Archives of orthopaedic and trauma surgery
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Arthrography of the wrist joint as a dynamic examination aids in confirming lesions of interosseous ligaments of the triangular fibrocartilage complex and soft tissue. The results of arthrography in 185 wrists, classified according to age of patients and pathological disorders with or without trauma demonstrate mostly post-traumatic discus lesions in younger patients. ⋯ Pathological changes of biomechanics of the hand and wrist are noticed more often and consequently are treated surgically. Arthrography of the wrist joint is a valuable means of diagnostic imaging.
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Arch Orthop Trauma Surg · Jan 1990
Comparative StudyAutomated percutaneous lumbar discectomy with and without chymopapain pretreatment versus non-automated discoscopy-monitored percutaneous lumbar discectomy. An experimental study in human cadaver spines.
Percutaneous lumbar discectomy has gained growing interest during recent years as an alternative to open surgery for protrusions and non-sequestrated subligamentous intervertebral disc herniations. As a less invasive method it competes with chemonucleolysis. At least two modifications are known to date: automated percutaneous lumbar discectomy (APLD) with a 2-mm suction probe and non-automated, discoscopy-monitored percutaneous lumbar discectomy with a suction rongeur and a motor-driven shaver (NAPLD). ⋯ By contrast, the rongeur, which first cuts the material to be removed and then carries it away by suction, was much more effective. Further data to support the advantages of non-automated percutaneous nucleotomy are discussed. Pretreatment of the disc with chymopapain did not result in a higher yield of nucleus material when combined with APLD.
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Arch Orthop Trauma Surg · Jan 1990
Comparative StudyThe APS knee joint prosthesis. A review of 32 patients.
First clinical and radiographic results with a new knee joint prosthesis, implanted without cement, are reported and the characteristics of the implant (dowel fixation and special instrumentation) presented. The first series of 35 joints with a follow-up period of 1-3 years shows excellent results. ⋯ If these two conditions are met, there is every probability of successful implantation. No problems specific to the implant have been encountered.
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Arch Orthop Trauma Surg · Jan 1990
Comparative StudyThe Tikhoff-Linberg procedure for bone tumors of the proximal humerus: the classical "extensive" technique versus a modified "transglenoid" resection.
The authors report on two groups of patients (each with 12) with primary bone tumors of the humerus who underwent either a classical Tikhoff-Linberg (T-L) procedure or a modified technique by which the body of the scapula was saved. The latter procedure was an "en bloc" resection of the glenohumeral joint after an extra-capsular osteotomy of the neck of the scapula, followed by reconstruction with a modular prosthesis. ⋯ Besides producing better aesthetic and functional results, the modified technique offered the advantages of shorter anesthesia time, less blood loss, and a better anchorage of the prosthesis. The results of this study show that the proposed modification of the T-L procedure is indicated in patients with bone tumors of the proximal humerus in which invasion of the joint capsule is present without macroscopic involvement of the glenoid.
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The instability of atlanto-axial subluxation remains a challenging problem in patients with rheumatoid arthritis. In order to preserve as much function of the cervical spine as possible, inclusion of the occiput into the fusion should exclusively be performed when there is a radiologically or clinically manifest pathological condition of the atlanto-occipital joint or marked upward migration of the dens axis. ⋯ This article presents a retrospective analysis of the clinical and radiological results of occipito-cervical fusion in 26 patients with rheumatoid arthritis using a modified Brattström technique. The complications encountered were mainly due to the use of wire fixation, reinforcement using bone cement and insufficient reduction of atlanto-axial subluxation.