Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2000
Case ReportsRotational acetabular osteotomy for severely dysplastic acetabulum.
The operative procedures chosen for arthrosis with severe acetabular dysplasia vary among orthopaedic surgeons. We operated on 250 hips using the rotational acetabular osteotomy (RAO) method of Ninomiya and Tagawa [8]. In this report, we describe the technique of RAO and the results of this procedure in patients with severely dysplastic hips. ⋯ After acetabular osteotomy with straight and curved osteotomes, smooth inferolateral rotation could be done in all cases. At the latest follow-up symptoms were improved remarkably, especially pain. Radiographically, adequate coverage of the femoral head was achieved and joint congruence improved in all 6 hips.
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Arch Orthop Trauma Surg · Jan 2000
Comparative StudyGrading of functional results of elbow joint arthrolysis after fracture treatment.
In the treatment of posttraumatic contracture of the elbow joint, arthrolysis is a proven procedure. We used a stepwise operative approach starting laterally and including an additional medial and dorsal incision if needed. A total of 91 patients with arthrolysis of the elbow could be followed-up on average 44 months (range 9-102 months) joint after operative (58, 63.7%) and non-operative (33, 36.3%) fracture treatment. ⋯ Although the rest also showed improvements, their functional benefit was less. The earlier the release of the joints was performed, the better was the functional outcome (p < 0.05). The importance of an intensive early rehabilitation programme is emphasised while indications for this procedure should only be seen in compliant patients.
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Arch Orthop Trauma Surg · Jan 2000
Case ReportsMorphologic and morphometric study of patellar resurfacing with woven carbon filamentous pads.
Analysis of retrieved woven carbon filamentous pads, used for resurfacing of the patellar joint surface, disclosed a 4-zonal organizational pattern. Zone 1, facing the articular cavity, was devoid of carbon filaments and consisted of fibrous tissue. Foreign body granulation tissue and fibrous tissue occupied about one-third and approximately 50%-60% of the interfilamentous space in zones 2 and 3, respectively. ⋯ The bone volume within the latter was approximately 25%. Given that the purpose of articular resurfacing with implants is repopulation of the defect by chondrocytes producing a cartilaginous matrix, the woven carbon filamentous pads did not fulfill this expectation. In an environment of an ongoing foreign body-induced granulomatous reaction, the stem cells permeating the interstices of the woven carbon filamentous pad are apparently incapable of maturing into highly differentiated cells (chondrocytes) synthesizing a highly complex (cartilaginous) matrix.
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Arch Orthop Trauma Surg · Jan 2000
Case ReportsHuman leukocyte antigen (HLA) phenotypes in siblings with osteosarcoma.
Osteosarcoma was detected in two siblings. Their human leukocyte antigen (HLA) phenotypes were completely identical, although they were different from those of osteosarcoma patients in previous reports. ⋯ These cases suggest that genetic similarity may influence the development of osteosarcoma. Ascertainment of the HLA phenotypes in siblings with osteosarcoma might be a useful strategy to facilitate the early diagnosis of this tumor.
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Arch Orthop Trauma Surg · Jan 2000
Comparative StudyThe pelvic external fixation: the mid-term results of 41 patients treated with a newly designed fixator.
The purpose of this study was to evaluate the clinical and radiological results of unstable pelvic fractures treated with a new external fixation device. Between May 1992 and May 1998, 43 patients with unstable pelvic fractures were treated with a new anterior pelvic external fixator. Two died, and therefore 41 patients' results were evaluated. ⋯ The fixator can be used alone in patients with type B pelvic injuries such as open book and lateral compression. However, it does not provide sufficient stability for severely displaced type C injuries when applied alone. Nevertheless, it may be helpful for fixing type C injuries like a posterior iliac fracture without dislocation of the sacroiliac joint.