Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsModification of the Wagner lengthener to permit dynamic axial loading.
The Wagner lengthener is mechanically excellent, but it lacks a function allowing dynamic axial loading (dynamization), which stimulates bone consolidation at the lengthened section. The authors devised a simple metal insert with which they modified the Wagner lengthener to permit dynamization. The modified appliance was successfully used in two patients.
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The present authors analyzed the pathological alterations of 1966 tendons examined in the National Institute of Traumatology, Budapest, during the past 18 years. The majority of cases proved to be tendinopathies (hypoxic-degenerative tendinopathy or calcific tendinitis, tendolipomatosis and mucoid degeneration) leading to tendon rupture. The incidence of tendon tumors, foreign bodies, infectious tendon diseases, and other pathological conditions was clearly lower. ⋯ In degenerative tendinopathies and alterations due to hereditary disease, electron microscopy was necessary. Polarization microscopy had a key role in examination of collagen structure and architecture, and identification of foreign bodies in the tendons. Enzyme histochemical and immunohistochemical examination were reliable but not absolutely necessary in the diagnosis of tendon pathology.
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Arch Orthop Trauma Surg · Jan 1990
Clinical TrialLimb lengthening and three-dimensional deformity corrections. A retrospective clinical study.
Different methods of limb lengthening as used at the Orthopedic Surgery Clinic of the Medical School, University of Zagreb, are compared. The results of operations performed between 1979 and 1989 on 111 patients are presented. These patients were subjected to surgery aimed at length equalization of limbs and/or correction of three-dimensional deformities. ⋯ These advantages manifest themselves in a reduced number of operations, lower incidence of infection and improved bone regeneration. It is preferable to perform corticotomy at the metaphysis site because of its optimum blood supply and its higher potential for osteogenesis. With corticotomy performed at the diaphysis site, satisfactory results were observed in only one-third of the cases.
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Arch Orthop Trauma Surg · Jan 1990
Vascularized pedicled bone graft into the femoral head--treatment of aseptic necrosis of the femoral head.
Revitalization of the femoral head in cases of aseptic necrosis was attempted in 13 hips of 11 patients 15-33 years of age. The necrotic bone was replaced by a vascularized pedicular iliac bone graft and free cancellous transplants. The results after an average follow-up of 53 months are satisfying in some cases. The surgical technique used is simple and applicable when a vascularized bone graft is needed in the hip region.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsBilateral congenital pseudarthrosis of the clavicle.
A case of bilateral congenital pseudarthrosis of the clavicle in a baby boy is described. The patient is fully asymptomatic, and no functional impairment is present. This is probably only the seventh case described of this rare congenital anomaly.