Clinical orthopaedics and related research
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Sixty-seven patients were treated for Pott's paraplegia: 58 were adults and 9 were children. Sixty-four patients had active disease, and 3 had healed disease. All patients had triple chemotherapy with or without decompression surgery. ⋯ It took 2 to 6 months for recovery for the patients with conservative treatment, whereas it took <2 months for the patients with anterior decompression. The patients who had the combined 2-stage procedure could be mobilized earlier after neurologic recovery than could the patients having the anterior radical surgery and the conservatively treated patients. It was proven that paraplegia of active disease can be treated successfully by conservative or surgical means and that paraplegia caused by healing of fibrosis in the severely deformed spine was difficult to treat successfully, even with radical surgery.
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Surgeries (1155 cases) for cervical myelopathy in a northeastern prefecture (population, 2.26 million) and surrounding areas were reviewed. The annual operation rate per 100,000 residents in the prefecture was 5.7. Most of the patients were in their sixth or seventh decade of life (27% each), but the annual operation rate per 100,000 people of each decade of age was the highest in the eighth decade (16.5 per 100,000 people). ⋯ Laminoplasty (93%) was predominant over laminectomy. Forty percent of the patients had developmental stenosis; 48%, dynamic stenosis; 27%, disc herniation; 11%, segmental ossification of the posterior longitudinal ligament; 9%, continuous ossification of the posterior longitudinal ligament; 8%, posterior spur; and 4%, calcification of the ligamentum flavum. Fifty-two percent had more than 1 of these spinal diseases.
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Clin. Orthop. Relat. Res. · Feb 1996
ReviewRadiographic course after acetabuloplasty and femoral osteotomy in hip dysplasia.
The radiographic course of 101 hips with residual dysplasia treated with roof plasty combined with intertrochanteric varus derotation osteotomy using the osteotomy wedge as a roof graft after Mittelmeier were reviewed. The average followup period was 8.8 years. The acetabular angle was improved by an average of 16 degrees (postoperative mean, 19 degrees; average at followup, 18 degrees). ⋯ There was no correlation of the postoperative of the neck shaft angle to patient age, preoperative valgus extension, correction angle, or length of followup. In nearly all cases, an almost anatomic joint shape was achieved. With a complication rate of only 1%, especially regarding the rate of necroses of the femoral head, the presented surgical technique can be recommended as highly effective, reliable, and safe for the treatment of congenital hip dislocation.