Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1999
ReviewPrevalence of popliteal cysts in children. A sonographic study and review of the literature.
Popliteal cysts in children differ from those in adults. They are considered to be less frequent and usually appear in the absence of intra-articular lesions. However, their prevalence in asymptomatic children is unknown. ⋯ A popliteal cyst could be identified in 4 patients. The prevalence of asymptomatic popliteal cysts was thus 2.4%. For 2 of these patients, we obtained magnetic resonance image of the knee which showed no concommitant intra-articular pathology.
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Arch Orthop Trauma Surg · Jan 1999
Clinical TrialNo effective prophylaxis of heterotopic ossification with short-term ibuprofen.
Ninety-five patients underwent primary total hip arthroplasty and routinely received ibuprofen for 5 days as prophylaxis for heterotopic ossification. This group was compared with a group of 99 patients who received indomethacin for 7 days as prophylaxis. ⋯ The widespread ossification, Brooker grades III and IV, was prevented better by indomethacin than by ibuprofen. We conclude that ibuprofen for 5 days is not effective as prophylaxis for heterotopic ossification after primary total hip arthroplasty.
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Arch Orthop Trauma Surg · Jan 1999
Comparative StudyEarly complications of surgically managed ankle fractures related to the AO classification.A review of 118 ankle fractures treated with open reduction and internal fixation.
The charts of 118 consecutive ankle fractures were reviewed. The patients' age, sex, energy of trauma, hospital stay, need for traction therapy, syndesmosis fixation and soft-tissue problems were related to the various types of fractures according to the AO classification. An interobserver check study revealed an agreement of 0.61 (kappa), which is considered good. ⋯ The energy of trauma was not related to perioperative problems. The period of hospitalisation was significantly longer in the patients with B2/B3 type fractures (P < 0.001). Judging by the significantly higher incidence of perioperative complications, longer hospital stay, and predominance of instability and skin damage in the AO B2 and B3 type fractures, these fractures may benefit from more attentive and urgent care.
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Arch Orthop Trauma Surg · Jan 1999
Randomized Controlled Trial Clinical TrialRelevance of the drainage along the linea aspera for the reduction of fat embolism during cemented total hip arthroplasty. A prospective, randomized clinical trial.
The aim of this study was to assess the relevance of drainage placed along the linea aspera for the prevention of fat embolism and cardiopulmonary impairment during the insertion of a cemented stem. We studied 40 patients with coxarthrosis randomly allocated to total hip arthroplasty with proximal drainage or without it. The venting hole for the drainage of the medullary cavity was placed posteriorly, between the greater and the smaller trochanter, in the prolongation of the linea aspera. ⋯ After major embolism, the pulmonary shunt values increased significantly in the control group (+22.7%), but there were no marked changes in the drainage group (+7.1%). The logical therapeutic measure to avoid intravasation of bone marrow, fat, and bone debris during the insertion of the femoral component is to prevent the rise of intraosseous pressure. The drainage of the venous system located along the linea aspera significantly reduces the risk of intraoperative embolism and cardiopulmonary impairment.
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Arch Orthop Trauma Surg · Jan 1999
Comparative Study Clinical TrialOn the timing of soft-tissue reconstruction for open fractures of the lower leg.
The timing of soft-tissue reconstruction for severe open fractures of the lower leg is considered crucial to the later outcome, and yet pertinent publications are few. The purpose of this study was to add some based on evidence arguments for the choice of the most adequate timing in the management of these injuries. Twenty-nine consecutive open fractures of the tibia, including 24 grade 3B and 5 grade 3C fractures, were treated using a protocol of immediate debridement, early definitive skeletal stabilisation and early soft-tissue reconstruction. ⋯ All patients were reviewed at a mean follow-up of 47 months (range 15-89 months). In the delayed reconstruction group the time to full, unprotected weight-bearing (P = 0.0021), the time to definitive union (P = 0.0049), the number of reoperations (P = 0.0001) and the infection rate (P = 0.0374) were significantly higher. The data suggest that immediate reconstruction is, the general condition of the patient permitting, the timing of choice for soft-tissue coverage.