Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1989
ReviewPost-traumatic osteomyelitis. Pathophysiology and management.
Osteomyelitis is one of the most severe complications that can arise following operative treatment of bone. It requires a long-term treatment. The patient can never be sure that it heals completely. ⋯ Stabilization is achieved by means of an external fixator. Once the fracture area has been cleaned, cancellous bone grafting is done once, twice, or even more frequently. For wound closure it is necessary to rotate muscle groups, to cover the bone with dermatomic skin, or to use microvascular flaps.(ABSTRACT TRUNCATED AT 250 WORDS)
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Arch Orthop Trauma Surg · Jan 1989
Factors associated with heterotopic bone formation following total hip replacement.
In order to delineate groups of patients suitable for treatment to prevent heterotopic bone formation (HBF) following total hip replacement, 99 patients were examined to evaluate predisposing factors. One year after surgery, HBF was found in 73% of the patients. ⋯ Previous ipsilateral hip surgery did not increase the risk of HBF. Although not significant, all patients who developed heterotopic bone after previous ipsi- or contralateral hip surgery showed HBF of the same or even a higher grade after the present replacement.
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Arch Orthop Trauma Surg · Jan 1989
Case ReportsNeurofibromatosis with spinal paralysis due to arteriovenous fistula.
A case of neurofibromatosis with spinal paralysis due to arteriovenous fistula is reported. Preoperatively, the appropriate diagnosis was missed because angiography had not been performed. Postoperative angiography disclosed that an arteriovenous fistula formed a tumor-like mass, and that a part of the mass had invaded the spinal canal, compressing the spinal cord. It is concluded that the possibility of an arteriovenous fistula should be kept in mind in neurofibromatosis patients with spinal cord symptoms.
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Arch Orthop Trauma Surg · Jan 1989
Evidence for spirochetal origin of Sudeck's atrophy (algodystrophy, reflex sympathetic dystrophy).
Four female patients with Sudeck's atrophy (SA) were evaluated at our department. Sera of all patients were investigated for antibodies against Borrelia burgdorferi. ⋯ In one patient structures identical with B. burgdorferi could be detected on histological sections from the skin of the affected limb. Our data and those of other authors suggest that a spirochetal infection can be regarded as an important etiopathogenetic factor in the development of SA.
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Arch Orthop Trauma Surg · Jan 1989
Leg-length inequality has poor correlation with lumbar scoliosis. A radiological study of 100 patients with chronic low-back pain.
Leg-length inequality and its hypothetical consequences, pelvic tilt and lumbar scoliosis, were measured in 100 young or middle-aged adults suffering from chronic low-back pain. Leg-length inequality had a good correlation with the pelvic tilt assessed from the iliac crests, a moderate correlation with the sacral tilt, but a poor correlation with the lumbar scoliosis. ⋯ Thus, there is a gradually decreasing correlation between the posture parameters when moving from the hips up to the lumbar spine. We conclude that before a radiologically observed leg-length inequality be considered as the cause of low-back pain, an erect-posture radiograph of the whole pelvis and lumbar spine is essential, in order to assess an existing pelvic tilt and scoliosis.