Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1990
Prognosis of primary anterior shoulder dislocation in young adults.
From 1982 to 1987, 194 patients with 196 primary traumatic anterior shoulder dislocations were treated in our hospital. One hundred and sixty-six patients with 168 shoulder dislocations (87%) were available for study at follow-up an average of 4 years after treatment. The most important prognostic factor in relation to recurrence was the age of the patient at the time of the primary dislocation. ⋯ Athletes in this age group had no worse a prognosis as to recurrence than non-athletes. A fracture of the greater tuberosity improved the prognosis significantly (P less than 0.01). Neither the presence of a Hill-Sachs lesion nor the period of immobilization influenced the recurrence rate in patients aged 30 years and younger.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsTreatment of an old infection in a total hip replacement with an interim spacer prosthesis.
When treating a septic hip-joint prosthesis with bone loss of the proximal femur secondary to osteomyelitis, we implanted a specially designed prosthesis to act as a local antibiotic and spacer between the acetabulum and femur until the infection abated. Arthroplasty could then be carried out with no trouble and there was no recurrence of infection.
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Arch Orthop Trauma Surg · Jan 1990
Diagnosis of bone and joint infection by leucocyte scintigraphy. A comparative study with 99mTc-HMPAO-labelled leucocytes, 99mTc-labelled antigranulocyte antibodies and 99mTc-labelled nanocolloid.
Fifty-five patients with 60 suspected infections of bones or joints were studied with 99mTc-hexamethylpropyleneaminooxine- (HMPAO-) labelled leucocytes and 99mTc-labelled antigranulocyte antibodies, in part supplemented with 99mTc-labelled nanocolloid. The findings using the different procedures were in good agreement. ⋯ Spondylitis usually shows as non-specific cold lesions. A subtraction technique with computer assisted analysis of HMPAO and nanocolloid scans provides a more precise diagnosis of this condition.
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Arch Orthop Trauma Surg · Jan 1990
Articulotrochanteric distance in slipped capital femoral epiphysis.
The difference in altitude between the proximal limit of the femoral head and the tip of the greater trochanter--the articulotrochanteric distance (ATD)--was recorded in 312 patients with slipped capital femoral epiphysis and compared with that in normal hips. The ATD was markedly reduced after severe slipping, independent of the method of treatment. ⋯ Nonoperative treatment and osteosynthesis with the Johansson nail or Nyström pin caused a slight reduction of the ATD, while no reduction was seen after hook-pinning. These differences probably reflect various degrees of damage to the subcapital growth plate, which may result in leg length difference and abduction insufficiency.
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Arch Orthop Trauma Surg · Jan 1990
Aseptic osteonecrosis of the humeral trochlea (Hegemann's disease).
A differential diagnosis of diseases affecting the elbow joint in children should also give due consideration to osteonecroses. They are very rare in the context of the humeral trochlea, the case with which we are concerned being one of a total of 15. In the light of this syndrome's relative rarity, we will report on the case of a 7-year-old boy. This is also the first time that a MR image of Hegemann's disease has been shown.