Archives of orthopaedic and trauma surgery
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Thirty injuries involving the proximal tibial epiphysis were treated during a period of 28 years. The epiphysis was displaced in 16 cases (53%). ⋯ Three of the six patients with unsatisfactory outcome had a discrepancy in leg length of more than 2.5 cm after concomitant ipsilateral fracture of the femur or the tibia. One patient had a positive 3-cm anterior drawer sign, one patient had a 10 degree valgus deformity of the tibia, and one had to undergo above-knee-amputation because of delayed diagnosis of the vascular lesion.
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Arch Orthop Trauma Surg · Jan 1991
Case ReportsPseudoarthrosis of the ulna in neurofibromatosis. A report of four cases.
Four children suffering from neurofibromatosis with ulnar pseudarthrosis and progressive reabsorption of the middle and distal thirds of the ulna are reported. None had any pain or sensory loss, but all had progressive deformity of the forearm. ⋯ Non-operative management was decided on in the patient with slow ulna reabsorption. The creation of a one-bone forearm is more likely to produce sound union, thus avoiding the need for further operations, while conservative management should be reserved for patients with a slowly progressive condition.
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The case is reported of a young girl who was bitten on the hand by a viper and developed compartment syndrome of the intrinsic muscles more than 24 h later. Multiple dorsal and volar fasciotomies resolved the acute episode with complete restitutio ad integrum. The clinical case is discussed in detail and the literature on these rare complications of snake bites in European countries reviewed.
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Arch Orthop Trauma Surg · Jan 1991
Influence of immobilization on autograft healing in the knee joint. A preliminary study in a sheep knee PCL model.
The influence of immobilization on patellar tendon autograft healing was investigated in 12 sheep with replaced posterior cruciate ligaments of the knee (PCLs). In one group achillotomy immobilized the operated knee joint. In another group initial reduced weight-bearing was obtained by hanging the sheep in a special trapeze. ⋯ The best data were observed in the no-protection group. This study demonstrates the negative effect of immobilization on autograft healing in a sheep PCL model. Even early in the healing process tissue may be extremely sensitive to stress and strain.
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Arch Orthop Trauma Surg · Jan 1991
Reconstruction of the anterior cruciate ligament alone in the treatment of a combined instability with complete rupture of the medial collateral ligament. A prospective study.
In a prospective study, 14 patients with a complete rupture of both the anterior cruciate ligament (ACL) and the medial collateral ligament (MCL) were treated by reconstruction of the ACL alone. The torn MCL was not addressed. The initial instability was documented clinically and by stress radiographs (20 kp) taken under anaesthesia. ⋯ Follow-up examination at an average of 14 months demonstrated excellent results in 11 cases, good in 2 cases, and fair in 1 case. With the exception of one residual anterior tibial translation of 8 mm, all knees showed almost normal stability in the frontal and sagittal plane, with full range of motion. These result confirm that ACL reconstruction utilizing the patellar tendon alone is sufficient in the treatment of combined instability due to ACL and MCL injuries.