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At least 1,027 records · Page 57Linked to original sources
PubMed1985

The role of non-prosthetic surgery in the treatment of rheumatoid arthritis by fusions and auto-arthroplasties. Current practice at the Rheumatism Foundation Hospital, Heinola.

After the introduction of modern artificial joints the classical operation methods, such as osteotomies, arthrodeses and auto-arthroplasties, have been forced aside little by little. Irrespective of the late complications following replacement surgery, the patients today expect a movable, painless endoprosthesis, which at it best seems to benefit the patient. The question arises whether the classical methods still have a role in the surgical treatment of rheumatoid arthritis. The reply is "yes", they do have a fair share of rheumatoid surgery, indeed. They still compete with the modern endoprosthetic surgery for the place of the primary operation in many cases. To give instances, tarsal reconstruction by subtaloid arthrodesis is superior to other methods and arthrodesis of the wrist is often only reasonable way to get a strong, painless key joint to the hand. Even the shoulder arthrodesis may successfully compete with an endoprosthesis. Also classical auto-arthroplasties such as resection arthroplasties of the metacarpophalangeal and elbow joints are serious rivals of respective endoprostheses. The practice of Rheumatism Foundation Hospital (RFH) in the golden mean between the endoprosthesis enthusiasts and their opponents will be described in this article. The practice varies greatly from clinic to clinic and is progressing--and regressing--all the time.

Ankle Joint↗
PubMed1985

[Titanium-coated hollow screw and reconstruction plate system for the bridging of jaw defects. II. Possible reconstruction variants with the THRP system].

The advantages and special features of the THRP-system enabled us to develop new operative techniques. The combination of the advantages of external fixation devices and those of the internal osteosynthesis has proved to be decisive in order to obtain good results. The clinical results in 30 patients confirm the recently published findings from animal studies. Histological examination of human specimens comparing 2 types of screws developed by us are discussed.

Bone Plates↗
PubMed1985

Osteoarthritis in the hand.

Patients who have disabling osteoarthritis of the hand are frequently given the wrong diagnosis, poor professional advice and inadequate treatment programmes. The exact cause of primary osteoarthritis remains unknown; however, an interplay of genetic factors, mechanical factors and biomechanical alterations in cartilage seems to be important. The incidence of primary osteoarthritis in the general population is very high. These patients should receive the benefits of good professional advice and reconstructive surgery when necessary. They may respond very well to moderating their activities and simple physical and medical therapy methods. Patients with destructive joint disease in the digits can have excellent results with arthrodesis and implant arthroplasty for the DIP and PIP joints and with implant arthroplasty for the basal thumb joints. Surgical reconstruction is an important method in the rehabilitation of this group of individuals. The term 'osteoarthritis' is preferred to 'osteoarthrosis'.

Aged↗
PubMedDate not supplied

Reduction of a fracture-dislocation of Lisfranc's joint by endoprosthetic implantation.

The medical literature demonstrates numerous documented cases of post-traumatic arthrosis following comminuted fracture-dislocations at the tarsometatarsal joint(s). Conventionally described reductions and methods of fixation, therefore, lend themselves to less than acceptable results. A newly devised, alternative method of approach to this disabling injury was indicated, and is presented by the authors in the hope of preventing the long-term sequelae commonly seen with this type of injury. After open reduction and remodeling of a severely comminuted fracture-dislocation at the second metatarsal-cuneiform articulation, a modified, double-stemmed Swanson Silastic implant was utilized in order to maintain second ray length and attempt prevention of the usual postinjury osseous consequences, i.e., fusion and arthritic changes. The case presented demonstrates that, after her last clinical evaluation 19 months postoperatively, the patient returned to her normal occupation, and at that time her foot was normal in appearance with no sign of traumatic arthritic change. This procedure thus far has proved to be very rewarding to the patient, and the authors believe it should be considered as an alternative approach in patients who present with injuries of this magnitude.

Adult↗
PubMed1985

Arthroplasty of the thumb basal joints.

Implant arthroplasty reconstruction of the thumb basal joints can provide pain-free, stable mobility and improved strength. The complications are few and essentially retrievable. The recommended operative procedures are challenging and must be carefully executed to obtain rewarding results.

Arthritis, Rheumatoid↗
PubMed1985

Total joint arthroplasty at the carpometacarpal joint of the thumb.

A series of 50 cases of total joint arthroplasty at the carpometacarpal joint of the thumb demonstrate surgical procedure and cement technique. Most patients showed a full range of motion within four weeks of suture removal and continue to demonstrate good long-term results. Less motion is anticipated in patients with contractures or systemic disease. Five patients showed clinical or radiographic evidence of loosening. Revision procedures document the retrieval potential of a failed implant. The author's ten-year experience with this system indicates that the concept is viable. Future modifications are discussed.

Carpal Bones↗
PubMedDate not supplied

Implant arthroplasty of the first metatarsophalangeal joint: a 12-year retrospective study.

A study was conducted of the long-term results on Silastic implant arthroplasties of the first metatarsophalangeal joint in 88 feet. Silastic implants were evaluated on the basis of patient satisfaction, function, and radiographic findings. The period of follow-up ranged from 6 months to 12 years, with an average follow-up of 6.3 years for hemi-joint implants and 2.1 years for total joint implants. The results showed that a majority of patients with hallux valgus and hallux limitus had good results with either hemi-implant or total implant. The most common complication found was hallux extensus.

Adult↗
PubMed1985

[Clinical studies and postoperative results of 51 nonambulatory rheumatoid patients with total joint replacements].

Between October 1971 and June 1984, total joint replacement was performed on 51 nonambulatory patients with rheumatoid arthritis (RA). These nonambulatory patients showed high RA activity, and many presented with extra-articular symptoms with reference to the heart, lung, etc. During follow-up, 13 patients died of diseases unrelated to the operation, and the whereabouts of other 3 patients were unknown. Thus, the total joint replacement was evaluated in the remaining 35 patients. The walking ability was improved in 27 patients. However, the hoped-for results were not attained in relation to various aspects of the activities of daily life. Complications developed in 6 joints of 6 patients. The factors responsible for poor results were loss of motivation, muscle weakness, reduced function of the upper extremities, osteoporosis, cervical spinal cord injury, etc. From these results, it is emphasized that properly-timed surgery at the right level can prevent RA patient from becoming nonambulatory.

Activities of Daily Living↗