In a prospective study radiographs and magnetic resonance images of 75 patients with calcifying tendinitis of the rotator cuff were analyzed. The aim was to evaluate any relation between calcifying tendinitis and subacromial impingement. A total of 83% of the calcifications were located in the supraspinatus or the adjoining part of the subscapularis tendon. On T1-weighted images they could be demonstrated with high accuracy as areas of decreased signal intensity. A magnetic resonance imaging categorization of the calcium deposits was carried out by means of a differentiation of form, outline, and density. A partial rotator cuff tear was found in one shoulder; in 11% variable aspects of degenerative alteration of the affected tendon were seen. By analysis of the radiographic outlet view 16% of the cases had a type III acromion. In conclusion, little correlation exists between calcifying tendinitis and additional findings associated with subacromial impingement.

Acromion↗

PubMedDate not supplied

[Wedge osteotomy of the tibial head using fractionated drilling. A complication-reducing surgical modification].

Two techniques of closed wedge osteotomy of the proximal tibia in 132 cases using external fixation device were compared retrospectively for neurological complication rate. While in group 1 (n = 89) wedge osteotomy was performed conventionally using an oscillating saw, in group 2 (n = 43) osteotomy was done with consecutive drill holes of increasing diameter followed by osteoclasis. Neurological complications in group 1 were found postoperatively 15.7% (transient) and after 7 months follow-up time in 12.4% (persistent), in group 2 14% transient and 4.7% persistent neurological deficits were registered. The lower complication rate in group 2 is due to the reduction of postoperative tibialis anterior syndrome (type B lesions). No differences for type C lesions (extension deficit of D1) were found. No complete peroneal palsy (type A) occurred in either group. The authors conclude that reduction of neurological complications in group 2 is related to the less extensive approach of the proposed technique.

Adult↗

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[Survey of materials in hip endoprosthesis].

While bone cement debris has been recognised as an important factor in aseptic loosening of prosthetic components, the interest is now focused on the impact of debris and wear-off particles from polyethylene and metal alloys. As an optimal lubrication cannot be generated yet, direct contact between the components produces wear particles, depending on the materials used. The materials reported on include alloys based on iron, cobalt, titanium and polyethylene, bone cement and ceramics. These all show the problem of debris, friction, corrosion (except ceramics) and load failure, related to the work up process. The practitioner is given an overview and tables are presented to compare the used material.

Alloys↗

PubMedDate not supplied

[Juvenile epiphyseolysis of the femoral head--coxa vara development and treatment].

Children's coxa vara is based on epiphyseolysis of the proximal femoral epiphysis due to relative overload of a primarily healthy metaphysis, or to a "normal" load on diseased structures. These give passively way in the direction of varus and retroversion of the head in the presence of fatigue fractures. Etiologically the idiopathic C. vara infantum can be differentiated from the symptomatic forms with known causes. Broadening of the epiphyseal line, spur formation and cystic bone resorption of the medial-caudad portions of the metaphysis are early x-ray signs. When the process involves the whole metaphysis, with C. vara, one ought to strive for a good straightening of the femoral neck and head by operation, if a specific treatment, based on etiology, does not provide for a spontaneous correction of C. vara.

Child↗

PubMedDate not supplied

[Proton spin tomography imaging of the rotator cuff in calcific tendinitis of the shoulder].

An analysis of the MR-images of 75 patients with calcifying tendinitis of the shoulder was performed. The aim of the study was to recognize characteristic findings of the calcific deposits and their relation to the involved tendons as well as the coincidence with additional degenerative alterations of the rotator cuff. The calcifications can be demonstrated with high accuracy (> 95%) in T1-weighted images as areas of decreased signal intensity. It is possible to characterize the calcifications similar to Gärtner's radiologic classification differentiating form and density of the calcific deposits as well as their delimitation to the tendon structure. In T2-images there frequently is a perifocal band of increased signal intensity which can be identified as an oedema around the calcification. Analysing two perpendicular planes the calcifications can be assigned to the corresponding anatomical structure. 83 percent were located in the supraspinatus tendon above the humeral head or in the superior part of the subscapularis tendon. Degenerative areas of the rotator cuff are demonstrated as small zones of increased signal intensity, abnormal morphology or discontinuity of the tendon. Only in one patient a partial tear could be found; 11 percent showed variable signs of degenerative alteration of the involved tendon.

Calcinosis↗

PubMedDate not supplied

[Cause of pain in early dysplasia coxarthrosis. A case report].

The case of a 48 year old woman with a synovial cyst of the hip joint and arthrosis secondary to dysplasia is presented Rheumatic disease could be excluded. During an arthrography, which showed the communication of the cyst with the hip joint, the formerly existing pain could be elicited. In this case the pain in beginning hip dysplasia is not directly related to arthrosis.

Diagnosis, Differential↗