P. Opdecam

Comparative radiologic study of the influence of ankle joint bandages on ankle stability

A comparative radiologic study was carried out to test the stabilizing value of ankle strapping and taping on unstable tibiotalar joints. Unstable ankle joints of 51 athletes were examined without bandages, with strap ping, and with taping before and after an activity pro gram. The use of taping proved to give the greatest decrease of the talar tilt (TT) angle. This improvement was greater, even after activity, than the stabilization obtained by strapping before any activity.

Traumatic haemarthrosis of the knee

We have investigated a prospective series of 100 acute traumatic haemarthroses of the knee in a general non-athletic population. All the patients had normal radiographs and an aspiration which confirmed the haemarthrosis, before undergoing ligament testing and an arthroscopic examination under anaesthesia. Only one patient had no serious pathology; in the other 99 a total of 193 lesions were recorded. Thirty knees had only one isolated lesion, 69 had combined lesions. This study confirms the serious nature of an acute traumatic haemarthrosis of the knee, even in non-athletic patients.

Split coronal fractures of the lumbar spine: Treatment by posterior internal fixation and transpedicular bone grafting

Abstract The clinical and radiological results of 12 patients with a split coronal vertebral fracture were analysed with minimum follow-up of 24 months. All patients were treated operatively with an AO internal spinal fixator and transpedicular bone grafting. The operation was supplemented with posterior bone grafts in 4 patients. All fractures healed without marked deformity. There were no vertebral body pseudarthroses. There were no neurological or vascular injuries due to the placement of pedicle screws or to transpedicular bone grafting. 10 patients, had excellent or good results.Résumé Les résultats cliniques et radiologiques de douze patients victimes d’une fracture du corps vertébral à trait frontal ont été analysé. Tous les patients avaient été opérés suivant la même technique: fixation interne de l’AO associéà une greffe osseuse transpédiculaire. Quatre de ces patients ont bénéficié en outre d’une greffe osseus postérieure. Toutes les fractures ont consolidées sans déformation marquante. Il n’y a pas de pseudarthrose du corps vertébral. Il n’y a pas eu de troubles neurologiques ou vasculaires dûs aux vis pédiculaires ou à la greffe transpédiculaire. Sur un suivi de minimum 24 mois, dix des douze patients ont un résultat classé excellent ou bon.

Treatment of isolated distal ulnar shaft fractures with below-elbow plaster cast

In a prospective study 52 patients with an isolated fracture of the distal ulna were treated with a below-elbow plaster cast. The histories of 46 patients were reviewed after a mean follow-up of 3.5 years (ranging from 10 months to 7 years). Forty-three fractures united. There were two non-unions. One fracture displaced while in the plaster, so that there was no longer any bone contact between the fragments. The fracture was consequently treated by open reduction and internal fixation. The type of fracture, the initial displacement (all fractures had bone contact) or the initial angulation (maximum 10 deg) was not found to influence the final clinical results. Below-elbow plaster cast appeared to produce satisfactory results in 89% of the patients.

Non-traumatic dislocation of tibialis posterior tendon in a child

SummaryA case of spontaneous dislocation of the tibialis posterior tendon in a 12-year-old boy is presented. Closed reduction under general anaesthesia was performed, and after immobilisation for 6 weeks in a plaster cast no recurrence was observed. This case illustrates an unusual case of habitual dislocation of the tibialis posterior tendon treated by conservative means.

The use of computerised tomographs in the diagnosis of thoracolumbar injury

This paper presents four patients with injuries to the thoracolumbar spine assessed by computerised tomography. This technique enabled an easy, quick and accurate diagnosis to be made, avoiding dangerous manipulation of the patient. The scans were analysed using the anatomical classification of Louis to evaluate the instability of the lesions. Control CT scans were used to monitor progress and to provide an accurate prognosis within acceptable limits of irradiation.

Our Experience with Frozen Allografts: First Short-Term Results

Since revision arthroplasty of hip and knee came to be performed, and cases frequently present a lack of good bone stock, the necessity of having a bone bank became obvious.

An unexpected cause of pathologic hip fracture: malignant fibrous histiocytoma

SummaryWe describe a case of a 68-year-old patient presenting with pathological hip fracture and multiple pulmonary metastases, who has been operated without a prior histological diagnosis. The hip lesion was thought to be a metastasis of an unknown primary tumor. The proximal part of the femur was resected and replaced by a Müller megaprosthesis. Histological analysis of the resected bone revealed a malignant fibrous histiocytoma, a rare but very aggressive bone tumor. The patient died three weeks after operation of widespread metastases. By presenting this case report, we want to stress the importance of pretreatment histological diagnosis of osteolytic bone lesions in older patients with metastases.ZusammenfassungFallbericht eines 68jährigen Patienten mit einer pathologischen Hüftfraktur und multiplen Lungenmetastasen, der ohne eine histologisch gesicherte Diagnose mit einer Müller-Prothese versorgt worden ist. Die Fraktur wurde als Metastase eines unbekannten primären Tumors aufgefaßt. Die Histologie des Resektates zeigte ein malignes fibröses Histiozytom — einen seltenen, aber sehr aggressiven Tumor. Der Patient ist postoperativ an den Komplikationen der Metastasierung verstorben. Bei der Präsentation dieses Falles verweisen wir auf die Bedeutung der präoperativen Histologie bei osteolytischen Prozessen und Metastasen hin.