Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2004
Randomized Controlled Trial Clinical TrialDorsolateral dislocation of the proximal interphalangeal joint: closed reduction and early active motion or static splinting; a retrospective study.
In a follow-up examination 50 patients who had sustained dorsal dislocations of the proximal interphalangeal (PIP) joint, the results of two conservative therapy regimens, either immobilisation or early motion, were investigated. The patients were assigned randomly. The inclusion criteria were: adult patients over the age of 18 with isolated, acute, closed dorsolateral dislocation of the PIP joint. ⋯ Early active motion after dorsolateral dislocation of the PIP joint produces significantly superior results regarding the active range of motion and pinch power than static splinting.
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Arch Orthop Trauma Surg · Sep 2004
Factors influencing the quality of life after burst fractures of the thoracolumbar transition.
Dorsal stabilisation has represented the standard procedure for the treatment of burst fractures of the thoracolumbar spine for a long time, but in the last few years the combined dorsoventral stabilisation has gained in significance due to its higher mechanical stability. However, there are no data yet available indicating whether the patients benefit from the combined operation with regard to their postoperative quality of life and what the advantages are in comparison with the dorsal procedures. Therefore, the question was researched in the framework of a matched-pairs analysis of patients suffering from an unstable fracture of the thoracolumbar transition. ⋯ The patients in this study showed a reduced quality of life, independent of the method of surgical treatment. Although better radiological results could be seen for the combined procedure, regarding the postoperative quality of life no advantage could be proved compared with the dorsally stabilized patients. Furthermore, there was no relation between the radiological results and the quality of life parameters. Therefore, it can be assumed that the injury itself seems to be the main cause of the decreased quality of life after a burst fracture of the thoracolumbar transition.
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Arch Orthop Trauma Surg · Jul 2004
Comparative StudyUnstable versus stable uncemented femoral stems: a radiological study of periprosthetic bone changes in two types of uncemented stems with different concepts of fixation.
Uncemented stems in total hip arthroplasty (THA) are used increasingly often because they are believed to offer a reliable long-term fixation. However, periprosthetic bone remodelling has been a worrying issue. A proximal demineralization has been noted in femurs with well-fixed stems, and it has been explained as by-passing of mechanical forces along the fixed implant (stress-shielding). Aseptic loosening has been a major problem in several uncemented series with earlier designs. The objective for this study was to investigate how the host bone adapts to a loose stem compared with a well-fixed stem after a long time. ⋯ The assessment of periprosthetic bone remodelling after uncemented THA with long-term observation shows a different host-bone response in stable versus unstable femoral implants. Prior to a femoral revision, measurement of the BMD could be beneficial; it may guide the surgeon when deciding which surgical technique to use.
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Arch Orthop Trauma Surg · Jul 2004
Case ReportsTreatment of missed posterior dislocation of the shoulder by delayed open reduction and glenoid reconstruction with corticocancellous iliac bone autograft.
This is a report of a 2-year follow-up of a missed posterior shoulder dislocation treated with open reduction and glenoid reconstruction with corticocancellous iliac bone autograft. In such cases, this treatment option may be an alternative to hemiarthroplasty of the shoulder.
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Arch Orthop Trauma Surg · Jun 2004
Review Case ReportsLate esophageal perforation complicating anterior cervical plate fixation in ankylosing spondylitis: a case report and review of the literature.
Esophageal perforation in ankylosing spondylitis (AS) is a rare complication in anterior cervical spine surgery and has not been reported before. A 50-year-old patient with AS developed incomplete tetraplegia after minimal trauma. C5 pedicle fracture was diagnosed and treated predominantly by physical therapy until neurological symptoms progressed. ⋯ We conclude that esophageal perforation after anterior spinal fusion is a rare complication. Minor traumas in patients with AS are unstable and can result in significant spinal injury. Dorsoventral stabilization should be performed to avoid further complications.