Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1991
Association of incipient disc degeneration and instability in spondylolisthesis. A magnetic resonance and flexion-extension radiographic study of 20-year-old low back pain patients.
The concurrence of early disc degeneration and abnormal segmental motion in spondylolysis of young low back pain patients (n = 14) was investigated using magnetic resonance imaging (MRI) and flexion-extension radiography. Seven patients with L5 spondylolisthesis had normal discs on MRI and 7 had disc degeneration below the slipped vertebra. ⋯ The present study shows that in adolescents the motion pattern and hydration of discs associated with spondylolysis and spondylolisthesis are not always abnormal. The early dehydration and degeneration of lumbar discs observed on MRI are not always associated with abnormal mobility of the corresponding motion segment.
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Arch Orthop Trauma Surg · Jan 1991
Case ReportsOverdistraction: a hazard of skull traction in the management of acute injuries of the cervical spine.
In acute cervical spine trauma, skull traction is used to reduce a dislocation or fracture dislocation, to immobilize an unstable lesion until definitive treatment (operative or conservative) is possible or, more rarely, as a definitive treatment until healing occurs. This method may be dangerous when an unstable lesion is accidentally overdistracted. A few cases have been reported in the literature, some with neurological complications. ⋯ After reduction is completed, traction is reduced to 2 kg. This weight is sufficient to immobilize a lesion until definitive treatment is possible. Inadvertent rotation may be prevented by placing sandbags on both sides of the head.
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Arch Orthop Trauma Surg · Jan 1991
Acceleration of wound healing by local application of fibronectin.
The process of wound healing under the influence of locally applied fibronectin, heparin and thrombin was studied in adult rabbits. Using immunofluorescence microscopy, a higher concentration of fibronectin within the wound area was found on the 1st day after fibronectin treatment. ⋯ On the 9th day the tensile strength of the fibronectin-treated wounds was significantly higher than that of the control wounds on the 12th day after operation. The addition of heparin and thrombin, each in combination with fibronectin, did not show any significant effect on wound healing.
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Arch Orthop Trauma Surg · Jan 1991
An analysis of the results of transferring the musculocutaneous nerve onto the median nerve in tetraplegics.
Following injuries of the cervical spinal cord at the common level with C6 neurological level sparing, abduction of the shoulder and elbow flexion remain active. The flexors of the elbow are controlled by the musculocutaneous nerve formed mainly from C5 and C6 fibers, the motor cells of which are usually located above the level of the spinal lesion. ⋯ In 32 patients this has restored simple grasping function of the hand, increasing the patients' independence. The operation is particularly indicated in cases of complete lesion of the spinal cord at the C6-C7 level in young people, and for best results should be performed with in the first few months after trauma.
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Back school is behavior training for the prevention and treatment of back problems arising from faulty body posture and muscular dysfunction. This paper describes the conception and evaluation of a back school program for patients with vertebral fractures. ⋯ The effectiveness of the program was measured by a knowledge test and a behavior test. The results suggest that this back school is an effective addition to conventional concept using physiotherapy exclusively.