Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1990
Kinematics of the patellofemoral joint. Investigations on a computer model with reference to patellar fractures.
Patellofemoral kinematics were studied on a computer model. The articulating point of the patella moves from distal to proximal during flexion, until the quadriceps tendon starts to turn around the femur tendo-femoral gliding. The pattern of patellofemoral movement consists of a gliding and rolling component, the latter at its maximum at the beginning of flexion. ⋯ The distal part of the patella is the part with mechanical stress at all angles of flexion. The conclusions to be drawn for treatment are that fractures within the proximal and central part of the patella need a very high stability of internal fixation, the distal part of the patella less so. Postoperative treatment must take into account the changing contact area, because the peak stress is always at the contact area.
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Arch Orthop Trauma Surg · Jan 1990
Absorbable polyglycolide pins in fixation of displaced fractures of the radial head.
In a prospective study 24 patients with a displaced fracture of the radial head were treated by open reduction and internal fixation using absorbable polyglycolide pins, 2 mm in diameter. All patients admitted with fractures involving a quarter or more of the radial head, whether comminuted or not, were included in the study whenever there was a displacement of 2 mm or more between the fragments. The mean follow-up time was 28 months (range 15-43 months). ⋯ A transient inflammatory reaction around the implants occurred in two cases 8-12 weeks postoperatively. The functional end-result was classified as excellent or good in 22 patients (91%). This study indicated that successful fixation of displaced fractures of the radial head can be accomplished by using absorbable pins.
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Arch Orthop Trauma Surg · Jan 1990
The value of intramedullary reaming in the treatment of chronic osteomyelitis of long bones.
Between 1985 and 1990 25 patients with chronic osteomyelitis (osteitis) of long bones were treated by intramedullary reaming. In most cases the aetiology of the osteomyelitis was posttraumatic. 22 of these patients who had undergone intramedullary reaming at least 6 months ago were evaluated. ⋯ One patient produced a little extraosseous sequestrum 3 months after the operation but since then has had no recurrence. The purpose of this study is to propose intramedullary reaming as an excellent treatment for chronic osteomyelitis of long bones and show the pathophysiological background that led to this modality.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsFragmentation of methylmethacrylate: a cause of late failure of total hip replacement. A case report.
Extensive localized bone lysis in the femur following implantation of a metal-on-metal total hip prosthesis was observed. Fragmentation of the cement occurred 10 years after implantation. Histologic and ultrastructural features of macrophages are consistent with the hypothesis that particles from the acrylic resin were the factors stimulating the macrophagic reaction. Both mechanical factors and changes of the physico-chemical properties of the cement may have an etiologic role.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsHemodialysis-associated amyloidosis of bone of beta-2 microglobulin origin.
A case of hemodialysis-associated amyloidosis in a patient who had been on hemodialysis for 10 years is described. Bone lesions were found in the humeral heads, carpal bones, and femoral heads and necks. ⋯ We reconfirmed that bone lesions associated with long-term hemodialysis are manifestations of amyloidosis of beta-2 microglobulin origin. Hemodialysis-associated amyloidosis should be considered in the treatment of long-term hemodialysis patients.