthritis. Based on current practice, total hip replacement (THR) seems the accepted method, though it presents problems such as loosening, sinking, and infections; because of these factors physicians hesitate to recommend THR surgery, particularly if the patient is otherwise healthy and appears to have many good years ahead of him. ⋯ A similar osteotomy technique has been used by Eppright and Wagner. We feel that our method achieves a more favorable result for an older patient with severe osteoarthritis, since both the surgery and the follow-up rehabilitation are more comprehensive. A modified acetabular osteotomy should not be regarded as merely an alternative to total hip replacement, but as the preferred choice for hip-joint reconstruction.
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Arch Orthop Trauma Surg · Jan 1990
Fracture incidence and bone mineral density of the distal radius in Japanese children.
The incidence of fractures of the distal radius in Japanese persons under 20 years of age was determined, and the bone mineral density of the radius was measured in 236 healthy Japanese children. The peak incidence of fractures occurred at 13 years of age (807 per 100,000) in boys and at 11 (300 per 100,000) in girls. ⋯ The age at the peak incidence of fractures thus coincided with the age at which the metaphyseal/diaphyseal density ratio was lowest. Thus, it is suggested that low bone mineral density at the metaphysis may be the cause of the high incidence of these fractures in adolescence.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsArterial lesions in major knee trauma: pedal pulse a false sign of security?
In major knee trauma fractures and/or dislocations can be associated with arterial lesions. Two case reports demonstrate the difficulties in the diagnosis of intimal lesions in the popliteal artery. ⋯ The importance of prompt diagnosis and treatment is emphasized. The use of arteriography is discussed.