Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2001
Scapular neck fracture--the influence of permanent malalignment of the glenoid neck on clinical outcome.
A scapular neck fracture is considered unstable if it is associated with an ipsilateral clavicular fracture or an acromioclavicular (AC) joint dislocation. Currently, it is recommended that stabilization of a disrupted shoulder girdle must be achieved through open reduction and internal fixation of the clavicular fracture or by reduction of the AC joint, without addressing the scapular neck. However, if the displaced glenoid neck is not simultaneously reduced, malalignment of the glenoid neck may persist. ⋯ Loss of motion was found in only 2 patients, and both had a severely displaced glenoid neck (P = 0.088). In conclusion, severe displacement of the glenoid neck may occur with or without associated fracture of the clavicle or dislocation of the AC joint and can be identified as a GPA less than 20 degrees. Scapular neck fractures with such malalignment have a less favorable long-term outcome compared with otherwise comparable cases with absence of glenoid malalignment as measured with the glenopolar angle.
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Arch Orthop Trauma Surg · Jun 2001
Mid-term results of the cementless CLS stem. A 7- to 11-year follow-up study.
Between 1986 and 1990, 335 primary total hip arthroplasty (THA) were performed using the cementless CLS stem. The mean age at surgery was 55.3 years. The retrospective study was performed at an average follow-up time of 8.9 years. ⋯ Radiolucent lines were found in 43.5%, and 11% showed enlargement with time. Focal osteolyses were present in 36%, of which 24% progressed with time. At the latest follow-up, we did not find any stem loosening clinically or radiologically.
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Arch Orthop Trauma Surg · Jun 2001
Case ReportsNon-union of the capitate with associated triangular fibrocartilage tear.
We report a case of a 19-year-old boy who presented with a painful wrist 3 months after a fall. Plain radiographs demonstrated a non-union of a capitate fracture which was unrecognised at the time of injury. Magnetic resonance imaging confirmed the diagnosis and also demonstrated a tear of the triangular fibrocartilage complex. This combination of injuries has not been previously described.
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Arch Orthop Trauma Surg · Jun 2001
Case ReportsTreatment and clinical management of recurrent knee empyema due to methicillin-resistant Staphylococcus aureus (MRSA) after total knee replacement.
We describe a patient with recurrent knee empyema and associated complications caused by methicillin-resistant Staphylococcus aureus (MRSA) after total knee replacement and the difficulties and limited options in its clinical management.
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Arch Orthop Trauma Surg · Jun 2001
Knee and ankle: human joints with different susceptibility to osteoarthritis reveal different cartilage cellularity and matrix synthesis in vitro.
Clinical experience shows that symptoms and pathological changes of primary osteoarthritis (OA) are more frequent and severer in the knee than in the ankle joint. The different anatomy of both weight-bearing joints implies that biomechanical differences may contribute to their varying susceptibility to OA. This study aims at elucidating other non-biomechanical factors to explain these fundamental differences in secondary OA prevalence. ⋯ In addition, cartilage from the ankle joint is significantly more cellular than cartilage from the knee joint. In general, ankle chondrocytes synthesize more proteoglycans (PGs) and collagens than knee chondrocytes, and deep zone chondrocytes more than superficial zone chondrocytes. The biochemical properties of chondrocytes of the ankle and knee joints differ significantly and might play an important role in the pathogenesis of OA.