Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2001
Case ReportsGlomangiopericytoma causing oncogenic osteomalacia. A case report with immunohistochemical analysis.
A 47-year-old woman suffered from gait disturbance due to back pain and muscle weakness. Laboratory data showed serum hypophosphatemia, elevated alkaline phosphatase, and a normal level of ionized calcium. Radiological examinations revealed multiple pathologic fractures in the ribs and pubic rami. ⋯ After removal of the tumor, her symptoms disappeared immediately. Laboratory data normalized 8 months later. To our knowledge, this is the first report of oncogenic osteomalacia caused by glomangiopericytoma.
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Osteoid osteoma is a benign bone tumor that rarely localizes in the hand or the carpal bones. We report two cases of osteoid osteoma localized in two different carpal bones. ⋯ Surgical treatment including excision of the nidus was dramatically curative. In young patients, osteoid osteoma should be considered in the differential diagnosis of chronic wrist pain.
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Arch Orthop Trauma Surg · Jan 2001
Alteration of collagen network and negative charge of articular cartilage surface in the early stage of experimental osteoarthritis.
Forty-eight mature male Japanese white rabbits were subjected to unilateral resection of a segment of the gluteal muscles at the sacral origin and a section of infrapatellar ligament. Animals were killed at 1, 2, 4, and 8 weeks postoperatively, and the articular cartilage of the femoral heads was evaluated. The collagen fibrillar network of the articular surface was observed by scanning electron microscopy (SEM) using microdissection by ultrasonication. ⋯ The thickness of the CF layer significantly decreased at 4 weeks postoperatively. This study confirms that alterations of the articular surface, such as derangement of the collagen network and loss of the negative charge, are some of the earliest changes in osteoarthritis. In addition, application of ultrasonication with proper frequencies to the articular cartilage effects an optimal removal of mucus, with the consequent exposure of a well-preserved articular surface for SEM study.
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Arch Orthop Trauma Surg · Jan 2001
ReviewA review of halo vest treatment of upper cervical spine injuries.
Thirty-five relevant studies involving in total 682 patients with 709 different types of injuries were evaluated in a review to determine the outcomes after immobilisation in a halo vest for various injuries to the upper cervical spine between 1962 and 1998. Studies were analysed according to the type of injury pattern and in terms of the treatment outcomes following primary treatment with a halo vest. The following types of injuries were evaluated: odontoid fractures (n = 420), hangman's fractures (n = 172), other axis fractures (n = 75), Jefferson fractures (n = 26), C1 arch fractures (n = 9), atlantooccipital (n = 2) and atlantoaxial dislocations (n = 5). ⋯ A halo vest can be recommended for patients with isolated Jefferson fractures, hangman's fractures, odontoid type III and type II fractures, with a low dislocation rate. The results of treatment with a halo vest were unsatisfactory with regard to combined injuries with an odontoid type II fracture. An overall healing rate of 86%, however, allows one to conclude that this treatment continues to be a good alternative to operative stabilisation of bone injuries to the upper cervical spine.
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Arch Orthop Trauma Surg · Jan 2001
Comparative StudyThe nail-insertion point in unreamed tibial nailing and its influence on the axial malalignment in proximal tibial fractures.
The consequence of choosing a point of insertion for the nail (i.e. medial or lateral of the lig. patellae) in unreamed tibial nailing (AO unreamed tibial nail, UTN) was studied in 22 formaldhyde-fixed tibiae. A lateral osteotomy at the transition from the first to the second fifth of the tibia was used as a model for the fracture. ⋯ Our results show that the insertion point of the nail is important for the alignment of the axis. Choosing a different point for the insertion of the nail can be useful in operative correction of malalignment of the tibia.