Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2000
The effect of extracorporeal shock waves on joint cartilage--an in vivo study in rabbits.
The application of extracorporeal shock waves has become a new mode of treatment for affections of the locomotor apparatus such as calcifying tendinitis, epicondylitis humeri radialis, calcaneodynia and pseudarthrosis. The treatment often takes place in the vicinity of joints. Up to now no systematic data have been published about possible side-effects on joint cartilage. ⋯ The left lateral femoral condyle of each animal was treated with 2000 shock waves of 1.2 mJ/mm2; the right condyle served as control. Macroscopical, radiological and histological analysis at 0, 3, 12 and 24 weeks after treatment showed no pathological changes in the joint cartilage. We conclude that extracorporeal shock wave treatment does not cause damage to the joint cartilage of growing rabbits.
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We report an unusual case of a femoral neck stress fracture leading to the fatigue failure of an AO spiral blade. An unreamed femoral nail with a spiral blade was inserted to treat an unstable subtrochanteric femoral fracture. which lead to fracture union at 5 months. Eight months post-operatively the patient started to complain of left hip pain. ⋯ The implant was removed and replaced by a cemented hemiarthroplasty. This case reaffirms the difficulty in diagnosing a stress fracture through a metallic implant. The delay in diagnosis may be shortened if stress fracture were included as an expected complication following an intramedullary nailing.
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Arch Orthop Trauma Surg · Jan 2000
Operative or conservative treatment of the acutely torn anterior cruciate ligament in middle-aged patients. A follow-up study of 133 patients between the ages of 40 and 59 years.
In all, 133 patients with an acute rupture of the anterior cruciate ligament (ACL) were reviewed (aged 40 to 59 years). Average follow-up was 29 +/- 10 months. Thirty-one patients underwent conservative therapy, 35 patients were treated by primary suture, while in 67 the primary suture was augmented with the semitendinosus tendon. ⋯ There was no significant difference between the patients with augmented ACL repair and conservative treatment in the assessment of range of motion, while the patients with primary suture had a significantly greater loss of flexion than those in the other two treatment groups. Increasing age was not found to have a negative effect on either operative or conservative treatment. The results indicate that patients between the ages of 40 and 59 years can be treated successfully by ACL surgery.
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Arch Orthop Trauma Surg · Jan 2000
Comparative StudyEffects of single-dose versus fractionated irradiation on the suppression of heterotopic bone formation--an animal model-based follow-up study in rats.
The histological and enzymatic effects of single-dose irradiation of 7 Gray (Gy) versus fractionated irradiation of 5 x 2 Gy on the suppression of heterotopic ossification were examined over a period of 60 days in adult male Wistar rats (n = 57). The standardized osteogenesis model system in rats 19, 10, 11, 16, 19] was used for this purpose. The course of developing ossifications was documented quantitatively and qualitatively by means of quantitative computed tomography/osteodensitometry and digital luminescence radiography. ⋯ Therefore, it may be concluded that the smaller degree of heterotopic ossification in the irradiated groups was due to damage of and a decrease in the number of mesenchymal stem cells at the implant site. Our results stress the necessity of instituting postoperative irradiation therapy as early as possible to prevent heterotopic ossification. In view of experimentally proven better effects, fractionated irradiation has to be preferred to a dose-equivalent single-dose radiation, especially considering the fewer side-effects noted with fractionated irradiation.
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Arch Orthop Trauma Surg · Jan 2000
Review Case ReportsIsolated dislocation of the hamate bone. Case report and review of the literature.
A case of isolated dislocation of the hamate bone is reported. Mechanism of the injury and treatment are described including a review of the literature.