Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1991
ReviewLocking screw-plate fixation of cervical spine fractures with and without ancillary posterior plating.
Forty consecutive patients with 19 fractures and 21 fracture-dislocations in the lower cervical spine were treated prospectively with open reduction and interbody fusion, using the AO titanium locking screw-plate system. There were 30 men and 10 women with a mean age of 36 years (range 16-90 years). Eight were admitted tetraplegic, 12 tetraparetic, and 6 had nerve root injuries. ⋯ Six screws transgressed facet joints below the fusion. Ten posterior fusions extended to adjacent mobile segments by exuberant bony overgrowth. Ancillary posterior plating significantly reduced the range of neck mobility and also caused significantly more pain than anterior plate fixation alone.
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Arch Orthop Trauma Surg · Jan 1991
ReviewBlood loss in total hip replacement. A retrospective study.
Two hundred and twelve total hip replacements performed in one clinic over 1 year were reviewed. The mean operative time was 89 min and mean total blood loss 1090 ml. Homologous blood was administered to 74% of the patients. ⋯ Despite a mean of only 12 total hip replacements per surgeon, both operative time and blood loss were small compared to what was found in other studies. The use of a posterior approach is believed to contribute to a shorter operative time as well as to moderate blood loss. Intraoperative blood loss was less under epidural than under general anaesthesia, but in contrast to others we found higher postoperative blood loss after epidural anaesthesia.
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Arch Orthop Trauma Surg · Jan 1991
Review Case ReportsNonunion of a comminuted intra-articular wrist fracture after external fixation. A case report and review of the literature.
Nonunion is a very rare complication of a comminuted intra-articular wrist fracture treated by external fixation. The authors describe the likely reasons and the after-care, in order to avoid this complication.
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Arch Orthop Trauma Surg · Jan 1991
ReviewSystemic effects of implanted prostheses made of cobalt-chromium alloys.
Systemic effects of Co-Cr alloy/polyethylene hip joint prostheses were investigated using instrumental neutron activation to determine the concentrations of up to 16 elements. First, in a prospective study whole blood and serum taken from 10 patients from 1 day before to 90 days after implantation were analyzed. Secondly, in a retrospective study whole blood and serum from 23 patients who had had prostheses in place for up to 18 years were analyzed. ⋯ The analyses of tissues from the vicinity of the implants in the two deceased implant patients showed strong local effects of Co, Cr, Zr, and Hf, the latter two elements originating from the X-ray contrast media in the bone cement. The analyses of organs revealed significant Co and Cr enrichment in several tissues and organs. Consequently, it can be seen that implant corrosion is not an occurrence of merely local significance, but one that affects the trace element status of the entire organism.
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Arch Orthop Trauma Surg · Jan 1991
Lateral band release for post-traumatic extension contracture of the proximal interphalangeal joint.
In the patient with scarring of just the central band and lateral bands, there is a loss of active and passive flexion of the proximal interphalangeal (PIP) joint because the lateral bands have lost their normal volar shift. Surgical freeing of the lateral bands from the central band using parallel incisions may be required to allow full flexion of the PIP joint. ⋯ All operations were successful, with an average gain in range of motion of 47.5 degrees. This technique is simple, quick, and can be performed effectively on an out-patient basis.