Clinical orthopaedics and related research
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The charts and radiographs of 70 patients older than 50 years of age with thoracic vertebral body collapse were reviewed retrospectively. Fifteen patients had traumatic fractures and 34 had osteoporotic collapse of thoracic vertebrae. Metastasis was the underlying disease process in 18 patients and multiple myeloma in the remaining 3 patients. ⋯ There were 11 metastatic, 80 osteoporotic, 14 traumatic, and 3 fractures secondary to multiple myeloma involving the lower dorsal spine. There were no infections or primary bone tumors. The difference in the frequency of metastatic fractures against other etiologies involving the upper versus the lower thoracic spine was highly statistically significant.
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Clin. Orthop. Relat. Res. · Jul 1996
An axially loaded model of the ankle after pronation external rotation injury.
Using a testing apparatus that allows axial loading and displacement in the sagittal, axial, and coronal planes, 6 ankles were tested under experimental conditions intended to model the Lauge-Hansen pronation external rotation injury. All specimens were rotated through a continuous range of sagittal motion with the ankle under 300 N of axial load as the coupled motion of the ankle in the coronal and axial axes was recorded. Combinations of fibular osteotomy, disruption of the syndesmosis up to 6 cm above the plafond, and deltoid transection were tested to mimic Stages I to III of the pronation external rotation ankle fracture. ⋯ When the deep deltoid was sectioned, the ankle dislocated in plantar flexion unless the fibula was stabilized. This prevented dislocation but failed to restore normal talar kinematics. This study found no biomechanical support for placement of a syndesmotic screw unless the medial side cannot be stabilized anatomically.