Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1994
[Radial head prosthesis with floating cup in recent and old injuries of the elbow: preliminary results].
In recent traumatology (complex radial head fractures with severe sprain of the medial collateral ligament), as well as in sequellae (extensive release for severe elbow stiffness), the implantation of a radial head prosthesis may be necessary to stabilize the humero-ulnar joint and the radial shaft. Its major advantage consists of allowing immediate postoperative mobilization. Swanson first proposed a silastic replacement of the radial head which turned out to have serious mechanical and biological disadvantages. ⋯ Indications for implantation of a radial head prosthesis were deduced from these observations: in recent trauma, implantation of the prosthesis should only be indicated in those fractures, in which osteosynthesis appears not to be possible (Mason 3 or 4), with the following associations: radial head fracture with severe sprain of the medical collateral ligament--patients with positive radio-ulnar index--extensive lesions of the interosseous membrane (Essex-Lopresti, or Monteggia affecting the ulnar shaft)--associated fracture of the proximal ulna (olecranon, coronoid process...). In sequellae, we propose the following indications: extensive elbow release compromising elbow stability--painful inferior radio-ulnar dislocation complicating resection of the radial head--valgus instability complicating radial head resection.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1994
[Treatment of osteomyelitis by local antibiotics using a portable electronic micropump].
Systemic administration of antibiotics in osteoarticular infections is characterized by: 1) systemic side effects: 2) questionable penetration of the antibiotic into the infected and ischaemic areas: 3) mandatory hospitalization for prolonged administration of antibiotics. Aware of these difficulties, orthopedic surgeons have long been seeking an effective method of local antibiotic administration. The authors report their original experience with the use of an external, portable electronic micro pump for continuous local delivery of antibiotics in conjunction with surgical debridement, in the treatment of osteomyelitis. ⋯ Our experience shows: 1) the simplicity and limited invasiveness of this technique, which, without excluding other forms of therapy, allows to deliver antibiotics in the infected focus for months; 2) the absence of side effects and technical complications; 3) the good quality of life of the patients during the treatment; 4) the low cost for the health care system, since the patients are followed-up and the reservoirs refilled on an out-patient basis.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1994
[Acetabular screw rings and surface effects: apropos of a continuous series of 115 primary implantations of Karl Zweymüller's acetabular screw rings after a follow-up of an average of 5.8 years]].
The authors review and analyze a series of patients treated by total hip arthroplasty with a Karl Zweymüller threaded cup. ⋯ Due to its biomecanical characteristics, excellent primary stability, thinness of its pure titanium micropitted surface and low module of elasticity, the Zweymüller screw ring achieves a quite successful compromise between the different conditions necessary not only to obtain but above all to maintain osteointegration at least at mid term.