Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1984
Randomized Controlled Trial Clinical TrialEarly results after Colles' fracture: functional bracing in supination vs dorsal plaster immobilization.
A randomized clinical study of functional bracing in supination (FUSU) versus dorsal plaster immobilization (DPI) was conducted in 145 patients with Colles' fracture. A dynamic wrist unit was developed and used in 68 patients allocated for FUSU. The anatomical end result after FUSU was excellent or good in 80% of the patients versus 64% after DPI (P less than 0.05), in particular due to less dorsal angulation (P less than 0.001) and less radial shortening. ⋯ At 6 months, 92% satisfactory results were achieved after FUSU versus 86% after DPI (P less than 0.05). Both anatomical and functional benefits were recorded in Frykman type V, VI, and VIII fractures and in the group of displaced intra-articular fractures. The functional benefit from FUSU is suggested primarily to be secondary to decreased fracture redislocation.
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Arch Orthop Trauma Surg · Jan 1984
Mechanical effects of reaming and implantation of acrylic cement into the medullary cavity of bones.
Changes in the mechanical properties of the rat femur caused by intramedullary application of bone cement were studied. In one group of animals reaming of the medullary cavity was performed, and bone cement was injected. In a control group only reaming was performed. ⋯ This may be attributed to more periosteal bone being deposited, as implantation of bone cement induced a significant increase in periosteal reaction. The elastic stiffness of the bone was not altered either by reaming or the implantation of bone cement. It is concluded that reaming and implantation of bone cement into the medullary cavity do not impair the mechanical properties of the femur in the young rat.
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Arch Orthop Trauma Surg · Jan 1984
Case ReportsPseudarthrosis resulting in complete paraplegia fifteen years after spinal fusion.
Paraplegia immediately following spinal fusion is a known problem. This case demonstrates the importance of long-term follow-up of fusion patients. Prompt attention must be given to any change in neurological status. A careful check must be made for pseudarthrosis and for secondary compression of the spinal cord as possible causes of neurological compromise.
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Arch Orthop Trauma Surg · Jan 1983
Supination-adduction injuries of the ankle in children--radiographical classification and treatment.
Diagnostical and therapeutical problems associated with supination-adduction injuries are presented. 457 ankle fractures were collected from a retrospective material of 919 children aged 0-18 years with fractures of the tibio-fibular shaft or the ankle. The ankle fractures were classified anatomically according to Salter and Harris and traumatologically according to Gerner-Smidt. 147 fractures were classified as due to supination-adduction, of which 128 had open growth plates. The first stage, a Salter-Harris type I, II, or III fracture through the lateral malleolus or only epiphyseal fracture without fracture through the growth plate, is easily overlooked and is probably more common than earlier registered. ⋯ The supination-adduction injuries are the second most common type of ankle fractures in children (32%) only exceeded by injuries due to supination-eversion (39%). Early recognition of the fracture pattern of supination-adduction injuries is important as growth disturbance and joint problems are not uncommon when there is fracture through the medial malleolus. The need for correct diagnosis and treatment is stressed by the risk for late problems.
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Arch Orthop Trauma Surg · Jan 1983
Animal experiments to examine the histology of fracture healing in osteosynthesis with external fixation and compression.
Tibia osteotomies in sheep were stabilized in nail-fixed and wire-fixed external devices with static longitudinal compression. During the 8-week study programme the mechanical situation of the osteotomies was checked via continuous measurements of interfragmentary tension, used as a functional indicator of stabilization. ⋯ Under stable osteosynthesis conditions primary bone healing occurred analogous to findings in flattened experimental shaft fractures. On grounds of varying stability performance of external pressure osteosynthesis differences in secondary healing of osteotomies were observed due to interfragmentary instability.