J Bone Joint Surg Br
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J Bone Joint Surg Br · Jul 1996
Randomized Controlled Trial Comparative Study Clinical TrialReamed or unreamed nailing for closed tibial fractures. A prospective study in Tscherne C1 fractures.
We performed a prospective, randomised study on 50 patients with Tscherne C1 tibial diaphyseal fractures comparing treatment with reamed and unreamed intramedullary nails. Our results show that reamed nailing is associated with a significantly lower time to union and a reduced requirement for a further operation. Unreamed nailing should not be used in the treatment of the common Tscherne C1 tibial fracture.
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J Bone Joint Surg Br · Jul 1996
Comparative StudyInfluence of materials for fixation implants on local infection. An experimental study of steel versus titanium DCP in rabbits.
Resistance to infection may be influenced by foreign bodies such as devices for fracture fixation. It is known that stainless steel and commercially-pure titanium have different biocompatibilities. ⋯ After the wounds had been closed, various concentrations of a strain of Staphylococcus aureus were inoculated percutaneously. Under otherwise identical experimental conditions the rate of infection for steel plates (75%) was significantly higher than that for titanium plates (35%) (p < 0.05).
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J Bone Joint Surg Br · Jul 1996
The afferent pathways of discogenic low-back pain. Evaluation of L2 spinal nerve infiltration.
The afferent pathways of discogenic low-back pain have not been fully investigated. We hypothesised that this pain was transmitted mainly by sympathetic afferent fibres in the L2 nerve root, and in 33 patients we used selective local anaesthesia of this nerve. Low-back pain disappeared or significantly decreased in all patients after the injection. ⋯ Our findings show that the main afferent pathways of pain from the lower intervertebral discs are through the L2 spinal nerve root, presumably via sympathetic afferents from the sinuvertebral nerves. Discogenic low-back pain should be regarded as a visceral pain in respect of its neural pathways. Infiltration of the L2 nerve is a useful diagnostic test and also has some therapeutic value.