Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jul 1975
Combined staged anterior and posterior correction and fusion of the spine in scoliosis following poliomyelitis.
The problems with severe forms of scoliosis following poliomyelitis include the associated muscle imbalance, soft tissue contractures and pelvic obliquity. Such deformities militate against optimal correction and maintenance of that correction and their treatment is often marred by pseudarthroses. Seventeen patients with an average curve of 93 degrees have been treated and followed for up to 38 months. ⋯ No pseudarthroses were seen when the Harrington rod was used. Great care must be taken if halo-pelvic traction is to be used for patients with pelvic obliquity, for preliminary correction halo-femoral traction will often be adequate. In the more severe forms of paralytic scoliosis a combined staged anterior and posterior correction and fusion should be considered if the aim is maximal correction of the scoliosis and avoidance of pseudarthroses.
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Clin. Orthop. Relat. Res. · Jul 1975
Case ReportsScheuermann's juvenile kyphosis. A histologic study.
The case histories and gross and microscopic findings of two adolescent patients with Scheuermann's kyphosis demonstrate that the anterior longitudinal ligament is bowstrung across the apex of the hyphosis. The microscopic findings include markedly irregular end plates and end plate disruption with protrusion of disk material into the vertebral body. ⋯ The intervertebral disk is interpreted as normal both by routine histology and electron microscopy. It is postulated that Scheuermann's kyphosis may be secondary to vertebral osteoporosis occurring during the juvenile period rather than to an intrinsic abnormality in the intervertebral disk or ring apophysis.
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Clin. Orthop. Relat. Res. · Jul 1975
Case ReportsLuxatio erecta of the hip. An interesting case report.
This is a case report of an inferior dislocation of the hip in a 5 1/2-year-old child, characterized by acute flexion with slight abduction of the hip and flexion of the knee. The dislocation is reducible by traction in a cephalad direction, gradual extension and internal rotation of the hip.
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Flexible wire and small pins cause minimal disturbance of osseous blood supply, and introduce minimal foreign material into the wound. Supplemental support by a plaster cast or by traction is required, but the external support can generally be discontinued early for joint mobilization. Several simple auxillary fixation devices extend the usefulness of wire fixation. ⋯ Autogenous iliac cancellous chips provide minimal and effective internal fixation for an infected ununited fracture of the tibia. The surgical instrument most important for making wire fixation highly successful is a tightener-twister which protects wire loops from excessive strain during application, and permits twisting at a predetermined and therefore reproducible tension. Other special and ordinary instruments are valuable assets.
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Clin. Orthop. Relat. Res. · Jan 1975
A simple technique for internal fixation of the clavicle. A long term evaluation.
A simple, effective technique for internal fixation of the clavicle with Knowles threaded pins is described in 11 patients with 1 to 21 year results. The method is applicable to fresh fractures of non-union and provides secure compression-fixation. The threads prevent migration of the pin, reduce the period of external immobilization, and obviate the need for removal of the pin.