Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Apr 1990
ReviewThe spastic mouse. And the search for an animal model of spasticity in human beings.
An animal model of chronic spasticity would be valuable. There has been little success at producing such a model, however, because there is no frequently occurring natural disease in animals and, after experimental injury, the animals tend to die or recover. Spasticity in animals or humans is one of the many manifestations of an upper motor neuron syndrome; there is no such thing as pure spasticity. ⋯ Genetically spastic mice are a homogeneous population that have an abnormally functioning neurotransmitter within the central nervous system. This model has been shown to develop abnormalities of muscle growth that ultimately lead to contracture. The spastic mouse shows some promise for investigation of the abnormalities of muscles and joints that occur in spastic humans.
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The CO2 laser was evaluated to determine its effectiveness for marginal cauterization of giant-cell tumors after resectional curettage. Average power densities of 11-53 W/cm2 for corresponding application times of 120 and 60 seconds were found to produce 30 degrees temperature rises in fresh human femoral heads. ⋯ CO2 laser resection was found to be accurate and reproducible. No damage to underlying hyaline cartilage and soft tissues was evident histologically at one and four weeks after experimental local laser cauterization of distal femoral condyles in rabbits.
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Clin. Orthop. Relat. Res. · Mar 1990
Case ReportsSubtalar arthralgia caused by juxtaarticular osteoid osteoma.
Juxtaarticular osteoid osteomas in the ankle are frequently misdiagnosed because their symptoms mimic arthritis and may precede roentgenographic findings. In addition, these tumors are rare compared to arthritis and other sources of ankle pain. ⋯ The use of plain tomograms, thin-section computed tomograms, and radionuclide scans aid an early and correct diagnosis. Arthroscopy and arthrotomy are often inappropriate.
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Luxatio erecta humeri is a rare type of glenohumeral dislocation. The pathomechanics of this injury involve either direct axial loading on a fully abducted extremity or leverage of the humeral head across the acromion by a hyperabduction force. The clinical presentation of this type of shoulder dislocation is unique, with the affected extremity held rigidly above the head in abduction. ⋯ Concomitant fracture of the acromion, clavicle, coracoid, greater tuberosity, and humeral head may also be seen. A computed tomography scan of the case reviewed here revealed a large humeral head defect oriented perpendicular to the classic Hill-Sachs lesion. Luxatio erecta humeri is associated with significant late morbidity, including recurrent dislocation, instability, and adhesive capsulitis.
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Ten patients with Scheuermann's kyphosis were surgically treated with posterior spine fusion and Harrington heavy compression-rod instrumentation. This procedure relieved pain and deformity in all ten patients. ⋯ The postoperative correction of kyphosis averaged 32 degrees (45%), with an average loss of correction of 7.8 degrees. Posterior fusion with Harrington heavy compression-rod instrumentation may prove to be the procedure of choice in Scheuermann's kyphosis that is severe but flexible on hyperextension with a curve greater than 65 degrees.