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1.
Congenital pseudarthrosis of the clavicle is very rare. We report the results of two cases, one managed conservatively and
the second surgically. Neither patient had functional deficit, but the one treated surgically ended up with a scar, persisting
non-union and a short clavicle. Surgical treatment should be discouraged for this condition.
Received: 17 June 2002, Accepted: 17 July 2002 相似文献
2.
Congenital constriction band syndrome has varied clinical presentations ranging from small, incomplete skin deep constriction band to in utero amputation. Pseudarthrosis of underlying bone most commonly tibia has been reported by many authors. We report the first case of congenital pseudarthrosis of the femur with congenital constriction band syndrome. Nine-day-old female presented with the constriction band in the left thigh with open pseudarthrosis of the femur. The left femur had gross recurvatum deformity and the posterior apex of the pseudarthrosis was exposed via skin ulceration. She had an ipsilateral paralytic clubfoot. She was treated with single-stage excision of constriction band and Z-plasty. Spontaneous union of the femur was achieved at 3 months. Procurvatum deformity of the femur improved gradually over 3 years. This happens to be the first and only reported case of congenital pseudarthrosis of the femur with sciatic nerve palsy due to congenital constriction band. 相似文献
3.
《Acta orthopaedica》2013,84(4):669-674
Four cases of infected non-union of the tibial shaft treated by Küntscher intramedullary reaming and nailing are presented, and on the basis of these cases the indications and prerequisites for the method are discussed. 相似文献
4.
《Acta orthopaedica》2013,84(1-6):489-492
Congenital pseudarthrosis of the clavicle is a rare entity. Its aetiology and pathogenesis still remain obscure. the condition is predominantly right-sided. Differential diagnosis lies between birth fracture and cleido-cranial dysostosis. Surgery when indicated gives good results. 相似文献
5.
目的:探讨经皮球囊扩张椎体成形术(percutaneous balloon kyphoplasty,PKP))治疗陈旧性椎体压缩性骨折并假关节形成的临床疗效。方法回顾性分析我科2009年9月~2014年3月收治的15例患者,均确诊为陈旧性椎体压缩性骨折并假关节形成,行经皮球囊扩张椎体成形术( PKP)治疗;术前、术后行视觉模拟评分( visual analogue scales,VAS)及日常生活能力( Macnab标准)比较,测量术前、术后伤椎节段矢状面指数,明确椎体后凸矫正情况。结果15例均顺利完成手术,无一例并发症。患者疼痛症状及日常生活能力明显改善,术后VAS评分:1d(2.53±0.51)、1个月(2.06±0.70)、3个月(2.13±0.51),均比术前(7.47±0.64)有显著性差异(P<0.05)。术后伤椎节段矢状面指数(25.8±5.12)°与术前(34.4±5.10)°有显著性差异(P<0.05)。结论 PKP技术可以稳定陈旧性椎体压缩性骨折后形成的假关节,改善椎体后凸,明显减轻患者的腰痛症状,提高患者日常生活能力。 相似文献
6.
Jan Erik Madsen Mika Hukkanen Per Aspenberg Julia Polak Lars Nordsletten 《Acta orthopaedica》2013,84(1):74-79
We studied time-dependent ingrowth of sensory nerve fibers into a bone defect in a rat bone conduction chamber model. In 10 male Sprague Dawley rats, a titanium chamber was implanted bilaterally in the proximal tibiae, representing an experimental bone defect. To mimic a clinical situation, the chambers were filled with a fresh blood clot. After 1, 2, 4, 6 and 8 weeks, 2 rats were fixed in vivo at each time before removal of specimens, and histological and immunohistochemical analyses. We used antisera against protein gene product 9.5, neural growth-associated protein 43/B-50, calcitonin gene-related peptide, and substance P, to locate regenerating sensory nerve fibers in the chamber. During bone defect healing, hematoxylin/eosin sections showed that new bone grew in through the ingrowth openings in the chamber, gradually filling it and replacing the blood clot. At 1 and 2 weeks after implantation, no nerve fibers could be detected. At 4, 6 and 8 weeks, however, small numbers of nerve fibers were seen in 8 of 11 specimens. The nerve fibers were located mainly in the dense fibrous tissue in close proximity to the new bone, and in some cases within the new forming bone. In this chamber model, the periosteum is not in contact with the bone ingrowth openings, and all ingrowing nerve fibers thus originated from the cortical bone, endosteum or bone marrow. We speculated that these late ingrowing sensory nerve fibers may actively participate in bone repair. 相似文献
7.
8.
Congenital pseudarthrosis of the tibia (CPT) is one of the most challenging problems in pediatric orthopaedics. The treatment goals are osteosynthesis, stabilization of the ankle mortise by fibular stabilization, and lower limb-length equalization. Each of these goals is difficult to accomplish but regardless of the surgical options, the basic biological considerations are the same: pseudarthrosis resection, biological bone bridging of the defect by stable fixation, and the correction of any angular deformity. The Ilizarov method is certainly valuable for the treatment of CPT because it can address not only pseudarthrosis but also all complex deformities associated with this condition. Leg-length discrepancy can be managed by proximal tibial lengthening using distraction osteogenesis combined with or without contralateral epiphysiodesis. However, treatment of CPT is fraught with complications due to the complex nature of the disease, and failure is common. Residual challenges, such as refracture, growth disturbance, and poor foot and ankle function with stiffness, are frequent and perplexing. Refracture is the most common and serious complication after primary healing and might result in the re-establishment of pseudarthrosis. Therefore, an effective, safe and practical treatment method that minimizes the residual challenges after healing and accomplishes the multiple goals of treatment is needed. This review describes a multi-targeted approach for tackling these challenges, which utilizes the Ilizarov technique in atrophic-type CPT. 相似文献
9.
Satoshi Kawaguchi Keiko Horigome Hideki Yajima Takashi Oda Yuichiro Kii Mitsunori Yoshimoto Tsuneo Takebayashi Toshihiko Yamashita 《European spine journal》2010,19(6):901-906
To determine the role of percutaneous vertebroplasty (PVP) in bone formation and the union of vertebral pseudarthrosis, we
analyzed 14 patients with an average follow-up duration of 21 months. Evaluation methods included back pain (visual analog
scale: VAS), wedge angle, dynamic mobility, radiographic remodeling including callus and spur formation, and union status.
The Student's t test was used for statistical analysis and a probability of less than 0.05 was determined as a significant difference. Back
pain improved in all 14 patients with a VAS score of 57.8 ± 23.5 mm (average ± standard deviation) preoperatively and 14.7 ± 16.4 mm
at the final follow-up (P < 0.001). The wedge angle decreased from 21.6° ± 8.3° (average ± standard deviation) preoperatively to 13.2° ± 6.9° at the
final follow-up (P < 0.001). Callus formation was seen in four patients. Bony spurs were seen in the affected vertebra in preoperative radiographs
in all patients, and were further developed to a solidified form during follow up after PVP. Dynamic mobility of the affected
vertebrae was 6.9 ± 2.9 mm preoperatively, which decreased to 1.1° ± 0.7° at the final follow-up (P < 0.001). Notably, all patients showed the dynamic vertebral mobility of 2 mm or less. Nevertheless, only two patients exhibited
the dynamic vertebral mobility of 0 mm at the final follow-up, which is referred to as bone union. These findings indicate
that PVP serves as a mechanical stabilizer for vertebral pseudarthrosis, which leads to immediate pain relief and segmental
bony responses. 相似文献
10.