Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · May 1993
Case ReportsThe management of soft-tissue problems associated with calcaneal fractures.
Soft-tissue problems associated with fractures of the calcaneus are common and can present many pitfalls. A classification of soft-tissue problems has been devised to facilitate treatment: Type 1, closed fractures treated by open reduction and internal fixation with an inability to close the skin. Type 2, wound break down after open reduction. ⋯ Type 5, calcaneal osteomyelitis. Type 6, chronic unstable soft tissue over the calcaneus. There are various surgical options of skin graft, rotational flaps, and free-tissue transfers that best reconstruct each of these individual problems.
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Clin. Orthop. Relat. Res. · May 1993
The operative treatment of intraarticular calcaneal fractures. Indications, technique, and results in 257 cases.
Since 1972, 257 intraarticular fractures of the calcaneus have been treated with operative intervention. A lateral incision and a third tubular plate were used in all cases. ⋯ Although 50% of patients showed a reduced mobility of the subtalar joint, pain and limited ambulation were rare. Only six patients required a late subtalar arthrodesis.
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During a 16-year period, 256 second hip fractures were found in 3898 persons 40 years of age and older who had a previous hip fracture. Ninety-two percent of the second fractures were contralateral, and 68% of these were the same type as the first. ⋯ The risk of the first fracture was 1.6 per 1000 men per year and 3.6 per 1000 women, and for the second fracture 15 per 1000 men per year and 22 per 1000 women. This increase was highly significant for both genders, especially for men.
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Clin. Orthop. Relat. Res. · Mar 1993
Review Case ReportsSalmonella typhi osteomyelitis in a nonsickle cell patient. A case report.
Few cases of osteomyelitis caused by Salmonella typhi in nonsickle cell patients have been reported. In a 33-year-old woman with a history of chronic, intermittent drainage of the right lower leg, roentgenographs indicated middiaphyseal osteomyelitis of the fibula. ⋯ The patient responded adequately to four weeks of intravenous antibiotic therapy, and the infection has remained arrested after 18 months. The characteristics of S. typhi osteomyelitis are as follows: All reported cases have affected female patients with no apparent immunocompromise; all had a history of S. typhi infection with long bone involvement; and all had a tendency to recurrence.
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Clin. Orthop. Relat. Res. · Mar 1993
Use of the pantaloon cast for the selection of fusion candidates in the treatment of chronic low back pain.
Forty-five patients with low back pain (LBP) of longer than six months' duration and for whom all conservative therapies failed were placed in a pantaloon cast for a two- to four-week trial period. Significant pain relief occurred in 31 (69%) of these patients. ⋯ After an average follow-up period of 14 months, 17 (74%) had significant pain relief. The pantaloon cast may be an effective tool for identifying those chronic LBP patients who might benefit from spinal stabilization procedure.