Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Feb 1986
Case ReportsSegmental spine plates with pedicle screw fixation. A new internal fixation device for disorders of the lumbar and thoracolumbar spine.
A new segmental spine plate fixation system, utilizing a posterior approach and screw fixation, has been developed for disorders of the lower thoracic or lumbar spine. The indications are significant instability and severe pain relieved by immobilization. ⋯ The spine plates can be contoured for anatomic positioning, reduction, and rigid stabilization to enhance graft consolidation and fusion. The surgical fixation technique is demonstrated in five case presentations illustrating the application and versatility of the method.
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Clin. Orthop. Relat. Res. · Feb 1986
Follow-up study of medial facetectomies and posterolateral fusion with instrumentation in unstable degenerative spondylolisthesis.
From 1978 to 1983, 54 consecutive patients with unstable degenerative spondylolisthesis were treated by medial facetectomies and posterolateral fusion with combined distraction and compression rod instrumentation. The average period of follow-up observation was 30 months. Twenty-five patients had a combination of disc herniation or instability, excluding olisthesis. ⋯ Difference between the values of %-slip and slip-angle before surgery and those at follow-up examination was not statistically significant. Rod breakage occurred in two patients with pseudarthrosis. The overall clinical results were satisfactory relief of clinical symptoms and regression of physical signs, with a high rate of solid fusion.
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Clin. Orthop. Relat. Res. · Oct 1985
Operative treatment of ankle fracture-dislocations. A follow-up study of 306/321 consecutive cases.
In a prospective study of 321 consecutive cases of dislocation ankle fractures, operatively treated according to the AO (ASIF) principles, 306 cases (95%) were followed up two to six years after surgery. The infection rate was 1.8% with no septic arthritis. The clinical results were "excellent and good" in 82%, "acceptable" in 8%, and "poor" in 10%. ⋯ There was a strong correlation between the degree of arthritis and the clinical result. A computer analysis (AID) revealed that the most decisive factors influencing the clinical result were the type of fracture, the accuracy of the reduction, and the sex of the patient. Exact reduction, rigid internal fixation, early postoperative joint exercises, and subsequent full weight-bearing in a below-the-knee walking plaster are essential for a good end result of fracture-dislocations of the ankle joint.
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Clin. Orthop. Relat. Res. · Sep 1985
The effect of alignment on results in arthroscopic debridement of the degenerative knee.
Fifty-two patients with severe degenerative joint disease of the knees were treated by arthroscopic debridement. The results of arthroscopic debridement on normally aligned degenerative knees are encouraging. A combination of arthroscopic debridement and high tibial osteotomy could be an appealing alternative to total knee arthroplasty in the young patients. Patients with varus angular deformity in the degenerative knee had a poor result and should be excluded from consideration for arthroscopic debridement.
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Clin. Orthop. Relat. Res. · Sep 1985
Shoulder arthrodesis for the treatment of brachial plexus palsy.
In 14 adult patients with brachial plexus injuries, shoulder arthrodesis was completed in a position of 30 degrees abduction, 30 degrees flexion, and 30 degrees internal rotation. Abduction was measured by the position of the arm in relation to the side of the body with the scapula in the anatomic position. Internal fixation was used in each case. ⋯ Seven patients required plate removal. Only one of the three patients who had had above-elbow amputation became a good prosthetic user. Shoulder arthrodesis is a reliable procedure that improves function in adult patients with brachial plexus palsy.