Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1991
ReviewTumors and tumor-like lesions arising in tendons. A clinicopathological study of 75 cases.
Eight cases of malignant tumors, 38 cases of benign tumors, 15 cases of metastatic tumors, and 14 cases of tumor-like lesions arising in tendons seen over a period of 22 years (1967-1988) are surveyed. Benign tumors of tendon occur relatively frequently - in 38 (1.7%) of 2143 tendon biopsies - but malignant tumors (0.37%) and metastases (0.70%) are extremely rare. Malignant tumors occurred most frequently in lower limb tendons, while benign tumors were most often found in the tendons of the hand.
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Arch Orthop Trauma Surg · Jan 1991
ReviewBlood loss in total hip replacement. A retrospective study.
Two hundred and twelve total hip replacements performed in one clinic over 1 year were reviewed. The mean operative time was 89 min and mean total blood loss 1090 ml. Homologous blood was administered to 74% of the patients. ⋯ Despite a mean of only 12 total hip replacements per surgeon, both operative time and blood loss were small compared to what was found in other studies. The use of a posterior approach is believed to contribute to a shorter operative time as well as to moderate blood loss. Intraoperative blood loss was less under epidural than under general anaesthesia, but in contrast to others we found higher postoperative blood loss after epidural anaesthesia.
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Among the available imaging techniques such as conventional radiography, radionuclide bone scan, and computed tomography (CT), magnetic resonance imaging (MRI) has made significant contributions to the diagnosis of acute hip joint disease in adults by enabling early differentiation between such conditions as idiopathic avascular femoral head necrosis, septic coxitis, degenerative disease, and tumors. In this study we investigated the use of MRI for evaluation of patients with transient osteoporosis (TO). MRI with T1- and T2-weighted sequences in coronal, transverse, and sagittal sections was performed in 12 patients with retrospectively confirmed TO, both at the onset of the disease and later as follow-up procedure. ⋯ Characteristic symptoms of TO are hip pain and a need for protective splinting of the hip joint. Conventional radiographs show demineralization of the hip joint without joint space narrowing. Clinical, radiologic, and MRI findings normalize within 6-10 months, indicating that TO has a good prognosis with complete restoration of bone density.
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Arch Orthop Trauma Surg · Jan 1991
Review Case ReportsMacrodystrophia lipomatosis in the foot. A case report and review of the literature.
A rare case of macrodystrophia lipomatosis in the foot is reported. The literature is reviewed and the different presentations of macrodactyly are discussed.
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Arch Orthop Trauma Surg · Jan 1991
ReviewIndications for and results of operative treatment of spondylitis and spondylodiscitis.
We present a retrospective follow-up study of 24 patients with spondylitis or spondylodiscitis whose treatment included surgical intervention. Tuberculous spondylitis was diagnosed in 14 patients and 10 suffered from non-specific spondylitis. The average age of the patients was 50.2 years and average follow-up was 3 years. ⋯ We recommend radical debridement and spinal fusion through a ventral approach in patients with destruction of the ventral vertebral body, progressive neurological impairment, septicaemia and antibiotic-resistant, symptomatic infections of the spine. In the elderly patient, even in reduced states of health, early surgical intervention can be particularly valuable. Although surgical intervention should be reserved for specific indications, we were able to document favourable results in all 24 patients treated with debridement and spinal fusion.