Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Sep 1994
Comparative StudyBasicervical fractures of the proximal femur. A biomechanical study of 3 internal fixation techniques.
A biomechanical cadaver study was performed to compare the stability and ultimate strength of 3 standard fixation techniques used for treatment of basicervical hip fractures. Twenty one pairs of mildly osteoporotic femurs were selected, based on a computed tomography bone density reading of 40-50 Hounsfeld units and a Singh index of III. After initial mechanical characterization of intact femurs, basicervical femoral neck fractures were created, reduced, and then instrumented with random assignment to 1 of 3 methods of fixation: (1) 3 parallel 6.5-mm cannulated cancellous screws; (2) a 135 degrees sliding hip screw with a 4 hole side plate; and (3) a 135 degrees sliding hip screw with a 4 hole side plate and a 6.5-mm cannulated cancellous screw placed proximal and parallel to the sliding screw. ⋯ There were no statistically significant differences in lateral bending or torsional testing behavior between the 3 fixation methods. Use of the sliding hip screw is recommended rather than use of multiple cancellous screws for treatment of basicervical femoral neck fractures. Although a superiorly located cancellous screw may provide rotational control during sliding hip screw insertion, it provides no incremental fixation after the sliding hip screw is placed.
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Clin. Orthop. Relat. Res. · Sep 1994
The relationship of pes planus and calcaneal spur to plantar heel pain.
A prospective study of pes planus by using calcaneal pitch and calcaneal spur was carried out in 82 patients with plantar heel pain and in 400 normal subjects. The mean normal calcaneal pitch was 20.54 degrees. The mean calcaneal pitch in patients with plantar heel pain was 15.99 degrees, which was significantly lower than in normal subjects. ⋯ Again, this was a highly significant difference. Excessive weight gain, aging, and gender may be important factors effecting the lowering of the pitch and the increasing of spur formation. These factors could lead to the development of plantar heel pain.
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Clin. Orthop. Relat. Res. · Sep 1994
Complications of anterior approaches to the thoracolumbar spine. Emphasis on Kaneda instrumentation.
One hundred eighty five consecutive patients underwent anterior decompression, stabilization, and/or fusion procedures of the thoracolumbar spine. At 1 year or more followup, the incidence of complications was analyzed. ⋯ The use of Kaneda anterior instrumentation provided marked improvement in the prevention of this problem. A custom made carbon fiber reinforced cage packed with autogenous cancellous bone graft used in the treatment of ten patients with large corpectomy defects resulted in a good outcome.