Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2009
Successful use of posterior instrumented spinal fusion alone for scoliosis in 19 patients with neurofibromatosis type-1 followed up for at least 25 months.
Posterior instrumented fusion alone has been considered inadequate to correct scoliosis in most patients with neurofibromatosis type-1 (NF-1) because of their weak bone structure. This study was undertaken to evaluate whether the extension of fusion one level beyond the conventional fusion level would enable posterior instrumented fusion alone to be as effective as anterior-posterior fusion in treating patients with NF-1 and scoliosis who are more than 10 years old and whose scoliosis is <90 degrees . ⋯ These results demonstrate that a satisfactory stabilization of scoliosis can be achieved by posterior fusion with instrumentation alone in patients with NF-1 who are more than 10 years old, and whose scoliosis is <90 degrees .
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Angiogenesis is known to be a critical and closely regulated step during bone formation and fracture healing driven by a complex interaction of various cytokines. Delays in bone healing or even nonunion might therefore be associated with altered concentrations of specific angiogenic factors. These alterations might in turn be reflected by changes in serum concentrations. ⋯ We conclude that fracture healing in human subjects is accompanied by distinct changes in systemic levels of specific angiogenic factors. Significant alterations of these physiologic changes in patients developing a fracture nonunion over time could be detected as early as 2 (bFGF) and 4 weeks (PDGF-AB) after initial trauma surgery.
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Arch Orthop Trauma Surg · Jul 2009
Case ReportsA case report of coronal fractures through the hamate, the capitate, and the trapezoid.
To our knowledge, the simultaneous coronal fractures of the hamate, capitate, and trapezoid have not been previously reported in the literature. There were few reports about coronal fractures of the hamate caused only by axial loading to the ulnar column. ⋯ We performed closed reduction and fixation with a percutaneous compression screw. At the last follow-up, the patient was able to return to sports activities without any symptoms.
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Arch Orthop Trauma Surg · Jul 2009
Sublaminar wiring stabilization to prevent adjacent segment degeneration after lumbar spinal fusion.
Adjacent segment degeneration (ASD) is a complication of lumbar spinal fusion. There are some reports on the cause of this degeneration but none concerning its prevention. We performed sublaminar wiring stabilization to prevent ASD after posterolateral lumbar spinal fusion with instrumentation. The purpose of this study was to prospectively evaluate the efficacy of this procedure. ⋯ In this study, it was suggested that sublaminar wiring stabilization significantly reduces the range of motion of the adjacent segment and preserves sagittal lumbar alignment, which lead to prevention of ASD. The clinical outcome of the subsequent surgeries is relatively poor, so it is important to prevent ASD by any prevention such as sublaminar wiring stabilization.
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Arch Orthop Trauma Surg · Jul 2009
Treatment of isolated posterior coronal fracture of the lateral tibial plateau through posterolateral approach for direct exposure and buttress plate fixation.
To present a case series of patients with isolated posterior coronal fractures of lateral tibial plateau treated by direct exposure and buttress plate fixation through posterolateral approach. ⋯ Direct posterolateral approach by dividing lateral border of soleus muscle, provides excellent fracture reduction under visualization and internal buttress plate fixation for posterior coronal fracture of the lateral tibial plateau. Good functional results and recovery can be expected.