Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1990
The importance of functional magnetic resonance imaging (MRI) in the planning of stabilizing operations on the cervical spine in rheumatoid patients.
Chronic inflammatory diseases, such as chronic polyarthritis or spondylarthritis ankylopoietica, can occasionally lead to vertebral instabilities of the occipitoatlantal or atlantoaxial level, requiring some form of stabilizing operation. By means of functional magnetic resonance imaging, i.e., with the cervical spine at its maximal range of flexion and extension, performed on 11 patients suffering from an instability at the above level, it was possible to demonstrate not only the extent of synovial tissue, but also how this sometimes excessive soft-tissue growth hinders an adequate reduction of the subluxated vertebrae. The importance of this investigation lies in the fact that the necessary operation can be planned appropriately. As such, three patients required a decompressing operation entailing resection of the posterior arch of the atlas, widening of the foremen magnum, or both.
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Pigmented villonodular synovitis is a benign disease of the synovial membrane of joints, tendon sheaths, or bursae, which nevertheless can cause marked local destruction. Its diagnosis is often delayed because complaints and symptoms are nonspecific. Familiarity with the disease may ensure an earlier diagnosis and consequently early onset of therapy, which may prevent serious damage. ⋯ Findings possibly suggestive of pigmented villonodular synovitis include hemarthrosis, soft tissue swelling, radiological evidence of cyst formation at a distance from the weight-bearing area of a joint, an increased triglyceride concentration, and a positive bone scan. A normal appearance on arthroscopy does not rule out the disease. Therapeutic results are better in the localized than in the diffuse form of the disease.
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Arch Orthop Trauma Surg · Jan 1990
The polymorphonuclear leukocyte: has it a role in fracture healing?
The aim of the present study was to assess whether the presence of polymorphonuclear leukocytes in the first stage of fracture repair was of any importance. In anesthetized male Wistar rats, a transverse osteotomy was performed at midshaft in one femur and immediately stabilized by an intramedullary Kirschner nail. The animals were allowed unprotected weight bearing immediately. ⋯ There were no differences in the amount of callus measured or in radiological healing. However, there was a significantly higher bending moment in femurs from animals treated with ANS than in those given NSS (P less than 0.02). No differences were observed in rigidity or total energy absorption.
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Arch Orthop Trauma Surg · Jan 1990
Comparative StudyInfluence of bone and soft-tissue operations on serum concentrations of growth hormone, somatomedin C and alkaline phosphatase.
After animal experiments suggested there was an interaction between growth hormone and bone healing, our aim in this paper was to ascertain whether there were any changes or possible interaction between the serum level of growth hormone, somatomedin C and alkaline phosphatase while a fractured bone was healing. To this end, the serum concentrations of growth hormone, somatomedin C, alkaline phosphatase and calcium were ascertained both pre- and post-operatively in two groups of patients--one with bone operations, the other with soft-tissue operations--and the results were compared. ⋯ An increase would have implied that these two hormones are directly involved in bone regeneration. There was no change in the serum level of alkaline phosphatase or calcium after either bone or soft-tissue operations.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsWhich X-ray views are required in juvenile ankle trauma?
Although ankle sprains are probably the most common injury in adolescent sports people, epiphyseal injuries are missed on the presumption of a ligamentous tear. The risk of damaged ligaments has been overemphasized while the potentially dangerous epiphyseolysis has been understressed. An oblique X-ray of the ankle joint is indicated prior to "stress" pictures.