Archives of orthopaedic and trauma surgery
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A Thomas splint of traditional design was fitted with measuring devices and examined for its hip-relieving effect during varying activities. It was shown that there is no complete weight relief of the hip joint with this orthosis. ⋯ In regard to the hip joint, the Thomas splint is a device that reduces weight but does not entirely remove it. The results proved to be practically independent of the fitting of the orthosis and of the kind of activity.
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Arch Orthop Trauma Surg · Jan 1991
Post-traumatic radioulnar synostosis after forearm fracture osteosynthesis.
One hundred sixty-seven forearm fractures treated with plate osteosynthesis were analyzed for synostosis occurring between the radius and the ulna. Eleven cases (6.6%) were found, in 7 of which both bones of the forearm had been fractured, while the other 4 were cases of isolated radial or ulnar fracture. Overall there were 89 cases of fracture of both bones; of the 65 cases treated utilizing the two-incision approach, cross-union was seen in only 1, while in a comparable group (12 cases) in which the fractures were stabilized using the Boyd approach, there were 5 synostoses. ⋯ Among 40 isolated radial fractures, 2 radioulnar synostoses occurred, one in an open fracture and the other after fixation via the Boyd approach. These results emphasize the importance of using two approaches for fractures of both forearm bones. The highest risk of post-osteosynthetic synostosis appears to be in fractures of the proximal third of both radius and ulna.
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Arch Orthop Trauma Surg · Jan 1991
Functional restitution after lower leg fractures. A long-term follow-up.
Twenty-five patients with fractures of the lower leg treated by closed reduction and plaster fixation were examined an average of 7 years and 8 months after trauma. The end result was assessed according to the following: (1) The patient's own opinion; (2) clinical examination including comparing range of motion in knee and ankle in the fractured and non-fractured leg, leg length discrepancy, malrotation of the injured extremity and muscle force analysis; (3) radiological examination. All fractures had healed after a mean of 13.4 weeks. ⋯ Only eight patients had remaining radiological displacement, in only one of which it was severe. The slight remaining malpositionings did not influence the final functional result. The muscle force analysis showed that fractures caused by high-energy trauma also brought permanent reduction of muscular strength to the fractured extremity.
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Arch Orthop Trauma Surg · Jan 1991
Comparative StudyQuantitative comparison of the histological effects of particulate polymethylmethacrylate versus polyethylene in the rabbit tibia.
Fourteen mature female New Zealand White rabbits underwent implantation of Simplex polymethylmethacrylate (PMMA) powder or particulate (average 67 microns) ultrahigh-molecular-weight polyethylene (UHMWPE) through a drill hole in the proximal right tibia. The left tibia functioned as a prepared but nonimplanted control. Animals were killed after 16 weeks. ⋯ The particulate UHMWPE group demonstrated positively birefringent UHMWPE fragments, rimmed by foreign-body giant cells and histiocytes, embedded in a loose connective tissue stroma. UHMWPE interfaces were thicker and contained more histiocytes and fibrocytes; PMMA interfaces contained more marrow cells and lymphocytes. This study underscores the importance of biomaterial debris in the process of aseptic loosening of cemented joint arthroplasties.
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Arch Orthop Trauma Surg · Jan 1991
Intramedullary wiring for tibial shaft fractures in children before epiphyseal closure. Indications and technique--experience of 36 patients.
Between 1958 and 1987 36 children underwent intramedullary wiring for tibial shaft fractures. Of these, 29 presented with combined tibial and fibular fractures, and 7 showed isolated tibial shaft fractures. Fractures were simple in 22 and compound in 14 patients. ⋯ Malalignment showed a tendency towards spontaneous correction, which decreased with increasing age. Correction surgery proved to be unnecessary. Differential longitudinal growth was not consistently evaluable because of the heterogeneity of the material; reported data on this parameter from the literature were equally inconclusive.(ABSTRACT TRUNCATED AT 250 WORDS)