Zeitschrift für Orthopädie und ihre Grenzgebiete
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Fractures of the hip in old patients are life-threatening events. A steady increase of that fracture type is likely in the near future. Surgical therapies and strategies have to consider the special requirements and problems of geriatric patients to achieve better results. They have to be designed together with new concepts of geriatric rehabilitation programmes. ⋯ Our results demonstrate that hip fractures in geriatric patients have a high mortality, especially in those living in a nursing home. The surgical concepts should aim to reduce that number and to allow the same daily activity of life as preoperatively. The main part in these concepts is an early start of geriatric rehabilitation. There are at least two groups. On the one hand, the active old patient who acquires his fracture during an activity. In this cases the aim must be the full rehabilitation and afterwards returning to normal environment. On the other hand there are the patients living in a nursing home who have the highest risk of injury related death. In these patients the first aim must be prevention of the accident.
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Z Orthop Ihre Grenzgeb · Sep 1999
Comparative Study[Validation of the North American Spine Society Instrument for assessment of health status in patients with chronic backache].
Pain and functional limitations are the chief symptoms in patients with back pain. However, standardized assessment of these domains are still not commonplace in clinical practice. The objective of this study was the cultural adaptation and validation of the North American Spine Society (NASS) Lumbar Spine Outcome Assessment Instrument for German speaking patients with back pain. ⋯ The German version of the NASS Cervical and Lumbar Spine Outcome Assessment Instrument allows the standardized assessment of pain, functional limitations and neurogenic symptoms in patients with back pain and the international comparison of health states and therapeutic outcomes.
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Z Orthop Ihre Grenzgeb · Sep 1999
[Effect of Harrington instrumentation spondylodesis on scoliotic thoracic deformity. A retrospective 5-year analysis].
Harrington-Instrumentation (HI) was the golden standard of scoliosis surgery for more than two decades and is still frequently used. The effects of instrumentation on rib hump reduction in long term follow-up is not well documented. 104 patients with idiopathic thoracic scoliosis were studied with a minimum follow-up of five years (min. 5 y., max. 8 years). ⋯ HI leads to a permanent and stable improvement of the frontal plane including apical vertebral translation. HI does not have derotational capabilities. The effect of the rib-cage deformity was less impressive with loss of correction at follow up.
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Z Orthop Ihre Grenzgeb · Jul 1999
[Secondary operations for improving shoulder function after brachial plexus lesion].
The results of an integrated concept of therapy are presented including a description of indications and the various operative procedures to compensate insufficient shoulder muscles following brachial plexus lesion. ⋯ In patients with brachial plexus palsy, secondary operations according to the individual pattern of paralysis result in an improvement of shoulder function and stability as well as patients satisfaction.
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Z Orthop Ihre Grenzgeb · May 1999
[Scoliosis in patients with osteogenesis imperfecta: a federal nation-wide cross-sectional study].
Quite different prevalence of scoliosis in patients with Osteogenesis imperfecta is reported, not at least owing to the difficult recruitment of patients. The present study aims to investigate Osteogenesis imperfecta-patients with scoliosis by means of a cross-section study. ⋯ Our cross-section study with 102 Osteogenesis imperfecta-patients showed scoliotic deformity in 74.5% of cases. 69 patients suffered from remarkable pain and impaired range of motion, which was not only attributable to scoliosis alone, but also to concomitant spinal deformities.