Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1992
Types I and III procollagen extension peptides in serum respond to fracture in humans.
Markers of types I and III collagen turnover were measured in serial blood samples in 16 patients with a Colles' fracture. The collagen markers were the carboxy-terminal extension peptide of type I procollagen (PICP) and the amino-terminal extension peptide of type III procollagen (PIIINP). Significant increases were found of PIIINP within 1 week and of PICP within 2 weeks. ⋯ Osteocalcin, a serum marker of osteoblast activity, increased within 1 week and levelled off after 9 months. Correlations between the change in osteocalcin and those in PICP and PIIINP, respectively, were weak. These new biochemical markers may prove relevant as non-invasive markers of normal and pathological fracture healing in humans.
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Arch Orthop Trauma Surg · Jan 1992
Case ReportsUse of a posterior calf fasciocutaneous flap with distal pedicle to reconstruct a huge ankle defect.
A distally based posterior calf fasciocutaneous flap was successfully used to reconstruct a major ankle defect with exposed bones and joints. The flap, which reaches easily this region, can also be used as a free flap for coverage of heel and ankle when the forefoot is not involved in the injury.
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Arch Orthop Trauma Surg · Jan 1992
The natural course of osteoarthritis of the hip due to subluxation or acetabular dysplasia.
In 59 patients, 86 hips with subluxation or hip dysplasia were examined to determine the natural course of the condition and select suitable treatment. Thirty-three percent of the joints (13/39 hips) developed early osteoarthritis from pre-osteoarthritis within an average term of 9.2 years, while the remaining, sixty-six percent (31/47 hips) developed advanced-stage osteoarthritis from early osteoarthritis within an average term of 7.8 years. ⋯ In pre-osteoarthritis, centre-edge angle, slope of the acetabular roof, acetabular head index, acetabular depth ratio and Japanese Orthopaedic Association (JOA) hip score were significant predictors, while in early osteoarthritis, a broken Shenton's line, cranial joint space and JOA score were significant. On the basis of multiple parameters, formulas for predicting development in patients with pre-osteoarthritis, those with early osteoarthritis, and all patients together were established, with an accuracy of 87%, 71%, and 68%, respectively.
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Arch Orthop Trauma Surg · Jan 1992
The modified Mayo procedure combined with basal valgus osteotomy of the first metatarsal for severe hallux valgus.
The modified Mayo procedure corrects valgus deformity of the great toe secondary to osteoarthritis in the first metatarsophalangeal joint. Basal osteotomy of the first metatarsal to correct metatarsus primus varus and to maintain correction of the valgus deformity may be performed simultaneously. We retrospectively reviewed the results in 55 of 70 feet treated by this combined procedure. ⋯ The results were either very good or good in 82%, moderate in 14%, and poor in 4%. Our technique of basal osteotomy of the first metatarsal is a simple and effective procedure to correct metatarsus primus varus and may restore the distal transverse arch. It should be considered as a possible method of treatment when the intermetatarsal angle is greater than 10 degrees.
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Arch Orthop Trauma Surg · Jan 1992
Physiopathology of the knee joint after distal iliotibial band transfer.
In an experimental study of 14 cadaver knee joints, the pressure load on the joint surface after distal iliotibial band transfer was measured using Fuji Prescale foils. With an intact anterior cruciate ligament, increases of up to 153% for the average pressure load and of 225% for the total pressure in the lateral compartment were found in relation to the fixation point chosen. At point P3--slightly dorsal to the insertion of the lateral collateral ligament--the area loaded with maximum pressure increased to six-fold. ⋯ After transection of the anterior cruciate ligament and iliotibial band transfer at the "over-the-top" point, a significant shift of pressure towards the medial compartment was seen, while the lateral pressure load decreased. Medially, the area loaded with peak pressure remained constant, while the corresponding area in the lateral joint space showed a highly significant decrease to nearly one-third of normal. After additional bilateral meniscectomy this tendency was even more pronounced.(ABSTRACT TRUNCATED AT 250 WORDS)