Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2001
Results of flexor tendon repair of the hand by the motion-stable wire suture by Towfigh.
We compared the motion-stable wire suture by Towfigh (MSWST) with a modified Kessler suture (MKS) by following up flexor tendon repairs (MSWST, n = 21/39 digits; MKS, n = 20/31 digits). For MSWST we found 31 (79.5%) "excellent", 3 (7.7%) "good", and 5 (12.8%) "fair" results, when using the scoring system of Buck-Gramcko. In 3 (14.3%) patients the MSWST had to be removed owing to local irritation. ⋯ Here we found 23 (74.2%) excellent, 7 (22.6%) good, and 1 (3.2%) fair result. The statistical evaluation of the data concerning the patients' age, sex, the involved zone, the side, and the functional outcome did not reveal a significant difference (P < 0.05) between both groups and the chosen type of repair. The results of MSWST and MKS are similar, but MSWST allows early motion therapy without a splint or rubber-band protection.
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Arch Orthop Trauma Surg · Jan 2001
An individualized approach for the implantation of a humeral prosthesis with the proper retroversion in fractures.
We applied a new methodology in 7 patients with a fracture of the upper humeral head that required hemiarthroplasty, to implant a humeral prosthesis with an individualized posterior version. Our goal was to determine preoperatively the distance from the posterior edge of the bicipital groove where the lateral fin of the humeral prosthesis should sit, in order to reproduce the individual retroversion during surgery. Using three computed tomography scan sections of the upper humerus and image processing software, we estimated the above-mentioned distance in the sound humerus and implanted the prosthesis in each patient accordingly. The differences in retroversion between the left and right humeral heads permit a better approximation to normal applying this methodology than inserting the prosthesis in a standard retroversion.
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Arch Orthop Trauma Surg · Jan 2001
Case ReportsForty-two year survival with bilateral Judet hip prostheses.
In this case report, a 70-year-old man is presented who had begun to suffer from ankylosing spondylitis when he was 12 years old and had been operated on because of bilateral hip ankylosis at the age of 21 years. The interesting aspect of this case is that both hips were replaced with Judet type prostheses, which survived for 42 years.
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Arch Orthop Trauma Surg · Jan 2001
Case ReportsPresacral tumor associated with the Currarino triad in an adolescent.
A 17-year-old woman presented with pain over the sacral region. Plain radiographs of the sacrum demonstrated a bony deformity of the sacrococcygeal region in the shape of a scimitar. Magnetic resonance imaging showed a cystic mass of the presacral region which appeared to be continuous with the dural sac. ⋯ In light of the combination of a sacral bony deformity, presacral mass including meningocele, and mass-rectum connection, we made the diagnosis of the Currarino triad, which is a rare complex of congenital caudal anomalies. The patient underwent excision of the presacral mass. Histologic examination of the resected specimen revealed features of an epidermoid cyst.
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Arch Orthop Trauma Surg · Jan 2001
Hypoxia-inducible factor-1 activation and cyclo-oxygenase-2 induction are early reperfusion-independent inflammatory events in hemorrhagic shock.
Hemorrhagic shock (HS) initiates an inflammatory response that includes increased expression of inducible nitric oxide synthase (iNOS) and production of prostaglandins. Induction of iNOS during the ischemic phase of HS may involve the activation of the hypoxia-inducible factor-1 (HIF-1). ⋯ The lungs of rats subjected to HS demonstrated a twofold increase in HIF-1 activation (P < 0.01) and a 7.4-fold increase in expression of COX-2 mRNA (P < 0.01) compared with sham controls. The upregulation of iNOS and COX-2 during ischemia are two important early response genes that promote the inflammatory response and may contribute to organ damage through the rapid and exaggerated production of nitric oxide and prostaglandins.