Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2000
Case ReportsSolitary osseous hemangioma outside the spinal and craniofacial bones.
Bone hemangioma is mainly seen in the skull and spine, and rarely occurs in other bones. We report herein four cases of osseous hemangioma arising in rare sites: In two cases, on a rib; a faintly painful mass in one case located on the scapula; and progressive pain in one case located on the ischium. The tumors presented clinically as incidental lesions on radiographs. ⋯ Markedly high signal intensity on T2-weighted magnetic resonance images was a characteristic finding. Open biopsy resulted in severe blood loss, but needle biopsy was performed safely under computed tomography guidance. It is important to note that bone hemangiomas may be misdiagnosed as malignant tumors.
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Arch Orthop Trauma Surg · Jan 2000
Comparative StudyFixation of proximal tibia fractures by a retrograde nail: a biomechanical investigation.
Surgical treatment of proximal tibial fractures requires open reduction and internal fixation. The operative exposure causes additional soft-tissue injury and reduces the blood supply to the bone. A cephalograde tibial nail should offer comparable mechanical stability without these disadvantages. ⋯ While both implants exhibited comparable stiffness under sagittal loading, the plate had a higher rotational and varus stiffness. Despite this higher stiffness, rotational displacements at the fracture gap were nearly twice as large for this implant during loading. We conclude that the retrograde nail provides similar mechanical stability to plate fixation for proximal tibial fractures, while the closed reduction and soft-tissue preservation of this new technique are definite advantages.
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Arch Orthop Trauma Surg · Jan 2000
Case ReportsA rare case of osteoporotic spine fracture associated with epidural lipomatosis causing paraplegia following long-term cortisone therapy.
Cushing's syndrome is frequently associated with osteoporosis. Therefore, the incidence of osteoporotic spine fractures is significant. They are a rare cause of paraplegic syndromes. ⋯ Our experience suggests that care should be taken before operative treatment of patients with pathological fractures in combination with Cushing's syndrome. In addition to vertebral fractures, epidural lipomatosis has to be taken into consideration. Those patients with neurological deficits have to be treated by an extensive laminectomy.
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Arch Orthop Trauma Surg · Jan 2000
Comparative StudySurgical treatment of muscular torticollis for patients above 6 years of age.
Eighteen patients with congenital muscular torticollis, aged 6-22 (average 11) years, underwent surgical releases of the contractive bands. There were 8 boys and 10 girls. Preoperative open mouth radiograph of the odontoid process in 16 patients showed asymmetry of articular facets of the axis and tilt of the odontoid process to the side of the torticollis. ⋯ The follow-up radiographs showed improvement of the tilt of the odontoid process, but the asymmetry of the articular facets of the axis persisted. We suggest that bipolar release is the treatment of choice for congenital muscular torticollis in patients of more than 6 years of age. To determine the influence of a bipolar release on the functions of the cervical spine, longer follow-up intervals are needed.
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Arch Orthop Trauma Surg · Jan 2000
Case ReportsSimultaneous anterior and posterior traumatic dislocation of the hip. A case report with review of the literature.
The presence of anterior dislocation of the hip along with contralateral posterior dislocation of the hip in the absence of other major trauma is a distinctly rare injury pattern. We report such a case resulting from a motor vehicle striking a pedestrian, along with a review of previous cases. The patient was managed nonoperatively within 6 hours of trauma with an excellent final outcome and no posttraumatic complications over a 3-year follow-up. The possible mechanism of this injury is discussed.