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PubMedDate not supplied

[Indications for rheumatoid orthopedic interventions and priorities in the long-term treatment plan].

The treatment of the polyarthritic patient has to consider the whole personality in order to be effective. This difficult task calls for a well functioning team. In this team the Rheuma-surgeon plays a decisive role. He will only be able to satisfy all the expectations if he masters, by virtue of his training and experience, the art of setting up a treatment plan with priorities. In order to outline a list of priorities, he has to answer the questions: What are the patient's needs, desires and expectations? What are the predictable end results of the measures envisaged and what are the remaining possibilities in case of surgical failure or when abstaining from surgery? Three categories of operation are outlined according to the expected success rate. Of particular importance is the patient's motivation.

Arthritis, Rheumatoid↗
PubMedDate not supplied

[Surgical treatment of fractures of the acetabulum (personal experience)].

A hundred and thirty-five cases of fracture of the acetabulum seen from 1964 to date are analysed. Thirty-four were treated conservatively, a hundred-and-one by surgery. A clinical assessment of the cases treated was carried out. The different types of fracture (of the anterior column, of the posterior column, of the posterior wall and transverse fractures) are briefly described. In conclusion, treatment by surgery gives much better results because anatomical reconstruction of the acetabulum is possible or, at least, partial reconstruction which can be completed by the application of a hip-joint prosthesis at a later date.

Acetabulum↗
PubMed1981

[Dynamic stressing of petrochanterically osteotomized femurs treated with endoprostheses (author's transl)].

In the treatment of pertochanteric fractures of the femur, the use of a hip joint prosthesis is indicated in exceptional cases for patients of advanced age. Mechanical testing of the combined system (osteotomized bone-cement-prosthesis) reveals high resistance to stress. A report is presented on stress tests on pertrochanterically osteotomized cadaver femurs which have been treated with endoprostheses. Dynamic stressing was done in four stages up to a maximal force of 2050 N. The resulting movement was measured medially and laterally along the osteotomy fissure. In the medial area it was between 0 and 0.06 mm, and in the lateral between 0 and 0.2 mm. The mechanical stability of this combined system seems to be higher than other surgical methods (Ender-nailing, combined osteosynthesis with bone cement and angle plate). Its load bearing capacity is substantially greater than that of the physiological system.

Aged↗