Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2000
Is there still an indication for operative treatment of femoral neck fractures with a ceramic hemiprosthesis? Four-year results.
From 1985 to 1995, 417 patients with dislocated medial femoral neck fractures (Garden III-IV) were treated with hemiarthroplasty using a Biolox ceramic head. The average patient age at the time of operation was 81.5 years. ⋯ At the time of follow up, 5 patients had severe hip pain, and in 8 the roentgenographic examination revealed protrusio acetabuli. Five of these 8 patients underwent revision surgery for replacement of the cup, leaving the stem in situ.
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Arch Orthop Trauma Surg · Jan 2000
Case ReportsBone remodelling in humeral arthroplasty: follow-up using CT imaging and finite element modeling--an in vivo case study.
Little material is available in the literature about remodelling of the human humerus after implantation of a shoulder hemiarthroplasty. A 73-year-old patient was examined by CT 4 years after implantation of a right shoulder hemiarthroplasty, and the bone density as represented by Hounsfield values was compared with the contralateral side. Additionally, a three-dimensional finite-element model was generated from the image data and analysed. ⋯ Distally from the prosthesis, high stresses were found. On the control side, a more homogeneous stress distribution was noted. The results could be explained by bone resorption around the prosthesis caused by stress shielding; this hypothesis has to be confirmed by future studies.
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Total knee joint transplantation has been performed in animal models and humans. This study investigates the impact of this operation on knee joint function in a dog model. Therefore, replantation was compared to transplantation during a 6-month follow-up period in four dogs in each group. ⋯ After 6 months, weight-bearing of all replant recipients was restored, but reduced in two transplant recipients with graft function. Full recovery after replantation, but impaired function after transplantation, was also reflected in the histological results: normal histological pictures of blood vessels, cartilage, bone and soft tissues were found in all replant recipients, but infiltrative vasculopathy indicating chronic rejection was found in the transplanted joints. The results of this animal study confirm that the procedure can lead to satisfactory functional results but also emphasize the need for perfect control of immunosuppression.
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Arch Orthop Trauma Surg · Jan 2000
Scaphoid nonunion treated by open reduction, anterior inlay bone grafting, and Kirschner-wire fixation.
Forty-three patients with ununited fractures of the scaphoid were treated by open reduction, anterior inlay bone grafting and Kirschner wire fixation. All but one achieved bone union. The one failure was successfully treated with a second anterior inlay bone grafting procedure. ⋯ Preoperatively, carpal instability was present in 25 patients. In these cases, carpal alignment demonstrated by the radiolunate and scapholunate angle was improved significantly after surgery: the radiolunate angle from 15 degrees before surgery to 2 degrees after surgery, and the scapholunate angle from 67 degrees to 54 degrees, respectively. Pain, restricted motion of the wrist, and the grip strength were improved after surgery.
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We treated a patient with giant schwannoma of the back. The tumor measured 35 x 25 x 12 cm and weighted 1840 g. Histological diagnosis was benign schwannoma. To our knowledge, there is no previous report of such a large schwannoma of the back.