Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1991
ReviewTumors and tumor-like lesions arising in tendons. A clinicopathological study of 75 cases.
Eight cases of malignant tumors, 38 cases of benign tumors, 15 cases of metastatic tumors, and 14 cases of tumor-like lesions arising in tendons seen over a period of 22 years (1967-1988) are surveyed. Benign tumors of tendon occur relatively frequently - in 38 (1.7%) of 2143 tendon biopsies - but malignant tumors (0.37%) and metastases (0.70%) are extremely rare. Malignant tumors occurred most frequently in lower limb tendons, while benign tumors were most often found in the tendons of the hand.
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The neurilemoma (benign schwannoma) is a benign tumor which arises from the Schwann cells of the peripheral nerves. In an intraosseous localization it is a very rare lesion, only forty cases being reported in the literature, and only two of these with the tumor located in the femur. This paper reports on a patient with a large neurilemoma in the lower part of the left femur.
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Arch Orthop Trauma Surg · Jan 1991
ReviewIndications for and results of operative treatment of spondylitis and spondylodiscitis.
We present a retrospective follow-up study of 24 patients with spondylitis or spondylodiscitis whose treatment included surgical intervention. Tuberculous spondylitis was diagnosed in 14 patients and 10 suffered from non-specific spondylitis. The average age of the patients was 50.2 years and average follow-up was 3 years. ⋯ We recommend radical debridement and spinal fusion through a ventral approach in patients with destruction of the ventral vertebral body, progressive neurological impairment, septicaemia and antibiotic-resistant, symptomatic infections of the spine. In the elderly patient, even in reduced states of health, early surgical intervention can be particularly valuable. Although surgical intervention should be reserved for specific indications, we were able to document favourable results in all 24 patients treated with debridement and spinal fusion.
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Arch Orthop Trauma Surg · Jan 1991
ReviewPathological fractures and lytic bone lesion of the femoral neck associated with beta 2-microglobulin amyloid deposition in long-term dialysis patients.
A correlation is demonstrated between chronic hemodialysis using cuprophane membranes (mean duration: 13 years) and pathological fractures (n = 7 in 6 patients) after lytic bone deposits of beta 2-microglobulin amyloid (n = 13 patients). The characteristic symptom complex includes painful impingement syndrome of the shoulder, carpal tunnel syndrome, painful hip and recurrent knee effusions. ⋯ Due to reduced regeneration capacity in amyloid bone lesions the resulting surgical therapy should aim at total joint replacement or augmented osteo synthesis. Definitive operative treatment should be aspired even in the absence of manifest fractures, as the natural course of the disease is characterized by progression of the bone destruction and a continuous pain syndrome.
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Arch Orthop Trauma Surg · Jan 1991
Randomized Controlled Trial Clinical TrialEffect of high-dose corticosteroids on the incidence of deep vein thrombosis after total hip replacement.
Fifty patients receiving uncemented total hip prostheses were examined by venography of the legs on the 2nd postoperative day. The patients were randomly divided into two groups, a non-steroid group (n = 26) and a steroid group (n = 24). Both groups received dextran thrombo-prophylaxis. ⋯ All patients were followed up clinically and plethysmographically up to 12 months after surgery. Distally located asymptomatic DVT were not given specific treatment. The postoperative course was uneventful except for one patient in each group who developed clinically, apparent DVT more than 3 weeks after operation, although the initial venographic studies were normal.