Acta Orthop Belg
-
Fracture healing is a complex process in which mechanical forces are essential for the regeneration of bone tissue. Mechanical loading can induce osteogenesis through the process of mechanotransduction. ⋯ The role of mechanosensors, loading-induced interstitial fluid flow, streaming potentials, the biophysical environment of the fracture gap and the significance of timing, strains and distribution of mechanical stimulation in long bone fractures are reviewed. Remodelling and biomechanical concepts of fracture healing are discussed from a clinical perspective.
-
Patients with trapeziometacarpal joint arthritis stage II or III (according to Dell) and no benefit from non-operative therapy were selected to undergo joint arthroplasty. We performed 32 arthroplasties for first carpometacarpal arthritis in 27 patients using a cementless total trapeziometacarpal joint prosthesis. We undertook a prospective cohort study and evaluated the clinical results of total joint arthroplasty after an average of 39 months. ⋯ In all our patients Vitamin C 500 mg daily was started two days before surgery and continued during 50 days. There were no cases of CRPS under vitamin C prophylaxis. These results justify further investigation in a randomised clinical trial.
-
Case Reports
Anterior ankle dislocation without associated fracture: a case with an 11 year follow-up.
Ankle dislocations without concomitant malleolar fractures, also called pure ankle dislocations, are rare injuries. We present what appears to be the third documented case of a true anterior pure ankle dislocation described in international literature. The mechanism, the management and the complications of this rare injury, are also discussed.
-
Posterior lumbar interbody fusion (PLIF) with cages can be combined with decompression of the spinal canal and with instrumented posterolateral fusion (IPLF) with pedicle screws, through a single posterior incision. The authors wanted to assess retrospectively the clinical and radiological outcome of PLIF + IPLF performed by the senior author. Between July 1997 and December 2003, 75 patients underwent PLIF with cages and IPLF with transpedicular instrumentation, for either degenerative disc disease, stenosis, spondylolisthesis or post-discectomy syndrome. ⋯ Three patients sustained a neurological complication, but only one was left with a partial drop foot. The results were comparable with similar studies. Therefore the authors recommend further use of PLIF + IPLF in painful lumbar degenerative spinal disease where conservative management has failed.
-
Randomized Controlled Trial
Extracorporeal shock-wave therapy (ESWT) with a new-generation pneumatic device in the treatment of heel pain. A double blind randomised controlled trial.
Although low-energy extracorporeal shock wave therapy (ESWT) is widely used to treat a variety of soft tissue disorders, no precise algorithm has been accepted in clinical management. Furthermore, the clinical use of a new generation pneumatic device has not yet been evaluated. ⋯ The main outcome measure was the patients' subjective assessment of pain by means of a Visual Analog Scale (VAS) and the Roles and Maudsley Score before ESWT, early after treatment and six months later. There appeared to be a significant placebo effect with low-energy ESWT in patients with heel pain, and there was also lack of evidence for the efficacy of ESWT when compared to sham therapy.