Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Oct 2003
Articulated distraction of the hip joint in the treatment of benign aggressive tumors located around the hip joint.
The proximal femur and acetabulum are frequent sites for benign active and aggressive lesions. The risk of pathologic fracture is great when a bone-destroying pathology involves an anatomic location such as the hip joint that undergoes profound mechanical loading. If the destruction involves a large area around the joint, secure fixation cannot be achieved with internal fixation implants. The study investigates use of articulated hip distraction to protect reconstructions performed for the treatment of benign active or aggressive tumors presenting with pathologic fracture. ⋯ According to the authors' knowledge, this investigation is the first in the literature describing the use of articulated joint distraction in the treatment of benign active and aggressive lesions around the hip joint. The procedure adopts principles of joint distraction into bone tumor surgery.
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Arch Orthop Trauma Surg · Oct 2003
Traumatic labral avulsion from the stable rim: a constant pathology in displaced transverse acetabular fractures.
During the treatment of a malunited transverse acetabular fracture, a hitherto undescribed extended avulsion of the labrum from the stable acetabular fragment was found. Based on the labral pathomorphology present in this case, the hypothesis was put forward that traumatic acetabular labral avulsions are a constant phenomenon in transverse acetabular fractures. ⋯ With displaced transverse acetabular fractures, consideration should be given to opening the joint at the time of open reduction and internal fixation to look for associated intracapsular injuries. An avulsed portion of the labrum should be left if stable and undamaged. If unstable and damaged, it is probably better resected and if unstable but intact and/or attached to a bony fragment, it should be repaired.
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Arch Orthop Trauma Surg · Oct 2003
Comparative StudyAO or Schatzker? How reliable is classification of tibial plateau fractures?
We compare the intra- and interobserver reproducibility of classifications of tibial plateau fractures most commonly used in our clinical practice. These were the AO and Schatzker classifications. ⋯ For tibial plateau fractures seen on plain x-ray, the AO classification is more reliable between observers than the Schatzker classification.
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Arch Orthop Trauma Surg · Oct 2003
Case ReportsBenign noninfectious subcutaneous emphysema of the hand.
A 17-year-old girl presented pain and subcutaneous crepitation in the left hand. Because of lack of systemic symptoms, non-infectious cause was considered. Radiographic and magnetic resonance imaging revealed subcutaneous emphysema. ⋯ Pneumomediastinum and subcutaneous emphysema disappeared during 6 weeks of follow up with conservative methods. This might have prevented unnecessary surgical intervention. This report demonstrates that benign non-infectious subcutaneous emphysema of the hand due to pneumomediastinum should be kept in mind in hand surgery.
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Arch Orthop Trauma Surg · Oct 2003
Case ReportsRecurrent aggressive chondrosarcoma of the middle phalanx of the index finger: excision and reconstruction with an osteocartilaginous allograft.
Chondrosarcomas are malignant tumours and need to be treated aggressively including ablative surgery. Bovée et al. and Mankin have recently drawn attention to a less aggressive behaviour of chondrosarcomas of the phalanges compared with those of other localizations including the metacarpals. ⋯ The potential for systemic disease of chondrosarcomas of the phalanges is probably much lower than in chondrosarcomas of other localizations, and therefore digit-sparing techniques may be considered rather than ablative procedures.