Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Sep 1985
Results of carpal tunnel release in renal hemodialysis patients.
Forty-eight renal hemodialysis patients were evaluated clinically and electrodiagnostically for carpal tunnel syndrome (CTS). The incidence (32%) was significantly higher than that previously reported by other authors. All patients with CTS also had peripheral neuropathy by electrodiagnostic criteria. ⋯ In patients with CTS treated by transverse carpal ligament release, 87.5% obtained relief from pain and numbness. Because of the high incidence of CTS in the chronic hemodialysis population, electrodiagnostic screening is recommended in these patients. Patients with clinical and electrodiagnostic signs of CTS will benefit from transverse carpal ligament release.
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Clin. Orthop. Relat. Res. · May 1985
Total hip acetabular cup flange design and its effect on cement fixation.
The design of pods and flanges on the acetabular cup surface was investigated to determine the effects on cement fixation of the total hip arthroplasty (THA) acetabular cup. To a basic cup designed with pods, four different types of flange designs were added: a cup without a flange, a cup having a flange with 12 scallops, a cup having a flange with three scallops, and a cup having a continuous flange. The cups were each inserted, via an MTS machine, into an instrumented simulated acetabulum containing polymerizing polymethylmethacrylate (PMMA). ⋯ Also, three continuous-flange cups were manually inserted into cadaver acetabula in order to study the shape of the cement mantle around the cup. A cup with a continuous flange generated significantly higher cement intrusion pressures and depths when compared with the other three cups. A cup with pods and a continuous flange produced concentric positioning of the cup with a uniform cement thickness around the cup and was well contained within the reamed acetabulum.
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Clin. Orthop. Relat. Res. · Apr 1985
Vertebral osteotomy for correction of kyphosis in ankylosing spondylitis.
Eleven patients with ankylosing spondylitis had severe disabling kyphosis with forward bending of the upper part of the spine. The kyphosis was corrected by osteotomy by removal of a wedge composed of the spinous processes and the neural arch of the second lumbar vertebra and by excision of bone from the inside of the posterior part of the vertebral body of L2. By hyperextending the spine, a wedge fracture occurs in the vertebral body, producing lordosis and correction of the deformity without an anterior opening of the lumbar discs.
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Clin. Orthop. Relat. Res. · Apr 1985
The roentgenographic evaluation of anterior shoulder instability.
Retrospective evaluations of roentgenograms of 83 patients with unilateral shoulder instability were surveyed to evaluate the usefulness of various radiographic projections and to correlate the information with the osseous pathology associated with prior glenohumeral dislocation. The Hill-Sachs and the osseous Bankart defects were considered pathognomonic radiographic signs of glenohumeral joint instability. Based on history, physical examination, and examination under general anesthesia, patients were divided into three categories--(1) dislocation group, (2) subluxation group, and (3) combination group. ⋯ The osseous Bankart defect on the anteroinferior glenoid rim was best documented on the Didiee and West Point views. The external rotation and axillary view did not add significantly to the preoperative radiographic findings. In a patient with an unstable shoulder, a radiographic series that includes an internal rotation, a Stryker notch view, and either a West Point or a Didiee view would maximize the diagnostic yield per radiographic cost, time, and exposure.
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Clin. Orthop. Relat. Res. · Apr 1985
Hyponatremia after spinal fusion caused by inappropriate secretion of antidiuretic hormone (SIADH).
The Syndrome of Inappropriate Secretion of Antidiuretic Hormone (SIADH) was found to occur in at least 5% of patients recovering from a spinal fusion operation. A retrospective review was undertaken for all patients who had had a spinal fusion in 1981. ⋯ There was no correlation with age, sex, type of fusion, or cause of spinal deformity. The diagnosis, treatment, and pathogenesis of SIADH suggest that an extensive spinal fusion operation is a previously unrecognized predisposing condition.