Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Sep 1978
Case ReportsOperative treatment of displaced Salter-Harris III distal tibial fractures.
Displaced, isolated Salter-Harris III fractures of the distal tibia are infrequent. Typically, the mechanism of injury is an external rotation stress to the adolescent ankle. The distal tibial growth plate fuses from medial to lateral during adolescence. ⋯ Closed reduction of displaced fractures is usually unsuccessful. In 5 displaced fractures, periosteal flaps were frequently found to have blocked closed reduction. Follow-up evaluation after open reduction and internal fixation revealed anatomic healing and normal ankle strength.
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Clin. Orthop. Relat. Res. · Jul 1978
Wide resection of primary tumors of bone and replacement with massive bone grafts: an improved technique for transplanting allogeneic bone grafts.
The treatment by wide resection of 104 local aggressive and low grade malignant bone tumors is presented with results after follow-up for 5.0 years on the average. The series comprises 29 giant cell tumors, most of them malignant or premalignant, 25 cartilaginous tumors (12 verified chondrosarcomas and 13 chondromas suspect of malignancy), 14 cases of sarcoma, 6 of fibrosarcoma, 4 parosseal sarcomas, 3 osteosarcomas and one chordoma. The remaining 36 cases include: aneurysmal bone cysts, fibrous dysplasia, chondroblastomas, osteoblastomas, giant chondromyxoid fibroma, and hemangiomas. ⋯ The overall results were good in 81% and fair in 11%. Five cases had to be amputated and 3 patients were lost to follow-up, a possible total of 8% poor results. Extensive resection with massive bone grafting is a worthwhile approach in the treatment of selected cases of aggressive and low grade malignant bone tumors.
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Clin. Orthop. Relat. Res. · Jul 1978
Case ReportsParaplegia, syringomyelia tarda and neuropathic arthrosis of the shoulder: a triad.
A casually related triad of syringomyelia tarda, postparaplegia with secondary neuropathic arthrosis of the shoulder has been presented. The development of neuropathic arthrosis of the shoulder has been presented. The development of neuropathic arthrosis of the shoulder in 2 of our paraplegic patients prompted us to look for a correlation and/or a common etiology. ⋯ There is an interesting pathological association of paraplegia and syringomyelia with neuropathic arthrosis. Earlier awareness of any neurological changes in the upper extremity of the paraplegic patient could point to recognition of syringomyelic process and portend a tendency toward neuropathic arthrosis of the shoulder. This would require a high index of suspicion, and subsequently a preventative, protective orthopedic approach to minimize the usual functional deformity that occurs when this neuropathy involves the shoulder.
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Clin. Orthop. Relat. Res. · Jul 1978
Case ReportsSurgical treatment of Scheuermann's adult kyphosis: case report.
A 39-year-old woman with severe Scheuermann's kyphosis complaining of back pain was treated surgically. The following operations were performed in stages to correct a fixed kyphosis: (1) total diskectomy through an anterior approach; (2) application of the halo pelvic distraction apparatus; (3) anterior spine fusion following correction by spinal distraction. She was relieved of her complaints and deformity at a 3 year follow-up examination.
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Clin. Orthop. Relat. Res. · Mar 1978
Case ReportsSuperficial radial neuritis and De Quervain's disease. Report of three cases.
Three patients with De Quervain's disease developed superficial radial neuritis, a complication which seems not to have been considered in the literature. All 3 patients were women. One responded to conservative therapy and the other 2 required tenolysis of the abductor pollicis longus and extensor pollicis brevis tendon sheaths to relieve symptoms.