Archives of orthopaedic and trauma surgery
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Since the definition of three-dimensional components of the scoliotic deformity, there have been important improvements in the surgical treatment of the problem. A derotation maneuver was proposed as a treatment option with CD instrumentation, but the reports of imbalance and decompensation with this system repopularized sublaminar wiring and translation as a corrective maneuver. Isola spinal instrumentation is one of the modern systems that utilizes vertebral translation instead of rod rotation. ⋯ All patients had complete balance (SH: 0 VU and SS: 0 VU) or balanced curves (0 VU < SH, SS < 0.5 VU). Finally, the study concluded that the translation maneuver, especially when used with the cantilever technique, resulted in high correction rates in the frontal plane. Additionally, the technique was also successful in obtaining normal sagittal contours and correcting balance values.
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Arch Orthop Trauma Surg · Jan 2001
Comparative Study Clinical Trial Controlled Clinical TrialBone mineral density after total joint arthroplasty of lower extremities in rheumatoid arthritis patients.
We studied the effects on the axial bone mass of total joint arthroplasty (TJA) for lower extremities in 48 female rheumatoid arthritis (RA) patients by using dual-energy X-ray absorptiometry (DXA). Twenty-nine postmenopausal RA patients treated only with nonsteroidal anti-inflammatory drugs (NSAIDs) served as controls. ⋯ The BMD of the femoral neck decreased significantly in both groups (p < 0.01-0.05) after 2 years, but it was not statistically different between the two groups. Our data suggest that TJA slowed the rapid axial bone loss usually associated with advanced RA.
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Arch Orthop Trauma Surg · Jan 2001
Comparative Study Clinical Trial Controlled Clinical TrialWalking ability and activities of daily living after limb salvage operations for malignant bone and soft-tissue tumors of the lower limbs.
We evaluated the number of steps, activities of daily life (ADL) score, Enneking score, active range of motion and muscle strength by muscle manual testing for function in lower limbs after reconstructive procedures in surgical treatment of tumors. The 56 patients with 20 malignant bone tumors and 36 malignant soft-tissue tumors averaged 7119 +/- 3563 steps per day, or 69.8% of the control group. The average ADL score of patients was 14.0 +/- 4.1 points (70.0%), and the average Enneking score 20.4 +/- 6.0 points (68.0%). ⋯ These scores were not correlated with the range of motion. The number of steps and ADL score were correlated with Enneking score (coefficient 0.52 and 0.84, respectively). The number of steps and the ADL score appear to be useful, as is Enneking score.
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Arch Orthop Trauma Surg · Jan 2001
Ipsilateral fracture of the femoral neck and shaft, treatment by reconstruction interlocking nail.
This study involved nine patients with ipsilateral fractures of the neck and shaft of the femur. They were all male with an average age of 28.5 years. All of the fractures resulted from high-energy trauma. ⋯ There were no cases of avascular necrosis or non-union of the femoral neck fracture. One hip healed into mild varus, one shaft fracture had a delayed union, and one developed a late infection of the femoral shaft. The use of the reconstruction nail offers superior stabilization over other currently used methods and is associated with fewer complications.
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Using a modified AO tension band wiring technique to treat a patellar fracture has become popular and has achieved a high success rate. However, the technique of Kirschner wire insertion has not been considered in detail, which may migrate and consequently introduce fragments loss of reduction. A revised technique involving bending both ends of the Kirschner wires was prospectively studied. ⋯ Skin irritation was noted in 2 patients (3%). All patients achieved a satisfactory result. We therefore recommend this revised technique to treat all patellar fractures because of its high union rate and low complication rate.