["One-stage" lengthening osteotomy of femur by the interlocking nailing technic].
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Biomedical subjects
Publications and source records attributed to A Grosse.
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The authors expose a new method for extemporaneous femoral lengthening osteotomy with intra-medullary locking nailing. The procedure is described with a stair-step osteotomy. The first results are presented and the main stages of the operation are discussed especially those preventing any loss in the surgical lengthening.
The variations of fibrinogen, alpha-antitrypsin, haptoglobin and C-reactive protein (CRP) were compared in sera from patients with a cranial trauma. All these protein concentrations were increased with CRP variation being the most marked and the most rapid. The prognostic and diagnostic value of CRP determination was studied in a series of 88 patients selected according to their clinical evolution. Four typical serum patterns of CRP were obtained according to the evolution of cranial trauma. The validity of this classification was tested in blind on 324 patients. The authors propose to determine daily serum CRP for four days after a trauma in order to survey its evolution. This biochemical information has to be added to the clinical data.
The authors describe a technique of Kuntscher intramedullary nailing combined with screws driven through the bone and the nail above and below the fracture site. This technique gives better stability of the fracture and allows extension of intramedullary nailing to severely comminuted fractures, fractures with loss of bone and to proximal or distal fractures. Risks of rotational instability or shortening are diminished. The technique is fully described. With the use of correct ancillary instruments, x-ray exposure is minimal. Biomechanical experiments conducted to determine the best position of the screws for optimal locking of the nail are described. The results obtained in one hundred and sixteen cases are analysed. The technique was also used in the treatment of non-union and in the fixation of osteotomies.
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AIMS: Osteoprotegerin and the receptor activator of the nuclear factor-kappaB ligand (RANKL) are decisive factors for maintaining the balance between bone formation and bone resorption. As new, sensitive ELISAs have been developed recently, reference serum ranges should be established to use these analytes for possible diagnostic purposes. METHODS: Measurements were performed in serum samples of 142 healthy adults (82 women, 60 men) between 20 and 70 years of age (mean age: 46 years) using ELISA kits from Immundiagnostik, Bensheim, Germany. RESULTS: Serum concentrations of osteoprotegerin were age and gender independent and showed a Gaussian distribution, while RANKL concentrations were also age independent but differed between males and females, with a non-Gaussian distribution. For osteoprotegerin a gender-independent upper 97.5 percentile limit of 3.6 pmol/L was calculated while the corresponding limits for RANKL and the ratio of RANKL to osteoprotegerin amounted to 3.29 pmol/L and 2.78 in women and 1.66 pmol/L and 2.18 in men, respectively. CONCLUSIONS: Both osteoprotegerin and RANKL were quantifiable in serum of healthy adults, which means that these compounds can be used as potential diagnostic tools.
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