Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2000
Review Case ReportsRecurrent chondroblastoma of the upper thoracic spine. A case report and review of the literature.
A very rare case of recurrent chondroblastoma of the upper thoracic spine with a follow-up of more than 20 years is presented and discussed with a review of the literature.
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Arch Orthop Trauma Surg · Jan 2000
Randomized Controlled Trial Clinical TrialThe epidemic of ankle fractures in the elderly--is surgical treatment warranted?
Ankle fractures in the elderly are extremely common (up to 184 fractures per 100,000 persons per year, and of these approximately 20%-30% occur in the elderly). The medical literature contains no research that has investigated ankle fractures in the elderly. A prospective, randomised study was conducted of 84 patients with displaced ankle fractures, who were over the age of 65 years and were assigned to operative or conservative treatment after closed reduction. ⋯ The costs of treatment were accordingly higher. These results call for consideration of a non-operative approach to the treatment of well-reduced ankle fractures in the elderly. Increased efforts should be invested in the prevention of these common fractures.
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Arch Orthop Trauma Surg · Jan 2000
Clinical TrialReduction of blood loss using tranexamic acid in total knee and hip arthroplasties.
There have been several attempts to reduce postoperative blood loss in patients undergoing total arthroplasty. Benoni et al. reported the usefulness of tranexamic acid in total knee arthroplasty (TKA). ⋯ Blood loss was significantly reduced in patients given tranexamic acid in both the TKA and THA groups, and no severe complications, such as venous or pulmonary thrombosis, were noted in any of the patients who received the agent. Administration of tranexamic acid seems to be useful for reducing postoperative blood loss in TKA and THA.
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Arch Orthop Trauma Surg · Jan 2000
Comparative StudyResults of posterior cruciate-retaining unconstrained total knee arthroplasty after proximal tibial osteotomy for osteoarthritis. A prospective cohort study.
The purpose of the study was to investigate the results of posterior cruciate ligament (PCL)-retaining total knee arthroplasty (TKA) after previous proximal closed wedge tibial osteotomy for degenerative arthritis according to the technique recommended by Coventry and Insall. Thirty-five patients with previous proximal tibial osteotomy were matched to 35 patients without previous osteotomy according to age, sex, and Knee Society patient category. TKA after osteotomy was technically more difficult, often requiring a more extensive exposure. ⋯ Knee Society scores were significantly lower in those with previous osteotomy, primarily because of decreased anteroposterior stability and pain. No significant differences were found in function scores, range of motion, or alignment. However, overall results of this PCL-retaining unconstrained TKA did not match those reported after PCL-substituting TKA.
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Arch Orthop Trauma Surg · Jan 2000
Value of myofibrillar protein catabolic rate in Duchenne muscular dystrophy. A study after lower limb surgery.
Previous studies have shown a decreased progression of the course in Duchenne muscular dystrophy (DMD) patients treated by lower limb surgery in early childhood. The use of 3-methylhistidine (3-MH) excretion and 3-MH/creatinine excretion ratio as an appropriate indicator for the myofibrillar protein catabolic rate (MPCR) in muscle disorders is discussed controversially. ⋯ However, the formula for the calculation of the MPCR contains quantities which are not precisely known in DMD or assumed to be constant over the progressive course of DMD. Summarizing MPCR cannot be recommended for the assessment of therapeutic efficacy in DMD.