Archives of orthopaedic and trauma surgery
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The locked or unlocked intramedullary nail is considered today in most institutions the first choice for stabilisation of the majority of closed diaphyseal fractures of the femur and tibia. In 1st and 2nd degree open fractures of the tibia, the unreamed locked nail may perhaps become the preferred implant. ⋯ The plate and external fixator will remain indicated in most fractures with meta- and epiphyseal extension as well as in situations in which the intraoperative fluoroscopy is not available. Our experience with the new AO universal femur and tibia nails are being reported.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsTibial hypo-/aplasia with preaxial syn- and polydactyly.
Tibial hypo-/aplasia with preaxial syn- and polydactyly is a rare autosomal dominant condition. Fewer than 20 cases have so far been described. One is presented here.
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Arch Orthop Trauma Surg · Jan 1990
Ultrasonographic detection of foreign bodies in soft tissue. A human cadaver study.
The usefulness of ultrasound in the detection of foreign bodies was examined in a blind study in human cadavers using glass, plastic and wood as foreign bodies. Of 65 foreign bodies placed in 102 cicatrices, 58 were found using a 5 MHz transducer. The sensitivity was 89% and the specificity 93% making ultrasound a useful clinical tool for this purpose.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsMassive wear of a steel ball head by ceramic fragments in the polyethylene acetabular cup after revision of a total hip prosthesis with fractured ceramic ball.
The purpose of this case study of severe metallosis is to draw the attention of orthopedic surgeons to extremely serious results of this kind in the event of the fracture of the ceramic ball in a total hip prosthesis. Eleven months after implantation of a KJF hip prosthesis with an aluminum oxide ceramic ball in combination with a polyethylene acetabular cup, fracture of the ceramic ball was observed. After examining the polyethylene cup during the revision operation, the operating orthopedic surgeon merely replaced the fractured ceramic ball with a metal ball head made of stainless steel. ⋯ It is these extremely hard ceramic fragments that were responsible for the massive wear of the steel ball head, the hardness of which is approximately ten times less than that of aluminum oxide ceramic. The fracture of the ceramic ball further resulted in damage to the metal taper of the stemmed femoral component. In cases of this kind it is consequently absolutely essential to remove both the polyethylene cup and the ball head, and--if necessary--the femoral component as well.
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Arch Orthop Trauma Surg · Jan 1990
Nonsteroid anti-inflammatory drugs prevent the recurrence of heterotopic ossification after excision.
The prophylactic effect of nonsteroid anti-inflammatory drugs on the recurrence of high-grade periarticular heterotopic ossification after resection was studied in ten patients operated on for loosening of one or both components of a cemented total hip prosthesis. These drugs, given at a standard dosage for 1-3 weeks after surgery, prevented the recurrence of heterotopic ossification. ⋯ At follow-up 2-5 years after surgery, all patients walked well and there were no clinical or radiographs signs of loosening of the prosthetic components. It is concluded that treatment with NSAIDs following resection of periarticular heterotopic ossification prevents recurrence.