Archives of orthopaedic and trauma surgery
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Three of 12 nonrheumatoid patients with bicipital radial bursitis had recurrent and recalcitrant symptoms and underwent operative treatment. Preoperative computed tomogram showed an anterior distended synovial cyst at the level of the radial tubercle. ⋯ Excision of the distended bursa and closing the capsular defect lead to excellent results. An antecubital cyst resulting from an acute or chronic tear of the anterior capsule at the sacciform recess may communicate with the bicipital radial bursa and become the cause of recurrent and recalcitrant symptoms.
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Arch Orthop Trauma Surg · Jan 1999
Case ReportsInsufficiency fractures, an often unrecognized diagnosis.
Diagnosis of sacral insufficiency fractures is difficult since the onset is mild, and usually discomfort is attributed to degeneration of the lumbar spine. Computed tomography and radionuclide bone scans are helpful in making the diagnosis, as regular X-ray and magnetic resonance imaging usually fail to demonstrate the fracture.
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Arch Orthop Trauma Surg · Jan 1999
Regeneration process of mechanoreceptors in the reconstructed anterior cruciate ligament.
We performed reconstructive surgery on the anterior cruciate ligament (ACL) of the rabbit using a free bone-patellar tendon-bone (BTB) graft and evaluated nerve regeneration in the graft. The right ACL of 15 Japanese white rabbits was resected and reconstructed using a BTB graft. The BTB and ACL from the contralateral knee served as controls. ⋯ The appearance of mechanoreceptors in the graft between 2 and 4 weeks postoperatively suggests that regeneration of mechanoreceptors occurred during this time period. At 4 and 8 weeks postoperatively, there was no significant difference in the number of mechanoreceptors between the intra-articular portion of grafted tendon and the contralateral ACL. The further increase between 4 and 8 weeks to control levels suggests that this regeneration may restore mechanoreceptors in BTB grafts to normal levels.
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Arch Orthop Trauma Surg · Jan 1999
Primary biomechanical influence of different sterilization methods on a freeze-dried bone-ligament transplant.
The transmission of bacteria and viruses in ligament transplants should be prevented by sterilization. In this study, the influence of two different methods on the mechanical properties of a freeze-dried medial collateral ligament was analyzed in sheep. Group I (n = 10) was treated with irradiation (26 kGy) and group II (n = 10) with ethyleneoxide. ⋯ The irradiation dose significantly reduced the maximal load, whereas ethyleneoxide sterilization resulted only in minor changes. Because of the potential cancerogenity of ethyleneoxide, a close monitoring of aeration times and its residuals are very essential. Further studies with lower irradiation doses of between 15 and 26 kGy seem to be justified.
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Arch Orthop Trauma Surg · Jan 1999
Outcome after palliative posterior surgery for metastatic disease of the spine--evaluation of 106 consecutive patients after decompression and stabilisation with the Cotrel-Dubousset instrumentation.
From 1987 to 1996, 106 consecutive patients with metastatic disease of the spine who underwent palliative decompression from a dorsal approach and subsequent stabilisation with Cotrel-Dubousset instrumentation (CDI) were followed prospectively, and independent of the surgeons. Parameters evaluated were neurological function, perioperative complications, survival and rehabilitation. Following the Frankel system for the assessment of neurological disorder, 33 patients had a major deficit (grade A, B or C), 23 a minor deficit (grade D) and 50 no deficit. ⋯ Overall survival time was 19.2 months, with 5 patients still alive. Six patients required re-operation for tumour recurrence at the same or at a new level. The results of this study show that neurological function, pain level and mobility can be enhanced by decompression and stabilisation through a posterior approach.