Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · May 2002
Case ReportsArthroscopical removal of a projectile from the intra-articular cavity of the knee joint.
We report the case of a 29-year-old patient with an uncommon handgun accident. A gun was resting in his pocket when an accidental shot was fired. ⋯ The bullet was localized by conventional X-rays and removed by arthroscopy. The patient developed no infection, and in a clinical follow-up examination 6 months postoperatively, we observed no pathological findings.
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Arch Orthop Trauma Surg · May 2002
The biological and biomechanical effect of different graft tensioning in anterior cruciate ligament reconstruction: an experimental study.
The objective of the present animal experimental study was to determine the effect of initial graft tension (1 N, 7.5 N, 17.5 N) on the biomechanical and histological behavior of the anterior cruciate ligament (ACL) graft using a rabbit model. After 2, 8, and 32 weeks, the femur-ACL-tibia complex was removed, and biomechanical and histomorphometrical studies were performed. The morphometric parameters cellularity, cell nucleus volume, and vascularity increased up to the 8th postoperative week and showed significant differences between the study groups. ⋯ In the present study, it was demonstrated that an intraoperatively selected initial tension of 17.5 N induces histomorphometric changes in the graft, which result in a higher biomechanical loading capacity. The results showed that higher initial graft tension resulted in improved histological and biomechanical parameters. Pathological changes in the graft such as an increased central necrosis rate or cartilage damage due to 'overconstraining' of the knee were not observed at the selected initial tensions.
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Arch Orthop Trauma Surg · Mar 2002
Review Case ReportsSpontaneous haematoma of the iliac psoas muscle: a case report and review of the literature.
Spontaneous haematomas of the iliac psoas muscle are rare lesions seen in patients receiving anticoagulant agents or suffering from clotting disorders. We report the rare case of a spontaneous iliac psoas haematoma causing femoral neuropathy in a patient not undergoing anticoagulant treatment or suffering from a coagulopathy. After conservative treatment the patient was entirely asymptomatic, and magnetic resonance imaging demonstrated complete dissolution of the haematoma. Spontaneous iliac psoas haematomas should be considered in the differential diagnosis of leg pain in otherwise healthy patients.
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Arch Orthop Trauma Surg · Mar 2002
Comparative StudyFunctional treatment after surgical repair of acute Achilles tendon rupture: wrap vs walking cast.
The aim of this study was to compare the clinical outcome for patients treated with walking cast immobilization and wrap early mobilization after surgical repair of acute Achilles tendon ruptures. A total of 39 consecutive patients with complete ruptures of the Achilles tendon were identified, treated, and functionally rehabilitated with either a walking cast or a wrap. Because the randomization was quasi-random, chi-square and t-tests were performed to compare the baseline characteristics. ⋯ One re-rupture was reported in the walking cast group (4.3%). Functional treatment after surgical Achilles tendon repair is safe, and there is no increased risk of re-rupture or wound healing problems. Functional treatment with a wrap is preferable to treatment with a walking cast with respect to hospitalization time and return to sports.
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Arch Orthop Trauma Surg · Mar 2002
Comparative StudyEffect of continuous versus dichotomous outcome variables on study power when sample sizes of orthopaedic randomized trials are small.
It is often not feasible to conduct large trials in orthopaedic surgery. Therefore, surgeons must identify strategies to optimize the statistical power of their smaller studies. The aim of this study was to compare study power in randomized trials with continuous versus dichotomous outcome variables. ⋯ Studies that reported continuous outcomes had a significantly higher mean power than those that reported dichotomous variables (power 49% vs 38%, p=0.042). Twice as many trials with continuous outcome variables reached acceptable levels of study power (i.e. >80% power) when compared with trials with dichotomous variables (37% vs 18.6%, p=0.04). When orthopaedic surgeons anticipate small sample sizes for their study, they can optimize their study's statistical power by choosing a continuous outcome variable.