Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1990
Femoral shaft perforation at arthroplasty: to treat or not to treat.
Femoral shaft perforation at total hip arthroplasty is a complication that is being noted more frequently, and it is often associated with femoral shaft fracture below the prosthesis. This study examines the anatomic and biomechanical effects of femoral shaft perforation at arthroplasty, and the effects of supporting the perforated bone with Partridge plates and bands. ⋯ Testing the bone models to failure in tensile mode showed that the perforations weakened the bone and that the Partridge plates and bands decreased the weakening effects of the perforation. The strengthening effect of the Partridge plates and bands on the bone with a perforation, allied with the presence of an internal splint in the event of a fracture through the perforation, suggests the benefit of using Partridge plates and bands if a cortical perforation is found at arthroplasty and revision is not feasible.
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Arch Orthop Trauma Surg · Jan 1990
Total decompression of the spinal cord for combined ossification of posterior longitudinal ligament and yellow ligament in the thoracic spine.
One of the causes of hyperostosis in the spinal canal, ossification of the posterior longitudinal ligament (OPLL) combined with ossification of the yellow ligament (OYL) in the thoracic spine, can result in serious myelopathy, leading to sandwich-type compression of the spinal cord from anterior and posterior. For such cases we devised a treatment of total decompression of the spinal cord and intervertebral body fusion. This operation consists of two steps. ⋯ This pre-treatment makes removal of the OPLL anteriorly during the second stage much easier, faster, and safer. This operation is lengthy and demanding. However, based on our experience so far, it appears to be a promising surgical procedure.
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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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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
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.