Medical and/or distal migration of the prosthetic stem was found in 63 out of 337 patients (19 per cent) treated surgically with a Christiansen hemiprosthesis, a Christiansen total hip prosthesis or a Charnley total hip prosthesis. Fractured bone cement, radiolucent zones at the cement/bone interface, resorption of the femoral calcar and cortical sclerosis were all associated with migration. Varus position of the Christiansen total hip prosthesis was significantly associated with medical migration, and a short stem was significantly associated with distal migration. The other structural variables could not be linked with migration. Distal migration was pain-inducing and was significantly associated with late infection. Medical migration had a less distinct association with pain, and was not correlated with infection. Both medical and distal migration were time-dependent, and 4 or more years after operation about 2.5 per cent of the prosthetic stems had migrated.

Bone Cements↗

PubMed1982

Effect of instability of experimental fracture healing.

Bilateral tibial osteotomy with fracturing of the fibula was performed on ten Wistar rats weighing 300--350 g. Intramedullary nailing was performed with 1.4 mm nails after reaming. On the left side solid stainless rods were used, while on the right side the nails had a middle part made of titanium-nickel wire covered with polyvinylchloride (PVC), giving the nail a high degree of flexibility. After 8 weeks, nine of the ten flexible nails showed fracture of the central wire. The continuity was, however, maintained by the PVC tube. The bones with flexible nailing always showed hypertrophic callus while there was only scanty callus on the side with rigid nailing. Strength, deformation at fracture and stiffness were measured in a three-point bending test after removal of the solid nails and the fibulae. The strength of the tibiae was greatest on the side with flexible nailing, as was the deformation at fracture. The mean stiffness was higher in the bones with rigid nails, but the difference here was not statistically discernible.

Animals↗

PubMed1980

Acetabular protrusion following endoprosthetic hip surgery: a multifactorial study.

Acetabular protrusion was found in 56 out of 211 patients fitted with a hemiprosthesis. The indication for operation was acute femoral neck fracture or failure following a previous internal fixation. A number of radiological variables were analysed with respect to their possible association with preoperative, operative and follow-up variables. After a preliminary screening of variables a deeper analysis was performed by fitting log-linear models to the data. Our analysis showed that the development of protrusion has a significant association with follow-up time. A previous hip operation was also significantly associated with the development of protrusion. This may be an indication for total hip replacement in some patients who now receive a hemiprosthesis as a secondary operation. Acetabular protrusion was significantly associated with the development of postoperative pain, while the other clinical symptoms and signs lacked any direct association with protrusion. Although acetabular protrusion and loosening of the prosthetic stem showed a significant association the analysis indicated that pain was primarily due to protrusion.

Acetabulum↗

PubMed1979

[Growth correction of misalignment following femoral shaft fractures in children].

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Child↗

PubMed1979

[Traumatic dislocation of the patella].

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Adolescent↗

PubMed1978

Myelography in Guillain-Barré syndrome (acute inflammatory polyradiculoneuropathy).

The Guillain-Barré syndrome has been studied by lumbar myelography with watersoluble contrast media in seven cases. Abnormalities, which consisted of widening of the nerve roots and obliteration of the root sleeves, were found in three of them. It is possible that myelography accentuated the symptoms in one case while the rest tolerated the examination well.

Adult↗