| 1. |
- Carlsson, Åke
(författare)
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Einfach- und doppeltbeschichtete STAR-Sprunggelenkprothesen
- 2006
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Ingår i: Orthopade. - : Springer Science and Business Media LLC. - 1433-0431. ; 35:Apr 21, s. 527-532
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Tidskriftsartikel (refereegranskat)abstract
- An up to 12-year follow-up of 51 single-coated STAR revealed that 15 ankles had undergone fusion. The mean time from primary surgery to the first revision was median 51 months. In a series of 58 double-coated STAR ankles followed up to 5 years only one ankle had to be revised for component loosening. In this series the clinical survival rate was 98% and the radiographic survival rate 94% at 5 years. The radiographic survival rate, with component loosening as endpoint, was significantly better for the last 31 cases in the series of the single-coated prostheses. However, the loosening rate did not differ when these latter 31 cases were compared with the cases operated on with a double-coated prosthesis. One may conclude that improvement of the anchoring surfaces has had a limited influence on the radiographic survival of the STAR ankle. However, from the clinical survivorship figures it is obvious that the learning process continues as the difference in revision rate between the 31 last implanted single-coated and the later on implanted double-coated prostheses approached significance.
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| 2. |
- Heyde, C E, et al.
(författare)
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[Treatment options for problematic thoracic and lumbar osteoporotic fractures]. : Behandlungsmöglichkeiten bei thorakalen und lumbalen osteoporotischen Problemfrakturen.
- 2008
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Ingår i: Der Orthopade. - : Springer Science and Business Media LLC. - 0085-4530 .- 1433-0431. ; 37:4, s. 307-20
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Forskningsöversikt (refereegranskat)abstract
- Most osteoporotic sintering fractures are treated conservatively. However, persistent pain and consecutive spinal deformity may require certain cement-augmenting interventions. These procedures have proven their intermediate-term efficacy in pain reduction, prevention of progressive sintering and improvement of the overall quality of life in the majority of patients. In fractures with relevant spinal stenosis, persisting instability, gross deformity and trauma-associated osteoporotic fractures with or without neurological deficits, the therapeutic options may call for more extensive surgical procedures. In this regard, poor bone quality, age and respective comorbidities of the individual patient must be considered during preoperative planning and management. This article provides an overview of the diverse problem-solving strategies discussed in today's literature. It is generally acknowledged that any decision to perform surgery on an osteoporotic fracture is strongly case-dependent. Treating physicians must therefore master the complete therapeutic spectrum in order to meet this complex orthopedic challenge appropriately.
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| 3. |
- Heyde, C. E., et al.
(författare)
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Treatment options for problematic thoracic and lumbar osteoporotic fractures
- 2008
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Ingår i: Der Orthopade. - : Springer Science and Business Media LLC. - 0085-4530 .- 1433-0431. ; 37:4, s. 307-320
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Tidskriftsartikel (refereegranskat)abstract
- Most osteoporotic sintering fractures are treated conservatively. However, persistent pain and consecutive spinal deformity may require certain cement-augmenting interventions. These procedures have proven their intermediate-term efficacy in pain reduction, prevention of progressive sintering and improvement of the overall quality of life in the majority of patients. In fractures with relevant spinal stenosis, persisting instability, gross deformity and trauma-associated osteoporotic fractures with or without neurological deficits, the therapeutic options may call for more extensive surgical procedures. In this regard, poor bone quality, age and respective comorbidities of the individual patient must be considered during preoperative planning and management. This article provides an overview of the diverse problem-solving strategies discussed in today's literature. It is generally acknowledged that any decision to perform surgery on an osteoporotic fracture is strongly case-dependent. Treating physicians must therefore master the complete therapeutic spectrum in order to meet this complex orthopedic challenge appropriately.
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| 4. |
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| 5. |
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| 6. |
- Svensson, M Y, et al.
(författare)
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[Nerve cell damages in whiplash injuries. Animal experimental studies] : Nervenzellschäden bei Schleudertraumen. Tierexperimentelle Untersuchungen.
- 1998
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Ingår i: Der Orthopäde. - 0085-4530. ; 27:12, s. 820-6
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Tidskriftsartikel (refereegranskat)abstract
- Mechanical loading of the cervical spine during car accidents often lead to a number of neck injury symptoms with the common term Whiplash Associated Disorders (WAD). Several of these symptoms could possibly be explained by injuries to the cervical spinal nerve root region. It was hypothesised that the changes in the inner volume of the cervical spinal canal during neck extension-flexion motion would cause transient pressure changes in the CNS as a result of hydro-dynamic effects, and thereby mechanically load the nerve roots and cause tissue damage. To test the hypothesis, anaesthetised pigs were exposed to experimental neck trauma in the extension, flexion and lateral flexion modes. The severity of the trauma was kept below the level where cervical fractures occur. Transient pressure pulses in the cervical spinal canal were duly recorded. Signs of cell membrane dysfunction were found in the nerve cell bodies of the cervical spinal ganglia. Ganglion injuries may explain some of the symptoms associated with soft-tissue neck injuries in car accidents. When the pig's head was pulled rearward relative to its torso to resemble a rear-end collision situation, it was found that ganglion injuries occurred very early on in the neck motion, at the stage where the motion changes from retraction to extension motion. Ganglion injuries did not occur when pigs were exposed to similar static loading of the neck. This indicates that these injuries are a result of dynamic phenomena and thereby further supports the pressure hypothesis. A Neck Injury Criterion (NIC) based on a theoretical model of the pressure effects was developed. It indicated that it was the differential horizontal acceleration and velocity between the head and the upper torso at the point of maximum neck retraction that determined the risk of ganglion injuries.
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| 7. |
- Weber, U, et al.
(författare)
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[Rare pathological alterations of the upper cervical spine requiring surgical treatment]. : Seltene krankhafte Veränderungen der oberen Halswirbelsäule mit operativer Behandlungsindikation.
- 2006
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Ingår i: Der Orthopade. - : Springer Science and Business Media LLC. - 0085-4530 .- 1433-0431. ; 35:3, s. 296-305
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Tidskriftsartikel (refereegranskat)abstract
- Because of its unique anatomy, specific diseases and lesions arise in the upper cervical spine, which differ widely from the rest of the spine. During the last two decades standardised diagnostic and therapeutic algorithms have been defined for most of the craniocervical pathologies often occurring in combination with an underlying disease requiring surgical intervention as well. On the other hand there are some very rare phathological alterations: about 20% of the patients suffering from neurofibromatosis type I develop spinal deformities. These are mostly found in the thoracic and lumbar spine (dystrophic/non-dystrophic type). In rare cases the dystrophic neurofibromatosis type I involves the upper cervical spine leading to bizarre deformities endangering the spinal cord. An aggressive, timely and combined operative therapy is necessary. Patients with Down syndrome should be investigated regularly for affections of the upper cervical spine. Though only in about 1% of all patients with Down syndrome do instabilities require surgical intervention, the upper cervical spine should be screened on a regular basis, since neurological changes due to the pathognomy of the underlying disease often remain undetected for a long time. The operative therapy of the instable os odontoideum in Down syndrome follows the general principles of this pathoanatomical variation. Even though the Klippel-Feil syndrome is generally not linked with neuropathological findings, rare associated deformities of the upper cervical spine should be excluded by proper diagnostic procedures.
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| 8. |
- Weber, Ulrich, et al.
(författare)
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Seltene krankhafte Veränderungen der oberen Halswirbelsäule mit operativer Behandlungsindikation
- 2006
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Ingår i: Der Orthopade. - : Springer Science and Business Media LLC. - 0085-4530 .- 1433-0431. ; 35:3, s. 296-305
-
Tidskriftsartikel (refereegranskat)abstract
- Because of its unique anatomy, specific diseases and lesions arise in the upper cervical spine, which differ widely from the rest of the spine. During the last two decades standardised diagnostic and therapeutic algorithms have been defined for most of the craniocervical pathologies often occurring in combination with an underlying disease requiring surgical intervention as well. On the other hand there are some very rare phathological alterations: about 20% of the patients suffering from neurofibromatosis type I develop spinal deformities. These are mostly found in the thoracic and lumbar spine (dystrophic/non-dystrophic type). In rare cases the dystrophic neurofibromatosis type I involves the upper cervical spine leading to bizarre deformities endangering the spinal cord. An aggressive, timely and combined operative therapy is necessary. Patients with Down syndrome should be investigated regularly for affections of the upper cervical spine. Though only in about 1% of all patients with Down syndrome do instabilities require surgical intervention, the upper cervical spine should be screened on a regular basis, since neurological changes due to the pathognomy of the underlying disease often remain undetected for a long time. The operative therapy of the instable os odontoideum in Down syndrome follows the general principles of this pathoanatomical variation. Even though the Klippel-Feil syndrome is generally not linked with neuropathological findings, rare associated deformities of the upper cervical spine should be excluded by proper diagnostic procedures.
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