Archives of orthopaedic and trauma surgery
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This 10-year retrospective review of spinal injuries at a destination ski resort was done to determine the incidence and type of spinal and neurologic injury associated with alpine winter sports. Spinal injury patterns and outcomes in skiers and snowboarders over a period of 11 seasons at a destination resort were studied. One-fourth of cervical injuries were associated with a temporary neurologic deficit. ⋯ There was approximately one significant spinal injury every 100,000 skier-days, and only 9% of spinal injuries required surgery. The incidence of death or associated permanent neurologic deficit is low (approximately one per two million skier-days). Skiing and snowboarding have a low incidence of significant spinal trauma.
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Arch Orthop Trauma Surg · Sep 2001
Magnetic resonance arthrography of the acetabular labrum: value of radial reconstructions.
The intention was to compare the sensitivity and specificity of radial planes with oblique coronal and oblique axial planes for the detection of labral abnormalities of the acetabulum on magnetic resonance arthrography (MRa). Twenty cadaveric hip joints were examined by radiography and MRa. For MRa, 15 ml of a solution of iodinated contrast material and gadolinium diethylene triamine tetra-acetic acid (Gd-DTPA; 100:1) were injected under fluoroscopic guidance. ⋯ Also, 3/6 labral degenerations without detachment, 6/7 partial detachments, 2/2 complete detachments, and 1/2 flap-like labra were correctly diagnosed. MRa of the acetabular labrum using radial reconstructions is well suited to delineate the acetabular labrum and to diagnose labral detachments. Radial reconstructions allow for perpendicular display of the whole acetabular circumference and are more accurate for the diagnosis of acetabular labral lesions, when compared with oblique coronal and oblique axial reconstructions.
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Arch Orthop Trauma Surg · Sep 2001
The influence of intermittent external dynamic pressure and tension forces on the healing of an epiphyseal fracture.
In vitro studies about the regenerative capacity of chondrocytes located in the growth plate of long bones revealed a potential for reparation. A measurable advance in the understanding of the physiologic processes in the bone growth plate and their modifications after defined lesions is based on the recognition of the role of the vascular architecture. Newly formed bridging arteries crossing from the metaphysis to the epiphysis through the growth plate are thought to be responsible for the cell proliferation observed after Salter-Harris I and II lesions. ⋯ This was more clearly seen with the use of the dynamic fixator. We conclude that a temporary ischemia with a reactive hyperemia takes place, which we could document by histological analysis and MRI. These results could modify the current clinical therapy of growth plate fractures.
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Arch Orthop Trauma Surg · Sep 2001
Solvent dehydrated bone transplants to bridge segmental bone defects: histomorphological and biomechanical investigations in an animal model.
Cancellous bone is routinely used in human surgery to fill skeletal defects. The availabilty of autogenous and allogenous grafts is limited, however. The aim of this in vivo study was therefore to determine the in-growth behaviour and biomechanical properties of solvent dehydrated human bone as an alternative to the use of autografts. ⋯ The degradation of the solvent dehydrated bone was not complete within the study period as shown by persistent bone remodelling. The bone per tissue volume of remaining solvent dehydrated graft particles together with newly formed bone was significantly higher than for controls. Our observation period was not long enough to document complete remodelling, but good osteointegration and reasonable biomechanical properties in this weight-bearing large animal model support the application of solvent dehydrated bone in cancellous defects of clinical relevance.
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Arch Orthop Trauma Surg · Sep 2001
Osteoid osteoma: technique of computed tomography-controlled percutaneous resection using standard equipment available in most orthopaedic operating rooms.
Symptoms of osteoid osteoma are cured by removing the nidus. 'En-bloc' resection is often not successful because the nidus is hard to find and remove totally. Recently, minimally invasive procedures have been advocated for the resection of osteoid osteoma. Preceding investigators have used a set of special instruments. ⋯ The average time in hospital after surgery was 1.5 days (range 1-3 days). There were two complications, one superficial wound infection and one change of operative technique to an open procedure due to a technical problem. The diagnosis could be confirmed histologically.