Biomedical subjects
Publications and source records attributed to G Fabry.
A male patient with gout, complaining of wrist pain, in the absence of trauma, was found to have an avascular necrosis of the capitate bone. A scapho-luno-capitate arthrodesis was performed.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
The flexion of the metacarpophalangeal and interphalangeal joints of both thumbs of 101 normal controls and of 10 patients with ligamentous injuries was measured. There is a close correlation between dominant and nondominant thumbs. With advancing age mobility of both joints decreases significantly. Stiffer joints are more vulnerable to ligamentous injuries.
Excessive or repetitive loading of an immature joint can lead to premature closure of the growth plate. In gymnastics this event is known as the gymnast wrist, or the Madelung-like deformity. Six new cases are presented. All had an ulnar-plus variance and an increased sagittal angle of the distal radial epiphysis. Five of them preferred to stop their sports career one was successfully treated with an arthroscopic debridement of the TFCC.
A case of both an os trigonum and a soleus tertius anomaly is presented in a patient with chronic posteromedial ankle pain. A resection of the os trigonum was performed, with complete relief of symptoms. The diagnosis and therapy are discussed, and the literature is reviewed.
One of the basic principles of orthopedic surgery is that gas gangrene does not develop in closed fractures. That there are exceptions to this rule is demonstrated by the following report of an extremely rare case. Clostridium septicum myonecrosis developed after surgical treatment of a closed femoral fracture in a fit 45-year-old man, treated by antibiotics. The patient survived after having a right hip disarticulation and administration of high doses of intravenous penicillin. Prophylactically administered cephalosporins failed to prevent the Clostridial infection.
Fifty-eight patients with acute acromioclavicular dislocations of Type III, IV and V (Rockwood classification) were examined to assess the late results of conservative treatment. The average age of the patients was 31 years, and the interval between injury and final review was 6.3 years. Seventy-nine percent of the patients had excellent or good late results. Surprisingly the age and activity level of the patients did not influence our late results, nor did the radiological appearance of acromioclavicular osteoarthritis or periarticular calcification. The radiological appearance of the acromioclavicular joint improved in 41% of patients. In 10 failed cases, excision of the distal end of the clavicle with reconstruction of the coracoclavicular ligament (Weaver and Dunn procedure) resulted in 90% excellent or good results after a 3-year follow-up. A high percentage of excellent results can be expected after this procedure, as long as it is correctly performed.
The orientation of the sigmoid notch of the distal radius is related to the ulnar length. In the ulna plus there is a spherical notch, in the ulna minus it is conical and in neutral it is usually cylindrical, sometimes conical.
Twenty-one supracondylar femoral and 11 tibial derotation osteotomies were performed in 17 patients to correct rotational deformities. Three different methods were used to fix the fragments after derotation: pins incorporated in plaster, plate and screws, and the Ilizarov external fixator. A retrospective review showed no difference in accuracy of derotation between the three methods. However, we recommend the use of the external fixator because it gives less malunion and permits early mobilization and (partial) weight bearing.
Injuries to the extensor mechanism of the knee require a profound rehabilitation. The authors present a case in which postsurgical weakening was complicated by quadriceps tendon rupture.
This is a report of an additional case of transverse fracture of the lunate with marked displacement, requiring open reduction and osteosynthesis. The lunate became necrotic with all features of Kienböck's disease.
In this report we describe the association of progressive anterior vertebral body fusion, generalized over-growth especially with large hands and feet and unusual thick skin and subcutaneous tissue of upper and lower limbs, and peculiar craniofacial appearance.
Acrometastases are rarely diagnosed. We present a new case. A literature review provides the opportunity to summarise the frequency, the clinical forms, the diagnoses, and proposed treatments. A biopsy of each chronic lesion in the hand, even without anamnesis seems to be indicated.
In this report we illustrate the variable expression and the different modes of inheritance in Larsen syndrome. The important contribution of the metacarpophalangeal profile pattern analysis in the final diagnosis is emphasized.
Six cases of nontraumatic avascular necrosis of the scaphoid are reported. Two cases were due to chronic steroid intake with several other sites of bone necrosis; for the other 4 cases no etiology could be established. Four were treated with a proximal row carpectomy, 3 with a very satisfying result, whereas one had to be converted into a wrist arthrodesis.
A closed fracture-dislocation of the tarsal navicular is presented. Open reduction and internal fixation are mandatory in order to restore the keystone function of the navicular to the longitudinal arch of the foot.