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  • 1
    Electronic Resource
    Electronic Resource
    Staple augmentation to treat a humeral nonunion after failed Seidel locked nailing (1998)
    Springer
    Archives of orthopaedic and trauma surgery 118 (1998), S. 42-44 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Seidel locked nailing has been successfully used to treat a humeral shaft fracture or nonunion. However, if union fails despite this treatment, the next approach to try has not been well defined. We, therefore, developed a technique using a staple to enforce the local stability without removing the failed nail. The technique was very simple, and the outcome was always satisfactory.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004020050308
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  • 2
    Electronic Resource
    Electronic Resource
    Cementless Roy-Camille femoral component (1998)
    Springer
    Archives of orthopaedic and trauma surgery 118 (1998), S. 85-88 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract From 1984 to 1987, a complete, single-layered, porous-coated femoral component (Roy-Camille type) was used for primary cementless total hip replacement in 80 patients. Seventy-two patients (77 hips) with a minimal follow-up of 5 years (mean 7.2 years) were assessed clinically and radiographically. Thigh pain occurred in 4 hips. Osteolysis appeared in 5 hips. Cortical thinning around the femoral component was significant at the proximal and middle levels. In total, 6 femoral components failed, which led to reoperation due to aseptic loosening (4 hips) and septic loosening (2 hips). The hip rating score (modified d’Aubigne and Postel rating system) in the surviving hips progressed from 9.0 (range 6–10) preoperatively to 16.3 (range 12–18) points at the latest follow-up. From this study, we found that the complete, single-layered, porous-coated stem had a low loosening rate after 5 years. Bone ingrowth into the porous coating was found in most of the cases. A lower stress shielding effect in comparison with the complete, multi-layered, porous-coated prosthesis was also noted.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004020050318
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  • 3
    Electronic Resource
    Electronic Resource
    Effect of reaming bone grafting on treating femoral shaft aseptic nonunion after plating (1999)
    Springer
    Archives of orthopaedic and trauma surgery 119 (1999), S. 303-307 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Rigid intramdullary nailing with cancellous bone grafting provided by intramedullary reaming was prospectively used to treat femoral shaft aseptic nonunions after plating. Indications for this technique were a femoral shaft nonunion with an inserted plate, no previous infection sign in the treatment course, less than 1.5 cm shortening, and no segmental bony defects. After the plate was removed, a flexible guidewire was inserted antegradely. The local wound was closed, and intramedullary reaming was done as widely as possible until some resistance to it occurred. Finally, a rigid intramedullary nail was inserted. Twenty-four consecutive patients were treated with this regimen, and 21 were followed-up for at least 1 year (range 1–5 years). All 21 nonunions healed with a union rate of 100% (21/21). The time to union was 4.5 ± 1.0 months. There were no significant complications. We conclude that for indicated cases, reaming bone grafting is a very effective technique and avoided donor site morbidity. Therefore, whenever possible, this technique could be considered first.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004020050415
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  • 4
    Electronic Resource
    Electronic Resource
    Treatment of cutout of a lag screw of a dynamic hip screw in an intertrochanteric fracture (1998)
    Springer
    Archives of orthopaedic and trauma surgery 117 (1998), S. 193-196 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Sixteen consecutive patients with cutout of a lag screw of a dynamic hip screw fixation in an intertrochanteric fracture were treated with reinsertion of a lag screw, bone cement supplementation in the neck-trochanter, and subtrochanteric valgus osteotomy. Postoperatively, patients were permitted to ambulate with protected weight-bearing. Fourteen patients were followed-up for at least 1 year (median 2 years; range 1–3 years), and all had a solid union. The union period took a median of 5 months, with a range of 3–7 months. Usually, union of an intertrochanteric fracture was faster than that of subtrochanteric osteotomy (P 〈 0.01). There were no complications of wound infection, loss of reduction, cutout of a lag screw, or osteonecrosis of the femoral head. From clinical and theoretical considerations, we conclude that despite cutout of a lag screw of a dynamic hip screw fixation being difficult to treat, out technique still can provide an excellent outcome. Therefore, we strongly recommend its wide use.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004020050228
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  • 5
    Electronic Resource
    Electronic Resource
    Arthroscopic posterior cruciate ligament reconstruction with quadriceps tendon-patellar bone autograft (1999)
    Springer
    Archives of orthopaedic and trauma surgery 119 (1999), S. 86-88 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Surgical reconstruction of the posterior cruciate ligament (PCL) is indicated in the PCL-deficient knee with symptomatic instability and multiple ligamentous injury. However, the choice of graft tissues continues to be controversial. We describe an arthroscopic PCL reconstruction technique using the quadriceps tendon-patellar bone autograft. From March through September 1996, this autograft was used in 12 patients with PCL injuries. After 1–1.5 years’ follow-up, the clinical outcome has been encouraging. In addition, the quadriceps tendon-patellar autograft has the advantage of being self-available. Furthermore, the technique is easy to perform and has comparable anatomic and biomechanical qualities to other available techniques. Quadriceps tendon-patellar autograft is a reasonable alternative choice for PCL reconstruction.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004020050362
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  • 6
    Electronic Resource
    Electronic Resource
    Dislocation after total hip arthroplasty (1999)
    Springer
    Archives of orthopaedic and trauma surgery 119 (1999), S. 263-266 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Hip dislocation has long been one of the major complications after total hip arthroplasty (THA). From 1980 to 1994, we performed 2728 THAs (including primary and revision cases). There were 97 hips (3.6%) with the complication of dislocation, 62 of which were followed up for at least 2 years (mean 5.3 years; range 2–12 years). Single dislocations occurred in 40% and recurrent dislocations in 60%. More than half of the dislocations (58%) occurred within 3 months after the index operation. The dislocation rate was not related to sex, age, previous revision surgery, or types of prosthesis, but was related to a smaller size of the femoral head. The rate of recurrent dislocation was not related to a history of previous surgery, but was related to a smaller femoral head, late onset of dislocation (〉 3 months), soft-tissue imbalance, and cup malposition in both anteversion and inclination. If the size of the femoral head was 26 mm or smaller, a posterior approach was not recommended. Closed reduction followed by 1–2 weeks of skin traction was the treatment of choice. The success rate for the first attempt at closed reduction for the treatment of dislocation was 41%; the success rate decreased gradually with the number of attempts. For the recurrent dislocation group, bracing for 4–6 weeks with training was recommended for the postural type and bracing for 3 months with muscle training for the soft-tissue imbalance type. Only 15% of the dislocated hips needed re-operation, and most of the patients resolved the problem after being informed and undergoing muscle training.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004020050406
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  • 7
    Electronic Resource
    Electronic Resource
    Anterior reconstructive spinal surgery with Zielke instrumentation for metastatic malignancies of the spine (2000)
    Springer
    Archives of orthopaedic and trauma surgery 120 (2000), S. 27-31 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract From March 1984 to April 1996, 60 consecutive patients with spinal metastasis underwent palliative surgery by anterior corpectomy and Zielke instrumentation. Their ages ranged from 21 to 76 years (mean 54 years). Thirty-two patients had metastasis to the thoracic spine, 20 to the lumbar spine, and 8 had both thoracic and lumbar metastases. The primary malignancies were lung cancer in 12 patients, colorectal cancer in 10, hepatoma in 9, thyroid cancer in 7, breast cancer in 3, and cancers of the stomach, kidney, nasopharynx, long bones, skin, and cervix in 1 patient each. A primary carcinoma was never identified in 13 patients. In the present series, 4 patients died within 1 month, and 56 patients were followed-up. All maintained spinal stability postoperatively. Forty of 52 patients with severe pain obtained significant symptomatic relief for 3 months or more, and 33 of the 46 paralyzed patients gained neural improvement. Sphincter dysfunction became better in 10 patients, and none became worse. We conclude that anterior corpectomy to decompress neural encroachment with instrumental reconstruction to stabilize the collapsed spine is a good adjunctive treatment in these highly selected patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004020050434
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  • 8
    Electronic Resource
    Electronic Resource
    A simpler surgical technique to treat aseptic nonunion-associated femoral length discrepancy (1992)
    Springer
    Archives of orthopaedic and trauma surgery 111 (1992), S. 160-164 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In a prospective study from December 1986 to August 1989, 17 consecutive patients with femoral shortening due to aseptic nonunion of femoral shaft fractures were treated with limitedly open Gross-Kempf locking nailing with a lengthening procedure. Patients were followed up for at least 1 year (average 25 months). There was a 88.2% union rate with an average union period of 5.2 months. Average lengthening was 2.4 cm (1.0 ∼ 3.0 cm) , and average operation time 90 min (70 ∼ 130min). The blood loss was slight (average 200ml). Complications (11.8%) were 5.9% implant failure and 5.9% nonunion which were not difficult to manage. No neurovascular complications were noted. We conclude that for 5 cm shortening or less in femoral aseptic nonunion, this treatment constitutes the simplest technique and can achieve a very satisfactory result.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00388091
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  • 9
    Electronic Resource
    Electronic Resource
    A small effect of weight bearing in promoting fracture healing (1992)
    Springer
    Archives of orthopaedic and trauma surgery 112 (1992), S. 28-32 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We treated 66 consecutive type IV comminuted femoral shaft fractures with static Grosse-Kempf interlocking nails and followed them up for at least 1 year (median 27 months). Although the effect of weight bearing was completely lost, 60 fractures healed primarily without dynamization. We conclude that weight bearing contributes only an auxiliary role in promoting fracture healing, and that the most decisive role is adequate mechanical stability with sufficient nutrition.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00431040
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  • 10
    Electronic Resource
    Electronic Resource
    Destructive spondyloarthropathy mimicking spondylitis in long-term hemodialysis patients (2000)
    Springer
    Archives of orthopaedic and trauma surgery 120 (2000), S. 594-597 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 63-year-old man with end-stage renal disease (ESRD) who had been undergoing hemodialysis for 18 years suffered persistent neck pain, progressive quadriparesis, and a deteriorating ataxic gait during the 6 months before admission. A sudden onset of aggravating quadriparesis and an inability to ambulate occurred during his trip to Sydney, Australia, 1 week before this admission. Vertebral tuberculosis osteomyelitis of the C5/6 segment was considered and treated in a hospital there. Findings from cervical magnetic resonance imaging (MRI; low signal intensity on both T1- and T2-weighted images) were diagnostic of destructive spondyloarthropathy (DSA) and distinguishable from spinal osteomyelitis preoperatively. Amyloid masses, mainly composed of B-2 microglobulin, filled in disc and paradiscal ligaments, with adjacent endplate destruction by cytokine-mediated reactive inflammation, and appeared to be mostly related to the pathogenesis of DSA. The cervical spine, especially C5/6, is the most common site of DSA. Spinal instability and neurologic compression cause the clinical symptoms and signs. Adequate decompression and successful cervical fusion ensure the best therapeutic results.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004020000135
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