Magnetic Resonance Imaging of the Axial Skeleton in Patients With Spondyloarthritis: Distribution Pattern of Inflammatory and Structural Lesions.

Purpose: Spondyloarthritis is a chronic inflammatory disorder of the musculoskeletal system driven by systemic enthesitis and typically involving the axial skeleton, ie, the spine and the sacroiliac joints. The purpose of this study was to assess the distribution pattern of inflammatory and structural magnetic resonance imaging (MRI) findings in spondyloarthritis.

Methods: Retrospective study of 193 patients with axial spondyloarthritis who received MRI of the spine and the sacroiliac joints.

Pathophysiological advantages of rinsing-suction-reaming (RSR) in a pig model for intramedullary nailing.

Although reamed intramedullary nailing has been one of the greatest advances in modern fracture care, the concomitant increase in medullary cavity pressure leads to intravasation of bone marrow content into the blood stream, an effect that can evoke serious systemic reactions. A newly developed rinsing-suction-reamer (RSR) was able to substantially reduce the pressure and bone marrow intravasation content during experimental femoral nailing. We investigated the pathophysiological effects using the RSR, testing the hypothesis that by reducing marrow fat embolization, RSR would also reduce the activation of coagulation compared with the universal AO-Reamer (AOR) and comparable to external fixation.

Effectiveness of hydroxyapatite-vancomycin bone cement in the treatment of Staphylococcus aureus induced chronic osteomyelitis.

In the field of local application of antimicrobials, a number of novel drugs and/or new drug delivery systems have been developed in recent years. The present study aimed to investigate hydroxyapatite cement (HAC) as a carrier for vancomycin in the treatment of chronic osteomyelitis due to Staphylococcus aureus strains with various mechanisms of resistance. The release of vancomycin from standard test cylinders was determined in vitro and the efficacy of the delivery system was measured in vivo using a rabbit model of chronic osteomyelitis.

Suspected central anticholinergic syndrome in a 6-week-old infant.

A 6-wk-old male infant became unresponsive after an uneventful general anesthetic for hernia repair. His symptoms were consistent with central anticholinergic syndrome. He appeared to awaken after treatment with IV physostigmine in a dose of 0.

Rinsing-suction reamer attenuates intramedullary pressure increase and fat intravasation in a sheep model.

Background: Reamed intramedullary nailing causes an increase of intramedullary pressure. A new rinsing-suction reamer (RSR) can reduce this problem, and it was evaluated in animal experiments in comparison with the AO reamer (AOR) to see its effects on intramedullary pressure and fat intravasation.

Methods: Reamed intramedullary nailing was performed in 14 sheep using the RSR or AOR.

Evaluation of an in situ setting injectable calcium phosphate as a new carrier material for gentamicin in the treatment of chronic osteomyelitis: studies in vitro and in vivo.

A study was performed to investigate the effectiveness of hydroxyapatite cement (HAC) as a new carrier system in the treatment of chronic, posttraumatic osteomyelitis. In the in vitro study, release of gentamicin from standard cylinders of HAC were measured by agar diffusion test. As a representative for mechanical properties, compression strength was measured in order to detect changes when mixing HAC with gentamicin.

[A new irrigation-suction boring system facilities low-pressure intramedullary boring of isolated swine femurs].

Aim: Intramedullary nailing is the treatment of choice for the stabilization of fractures of long tubular bones. An important disadvantage of this method is the increase in intramedullary pressure and the resulting release of fat into the venous blood system during reaming of the medullary canal. We have developed a new type of rinsing-suction-reamer (SSB) in order to minimize these disadvantages.

[Postoperative radial paralysis. Fate or negligence, conservative wait or revision?].

Radial nerve palsy is a rather frequent complication caused by an accident as well as by surgery of the humerus. As a primary, i.e.

A new clamping technique for biomechanical testing of tendons in small animals. aprobst@uni-muenster.de.

When biomechanical properties of tendons are studied, the technique of clamping the tendons in the testing machine presents a methodological challenge, especially when murine tendons are examined. These short tendons tend to rupture at the transition line to the fixation, leading to false interpretations. Therefore a new clamping technique for investigation of healthy murine Achilles tendons (n = 50) was developed, in which the intramuscular tendon fibers were fixed between two paper strips and the calcaneus was wedged into a conical slot in a wooden block and then mounted in the testing machine (n = 20).

[Late sequelae and treatment strategies of distal radio-ulnar dissociation after undetected Essex-Lopresti lesion].

The Essex-Lopresti lesion, a combination of radial head fracture and distal radioulnar dislocation, rarely occurs but nevertheless represents a frequently unknown result after forearm fracture. The responsible physician soon has to initiate surgical treatment to prevent his patient from permanent pain of the wrist. Previously unrecognised distal radioulnar dislocation remains to be an unsolved problem.

[Callus distraction of the first metacarpal bone for thumb reconstruction after traumatic amputation].

From 1990 to 1997, callus distraction of the first metacarpal bone was performed on 34 patients with a traumatic amputation of the thumb, if replantation was not possible. After a period of 7 +/- 11 months (range, 1-48), a corticotomy and continuous distraction with an external fixator was carried out. Of the patients, 31 (91%) were reviewed after treatment.

The use of an in situ curing hydroxyapatite cement as an alternative to bone graft following removal of enchondroma of the hand.

Following curettage of enchondromata of the phalanges we filled the resultant bone cavity with hydroxyapatite cement in eight patients to avoid cancellous bone grafting. This material differs significantly from the ceramic hydroxyapatite commonly used in clinical practice. It is produced by the combination of two calcium phosphates which, in the presence of water, form a paste that cures to a solid implant with a microporous structure.

CT of metal implants: reduction of artifacts using an extended CT scale technique.

Purpose: The purpose of this work was to use an extended CT scale technique (ECTS) to reduce artifacts due to metal implants and to optimize CT imaging parameters for metal implants using an experimental model.

Method: Osteotomies were performed in 20 porcine femur specimens. One hundred cobalt-base screws and 24 steel plates were used for osteosynthesis in these specimens.

[Significance of score systems in open complex trauma of the pelvis].

A quantitative analysis of the injury severity of 40 patients with open pelvic fractures was performed. Data were analyzed using the Statistical-Analysis-System (SAS Institute Inc., Cary, NC) with regard to patients' age, gender, trauma mechanism, classification and nature of the pelvic injury, associated lesions, and mortality.

[The treatment of unstable fractures of the distal radius using a bridging external fixator. Results from a long-term evaluation].

Introduction: The aim of our study was to evaluate external fixation in the treatment of unstable distal radius fractures in a long-term follow-up.

Methods: Within 8 years 174 patients with severely displaced distal radius fractures were included in a prospective study and treated with an external wrist fixator (Orthofix Srl, Italy). A total of 148 patients were reviewed with an average follow-up time of 28 months.

[Gangrene of the fingers caused by accidental intra-arterial injection of diazepam].

History: A 51-year-old woman was accidentally given an intra-arterial injection of 10 mg diazepam to control an acute claustrophobic anxiety attack. She complained of severe knocking pain in the entire left arm during the injection. On the second day the hand and lower arm were red an swollen and she complained of increasingly feeling cold and having paraesthesias.

Anterior interosseous nerve compression after supracondylar fracture of the humerus: a metaanalysis.

Object: The authors conducted a metaanalysis of reports of anterior interosseous nerve syndrome, a rare nerve compression neuropathy that affects only the motor branch of the median nerve. This syndrome is characterized by paralysis of the flexor pollicis longus, the flexor digitorum profundus to the index finger, and the pronator quadratus, with weakness on flexion of the interphalangeal joint of the thumb and the distal interphalangeal joint of the index finger without sensory loss.

Methods: The authors reviewed reports of 34 cases of anterior interosseous nerve syndrome combined with supracondylar fractures of the humerus in children.

[Patient motivation--an essential therapeutic tool].

A deciding factor for the future functioning of a hand with a mutilating hand injury is the self-motivation that the patient brings with him to rehabilitation. This is illustrated in the case of a guitar teacher who returned to his career after subtotal and total finger amputation of his left hand (used for gripping chords). With consistent exercise on his instrument he compensated for the functional deficits of his hand and won a law suit against his employer who denied that he had the physical ability to play the classical guitar.

[Osseous avulsion of the ischio-crural muscle group with concomitant sciatica].

Avulsion fractures of the ischial tuberosity are rare. They are often caused by a typical "splits"-like accident. In general the patients feel sudden severe pain in the buttock with localized tenderness in the region of the ischial tuberosity, rarely in combination with sciatic nerve irritation.

[Differential anterior interosseous nerve syndrome diagnosis].

The differential diagnosis of the rupture of flexor pollicis longus tendon and profundus tendon to index finger to the interosseus anterior nerve syndrome can be difficult and can lead to misinterpretation of the clinical impression. Two cases are reported to demonstrate this problem. In the first case a spontaneous rupture of flexor pollicis longus was found, when first an interosseus anterior nerve syndrome was suspected.

[Post-traumatic anterior interosseous nerve syndrome after supracondylar humerus fracture in a child].

The interosseus anterior syndrome is a rare nerve compression syndrome that concerns only the motor branch of the median nerve. It is evidenced by paralysis of the M. flexor pollicis longus and M.