Acta Orthop Belg
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Comparative Study
Paralysis of the peroneal nerve following hip fracture treatment.
A prospective study was performed over a period of 2 years to identify the cause of peroneal palsy following hip fracture treatment. Sixty-eight patients in Group I had their injured leg placed in traction in a splint with a metal frame. ⋯ The difference is significant. Direct pressure on the nerve in the area of the fibular head during the preoperative traction period seems to be the cause of this transient dysfunction.
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Review Case Reports
Surgical management of bipolar clavicular dislocation.
We present case of bipolar dislocation of the right clavicle in a 26 year-old man. He was treated by open reduction plus internal fixation with Kirschner wires at the acromioclavicular joint, and orthopedic reduction of the sternoclavicular joint plus percutaneous osteosynthesis with Kirschner wires. An excellent (functional and cosmetic) result was obtained. A review of the literature is included, and some aspects of the treatment are discussed.
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A closed fracture-dislocation of the tarsal navicular is presented. Open reduction and internal fixation are mandatory in order to restore the keystone function of the navicular to the longitudinal arch of the foot.
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Case Reports Clinical Trial
Long-term results with the uncemented thrust plate prosthesis (TPP).
The long-term clinical results of a novel concept for total joint replacement called the Thrust Plate Prosthesis (TPP) are presented. Only a restricted number of patients were provided with this new prosthesis (115 at the Orthopedic Department, Canton Hospital, Chur, and 47 at the Department of Orthopedic Surgery, University of Zurich). All patients have undergone clinical and radiological follow-up covering a period from 1980 to 1991. ⋯ The clinical results and histological findings have confirmed the validity of the biomechanical principle of the TPP. The TPP is therefore to be considered a true alternative to the conventional hip prosthesis. In contrast to the conventional intramedullary anchored stem prosthesis the TPP requires the removal of a minimum amount of bone stock, which is certainly important in young patients.
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Several physiological and anatomical methods of scoring severely injured patients have been developed since the 1970s, based on very large series of patients. In this study, 59 patients are assessed by the ISS (Injury Severity Score) and the RTS (Revised Trauma Score). The mean ISS is 28, and the mean RTS is 6; the overall evolution shows a 42.4% mortality. Analysis by the TRISS method shows 12 out of 18 "unexpected" deaths, the majority of which can be explained by the fact that the ISS underestimates severe neurological trauma, and that the RTS is not consistently obtained in the early patient notes in our emergency care system.