Acta orthopaedica Scandinavica
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Statokinesimetric characteristics were analysed in patients with scoliosis which had developed in the course of degenerative neuromuscular disorders and in patients with adolescent idiopathic scoliosis. Patients with Duchenne and limb- girdle muscular dystrophy and spinal muscular atrophy showed markedly decreased oscillations of the body's centre of gravity, in addition to a forward shift of its mean position. ⋯ On the other hand, patients with idiopathic scoliosis did not show any significant changes as compared with normal subjects. The present study therefore does not support the suggestion that the pathogenesis of scoliosis, at least in neuromuscular patients, is triggered by an impairment of descending postural control.
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Comparative Study
A new thermoplastic casting material. A comparison between plaster of Paris and Hexelite.
Plaster of Paris and Hexelite, a new thermoplastic bandage, were compared in the treatment of 183 patients with malleolar fractures, Colles' fractures or distortions of the finger joints. There were no statistically significant differences between the two types of bandages taking into account the strength of the bandage, the amount of skin damage and the patient's opinion of the bandage. Hexelite is seven times more expensive than plaster of Paris, and, in addition, is more difficult to handle. Hence its use has been discontinued.
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The effect of 3- and 5-hour pneumatic tourniquets on skeletal muscle physiology was investigated. Maximum isometric tension development, contraction and half relaxation times were measured in the muscles lying immediately under and distal to the tourniquet. On release of the tourniquet no consistent difference between control and experimental muscles was observed with respect to contraction and half relaxation times; however, there was a marked reduction in maximum isometric tension development. ⋯ Six days after a 3-hour tourniquet the compressed muscle tension was reduced to approximately 80 per cent of the control value whilst in the distal muscle, tension development varied from normal to 64 per cent of the control value. Thus it is shown that the effect on muscle contraction after a 3-hour tourniquet is not immediately reversed by the restoration of the blood supply. A reduction in muscle strength follows which may take a week or more to recover.
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Seven patients (nine hips) who suffered from coxa vara were treated by distal transfer of the greater trochanter. The operation eliminated or markedly diminished the preoperative Trendelenburg sign, thus improving gait. In three patients (four hips) operated upon at the aged of 9 and 12 years, the initial coxa vara was converted into an almost normal valgus kemoral neck. There was one poor result due to technical failure.
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Six patients with peripheral nerve lesions after total hip replacements were reviewed. The incidence of peripheral nerve lesions was six out of 825, i.e. 0.7 per cent. The neuropathies, four sciatic, one femoral and one combined femoral and sciatic, were due to damage by the reamer in one case, haemorrhage in two, whereas the cause was unknown in three patients. After conservative treatment and 1-5 years follow-up the recovery was classified as good in three, fair in one and poor in two patients.