1/341. Vascularized fibular graft after excision of giant cell tumor of the distal radius. A case report.Although hemiarthroplasty of the wrist using vascularized proximal fibula has been described often, long term results with documentation of results are insufficient. A case of giant cell tumor of the distal radius with remarkable extraskeletal extension is reported. Vascularized fibula including its proximal head was used to replace the defect created after en bloc resection of the tumor. There was no deterioration in radiographic findings or function of the new joint at the time of the 10-year followup. Satisfactory range of motion of the wrist and the forearm was maintained. There was no instability in the joint, and grip strength measured 65% of the opposite side. Postoperative magnetic resonance imaging showed survival of the whole graft, including the subchondral portion. In addition to thorough revascularization of the graft, appropriate soft tissue reconstruction using dynamic tendon transfer contributed to the success. When these requirements are fulfilled, the graft can provide a functional and durable result. Although this is a single experience, the authors recommend wrist arthroplasty, rather than arthrodesis, in carefully selected patients.- - - - - - - - - - ranking = 1keywords = joint (Clic here for more details about this article) |
2/341. Revision hip arthroplasty in patients with a history of previous malignancy.BACKGROUND AND OBJECTIVES: The potential association between implants and malignancy has been discussed in the literature, but never as a cause of loosening of joint arthroplasty. methods: The records of all patients who underwent revision arthroplasty at our institution between 1992 and 1995 were reviewed. RESULTS: Among 93 patients who underwent revision hip arthroplasties, 11 (11.8%) had a history of previous malignancy. At surgery, in 2 of these patients, metastasis was found to be the cause of loosening in the affected hip. CONCLUSIONS: When revision hip arthroplasty is considered, patients with a history of malignancy require attenuated pre-, intra-, and postoperative workup. Management algorithm in such cases is proposed.- - - - - - - - - - ranking = 0.5keywords = joint (Clic here for more details about this article) |
3/341. chondrocalcinosis after parathyroidectomy.In this retrospective study of 57 patients with primary hyperparathyroidism who underwent parathyroidectomy, the overall incidence of chondrocalcinosis was 40%. Neither joint symptoms nor chondrocalcinosis regressed after the operation. In several patients the condition appeared to deteriorate both clinically and radiologically after the operation, while in a few both the chondrocalcinosis and the associated symptoms first appeared some time after the operation.- - - - - - - - - - ranking = 0.5keywords = joint (Clic here for more details about this article) |
4/341. Tibial and pretibial cyst formation after anterior cruciate ligament reconstruction with bioabsorbable interference screw fixation.We report a case of an osteolytic tibial enlargement in association with a pretibial cyst formation 8 months after successful anterior cruciate ligament reconstruction with autologous bone-patellar tendon-bone graft and tibial graft fixation with a bioabsorbable interference screw. No joint inflammatory reaction or graft insufficiency was detected. The patient underwent cyst excision and curettage of the tibial tunnel with full recovery and return to preinjury level of activity 2 months after the revision surgery. To our knowledge, the reported complication is the first obvious adverse reaction to a poly-D,L-lactide interference screw in anterior cruciate ligament surgery.- - - - - - - - - - ranking = 0.5keywords = joint (Clic here for more details about this article) |
5/341. classification and treatment of intercondyloid fractures of the humerus.The authors describe the satisfactory results obtained in sixteen intercondyloid fractures of the humerus, thirteen of which were treated surgically. The preference for surgical treatment in such fractures is based in the assumption that, as in all articular fractures, a good functional result can only be achieved if there is the most perfect possible reconstruction of the fragments and the joint surface. A classification is therefore suggested which is based not purely on anatomical criteria, but is also related to treatment and prognosis. The slendor nature of the distal end of the humerus and the danger of metal reaction call for the use of fixation devices that are efficient but slender, such as fine screws and crossed wires. The precise method of fixation is conditioned above all by the direction of the fracture lines. More solid fixation with early mobilisation can be achieved by compression screws, and less solid fixation with longer immobilisation is achieved by fixation with crossed Kirschner wires. Consequently, the more oblique types of fracture with fragments with long beaks that allow more stable fixation with compression screws have the more favourable prognosis. In the evaluation of results, the authors emphasize the importance of using parameters which take into account the functionally useful range of joint movement.- - - - - - - - - - ranking = 1keywords = joint (Clic here for more details about this article) |
6/341. Differential bone scanning.This is a preliminary report of eleven patients with painful total joint arthroplasties. In their evaluation the difficulty in the differential diagnosis between the loose and the infected total joint becomes apparent. We have found the use of differential bone scans an accurate method to identify the infected total joint. Further study along these lines is indicated with a larger series and generalization to other types of implants.- - - - - - - - - - ranking = 1.5keywords = joint (Clic here for more details about this article) |
7/341. Complications following metatarsal lengthening by callus distraction for brachymetatarsia.We performed six metatarsal lengthenings in four patients for brachymetatarsia of the fourth toe by callus distraction from 1991 to 1995. Healing was achieved in all cases. The average amount of lengthening was 30% (range, 15-41%) of the original length. The average healing index was 82 days/cm (range, 66-113 days/cm). After the operation, range of movement of the metatarsophalangeal joint decreased in all cases (120 degrees before and 57 degrees after surgery). In two cases in which the lengthening exceeded 40% of the original length, stiffness of the joint (20 degrees and 0 degrees each) and joint deformity occurred. These two cases also had angulation of the metatarsal. Corrective osteotomy and release surgery was performed in one case. Angulation of the metatarsal was corrected, but the range of movement of the joint did not much recover after surgery. Another case was left untreated because the patient had no complaints. In metatarsal lengthening by callus distraction, the amount of lengthening should not exceed 40% of the original length.- - - - - - - - - - ranking = 2keywords = joint (Clic here for more details about this article) |
8/341. Emergency reconstruction of a collateral ligament of a metacarpophalangeal joint using Dacron material.We present a case in which an open wound involving the ulnar collateral ligament of the metacarpophalangeal joint of the little finger was treated by ligament reconstruction using a strip of Dacron material, nerve grafting and coverage by a posterior interosseous artery pedicled flap. At a long term follow-up of 4 years, the joint was stable and had a full range of movement.- - - - - - - - - - ranking = 3keywords = joint (Clic here for more details about this article) |
9/341. Irreducible Galeazzi fracture-dislocation due to an avulsion fracture of the fovea of the ulna.We report a rare case of Galeazzi fracture-dislocation with an irreducible distal radioulnar joint. The cause of the irreducibility was entrapment of a fragment avulsed from the fovea of the ulna. The patient was successfully treated with open reduction and internal fixation of the radius, ulnar styloid process and avulsed fracture at the fovea of the ulna.- - - - - - - - - - ranking = 0.5keywords = joint (Clic here for more details about this article) |
10/341. Intraarticular methyl methacrylate: a complication of hip surgery.Methyl methacrylate, used as a grout during hip arthroplasty, can inadvertently become lodged between acetabular and femoral components during surgery. After resumption of ambulation, crescentic fragments may extrude into the pseudocapsule. If mobile methyl methacrylate fragments lodge within the joint, late surgical failure may result because of methyl methacrylate's abrasive character. Two cases of total hip replacement and one case of femoral arthroplasty are reported in which intraarticular methyl methacrylate was identified retrospectively; all three patients remain asymptomatic at the time of the report.- - - - - - - - - - ranking = 0.5keywords = joint (Clic here for more details about this article) |
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