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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    European journal of orthopaedic surgery & traumatology 7 (1997), S. 281-284 
    ISSN: 1432-1068
    Keywords: Lymphoma ; Lymphome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Le cas d'une jeune femme de 19 ans porteuse d'un lymphome à cellules béta primitif est présenté. Une imagerie médicale complète avec scanner, IRM ainsi qu'une étude histologique ont été nécessaires au diagnostic, qui a d'abord été erroné avec suspicion d'ostéomyélite chronique. Une résection du fémur distal comprenant le genou a été réalisée et une distraction bipôlaire du cal fut ensuite appliquée. Après une inflammation locale, le diagnostic de lymphome à cellules béta put être posé et une étude immunohistochimique sur un prélèvement de tissus mous fut demand'ee. Une amputation de cuisse dut être effectuée à cause d'une grave nécrose et d'une surinfection des tissus mous. Des problèmes diagnostiques survinrent à cause de symptomes aspécifiques, d'incertitudes radiologiques et d'une absence de diagnostic histologique. Les facteurs de croissance ont probablement stimulé la croissance tumorale après la mise en route de la distraction du cal.
    Notes: Summary A case of a 19-year-old female patient with a primary B-cell lymphoma of bone is presented. Although extensive diagnostic procedures including CT and MRI scans as well as bone histology were used, the case was initially misdiagnosed as chronic osteomyelitis. Resection of the distal femur including the knee joint was performed and bisegmental callus distraction was initiated. After local exacerbation a B-cell lymphoma was diagnosed histologically and immunohistochemically in a soft tissue specimen. Above-knee amputation had to be carried out due to severe local soft tissue necrosis and superinfection. Diagnostic problems arose from non-specific clinical symptoms, uncertain radiographic signs and non-diagnostic histology. Growth factors may have stimulated tumor growth after initiation of callus distraction.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    European journal of orthopaedic surgery & traumatology 8 (1998), S. 133-139 
    ISSN: 1432-1068
    Keywords: Total hip replacement ; Results ; Aseptic loosening ; Cemented ; Uncemented ; Titanium
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Mid- and long term stability is still the major challenge in total hip replacement (THR). A consecutive series of cemented 250 cases and of uncemented 250 cases was analyzed in a prospective follow-up study. The femoral component of the BiCONTACT hip stem system with the same design for cemented and uncemented implantation was used. While the cemented stems had a smooth surface, the cementless implants were proximally coated with a microporous titanium plasmaspray (Plasmapore®). Follow-up time averaged 7 years for cemented and 6.5 years for uncemented THRs. Follow-up rate was 88.7% in cases treated with cemented stems and 93.1% in cases treated with an uncemented stem. The rate of aseptic loosening was 1.2% for the cemented version and 0.4% for the uncemented one. Radiological loosening could be observed in another 1.2% of the cemented stems but was not found in the uncemented cases. Our data suggest excellent midterm stability of both the cemented and the uncemented version of the BiCONTACT hip stem system. Early aseptic loosening especially of the cemented titanium alloy straight stem has not occurred in our series as reported recently. The prosthesis design and follow-up time may therefore play an important role. The long-term results for both cemented and uncemented BiCONTACT prostheses of our series are still to be evaluated.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1433-044X
    Keywords: Key words Pathological fracture • Osteolysis • Unreamed intramedullary nailing • Palliative surgery • Minimal invasive procedures ; Schlüsselwörter Pathologische Fraktur • Osteolyse • Unaufgebohrte Marknagelung • Palliative Chirurgie • Minimal-invasive Verfahren
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Patienten mit fortgeschrittenem Tumorleiden sind durch stabilitätsgefährdende Osteolysen oft mehrerer langer Röhrenknochen z. T. erheblich in ihrer Mobilität und Lebensqualität beeinträchtigt. Zwischen 6/1993 und 10/1995 wurden bei prospektiv ausgewählten Patienten (n = 19) mit einem fortgeschrittenen ossär metastasierenden Tumorleiden in palliativer Indikation unaufgebohrte Marknägel an Femur (UFN) (n = 13) sowie Tibia (n = 1) und Humerus (UTN) (n = 7) implantiert; z. T. erfolgten bilaterale und simultane Stabilisierungen an oberen und unteren Extremitäten. Die postoperativen Verläufe bis zum Tode am Grundleiden zeigten eine erheblich verbesserte Lebensqualität durch die wieder mögliche Vollbelastung; ein Implantatversagen wurde nicht beobachtet. Die unaufgebohrte Marknagelung erscheint als minimal-invasives und komplikationsarmes Verfahren bei stabilitätsgefährdenden Osteolysen und pathologischen Frakturen langer Röhrenknochen.
    Notes: Summary Pathological fractures and osteolyses with impending fractures of long bones impose a severe problem in patients with advanced cancer. For palliative treatment between June 1993 and October 1995 intramedullary nailing was performed in 19 patients with 13 femoral, 7 humeral and 1 tibial lesions; AO unreamed nails were used for this purpose (unreamed femur nail UFN with or with spiral blade for femoral lesions and unreamed tibia nail UTN for humeri and tibia). Stabilization was achieved without severe complications; full weight bearing of both femora and humeri (while using crutches) was allowed. Simultaneous and bilateral nailing was done. Follow-up until death due to advanced cancer demonstrated no implant failure and improved quality of life as well. Unreamed intramedullary nailing seems to be a minimally invasive procedure with a low complication rate for palliative treatment of (impending) pathological fractures in advanced cancer.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Der Unfallchirurg 101 (1998), S. 658-660 
    ISSN: 1433-044X
    Keywords: Key words Tuberculosis • BCG • Vaccine • ; Soft tissue infection • Therapy ; Schlüsselwörter Tuberkulose • BCG • Impfstoff • Weichteilinfektion • Therapie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Komplikationen nach BCG-(Bacillus-Calmette-Guérin-)Impfung sind insgesamt selten und reichen vom lokalen Abszeß bis zu chronischen Ulzerationen. Hinsichtlich der Therapie der Komplikationen schwankt das therapeutische Vorgehen zwischen konservativer und operativer Behandlung. Im vorliegenden Fall war es durch eine akzidentelle Inokulation mit BCG-Impfstoff zu rezidivierenden Weichteilinfektionen gekommen. Der bisherige Krankheitsverlauf mit seinem therapeutischen Vorgehen wird diskutiert und ein Behandlungskonzept vorgeschlagen. Die radikale Exzision unter Schutz mit Antituberkulotika stellt aus heutiger Sicht die vielversprechenste Therapie dieses spezifischen Weichteilinfekts dar.
    Notes: Summary Complications after BCG vaccine (bacilli Calmette-Guérin) occur rarely. They can reach from a local acute abscess to chronic ulceration's. Therapeutically concepts of these complications range from conservative to operative treatment. In the following case history recurrent soft tissue infections occurred after accidental inoculation with BCG vaccine. The time course of these recurrent infections with its therapeutic options is discussed and a treatment strategy is suggested. Currently, radical excision combined with antituberculotic treatment seems to be the most promising therapy of this specific soft tissue infection.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Archives of orthopaedic and trauma surgery 117 (1998), S. 397-398 
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Consecutive distalization of the patella is described in two patients undergoing segmental transportation after high tibial corticotomy. Revision surgery with loosening and proximal reattachment of a portion of the patellar ligament bridging the callus distraction zone could re-establish the correct patellar position. Despite excellent callus formation after tibial corticotomy just below the tibial tuberositas, this procedure should be performed more distally as the fibers of the patellar tendon spread laterally and distally.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    International orthopaedics 23 (1999), S. 253-259 
    ISSN: 1432-5195
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé  La présence de facteurs de croissance a été montrée dans la consolidation osseuse mais pas encore établie dans les cals par distraction. Nous avons étudié les cytokines durant la distraction chez 3 patients. Des examens immuno-histo-chimiques ont été faits à partir de biopsie pour étudier les facteurs TGF-β, IGF-I, récepteurs TGF-β II, récepteurs IGF et l’antigène nucléaire de prolifération (PCNA). Histologiquement, nous avons trouvé de l’os immature dans la zone médiane du cal et, dans la zone de remodelage une calcification avec os lamellaire. Les ostéoblastes en général et les cellules fibroblastes-like de la zone médiane ont été positives pour le facteur TGF-β et son récepteur. Il existe une corrélation entre la quantité de cellules positives et l’activité proliferative trouvée par la PCNA et par la densité radiologique. Le facteur IGF-I a été détecté ubiquitairement. En conclusion, les facteurs de croissance sont présents dans l’os en formation et en remodelage des cals par extension. La correlation entre l’activité proliferative cellulaire et la densité radiographique, souligne leur rôle dans le processus ostéogénique.
    Notes: Abstract  Although growth factors have been demonstrated during bone healing, their presence has not yet been confirmed in callus distraction. Therefore, in 3 patients we searched for cytokines during callus distraction. Bone biopsies were immuno-histochemically stained for TGF-β1, IGF-I, TGF-β type II receptor, IGF receptor, and proliferating cell nuclear antigen (PCNA). Histologically we found immature woven bone in the middle of the callus zone and increasing calcification and lamellar bone in the re-modelling zone. Osteoblasts and fibroblast-like cells in the middle zone, and osteoblasts in all zones stained for TGF-β and its receptor. The number of positive staining cells related to proliferous activity as assessed both by PCNA, and by bone density in radiographs. IGF-I could be detected everywhere. In conclusion, growth factors are present in bone formation and in areas of re-modelling during callotasis. Their relation to proliferous activity and radiographic density supports their involvement in osteogenesis.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    International orthopaedics 21 (1997), S. 25-29 
    ISSN: 1432-5195
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé. Les fractures fémorales périprothétiques constituent en chirurgie orthopédique un problème majeur. Les traitements conventionnels, pose d’une plaque et/ou de ciment, accentuent la diminution de la masse osseuse dans le fémur proximal. Une méthode de conception différente a été employée chez 12 sujets depuis février 1992. Cette intervention de reprise sans utilisation de ciment consiste à implanter une longue tige de reprise avec un verrouillage distal pour la stabilité initiale et une allogreffe osseuse. La formation et le remodelage osseux ont permis une excellente restauration du fémur proximal. L’ablation des vis distales (dynamisation) après remodelage de l’os convertit le transfert distal de charges en ancrage proximal de la tige de reprise et favorise l’Osteointegration dans la région intertrochanterienne. De bons résultats cliniques ont été obtenus chez tous les sujets au terme d’une période de suivi de 6 à 39 mois (23,5 mois en moyenne). La reprise prothétique sans utilisation de ciment, avec greffe osseuse et dynamisation, est considérée comme une ostéosynthèse biologique convenant surtout aux sujets assez jeunes.
    Notes: Summary. Fractures around a femoral prosthesis have been treated with plating and additional cement, but this leads to further reduction of bone stock in the proximal femur. Since February 1992, we have dealt with this problem in 12 patients by revision using a long uncemented stem and distal interlocking combined with homologous bone grafting. Bony ingrowth and remodelling led to restoration of the proximal femur. After bone healing, removal of the distal interlocking screws converts the distal load transfer to the proximal anchoring of the revision stem so that osteointegration can occur in the trochanteric region. The clinical results were good in all the patients after a mean follow up of 23.5 months. This is a method which provides biological osteosynthesis and is especially indicated in younger patients.
    Type of Medium: Electronic Resource
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