Twelve patients were operated upon after unsuccessful conservative treatment for complete dislocation of the sternoclavicular joint. Three methods were used; stabilisation using fascial loops, reconstruction with a tendon graft, and resection of the sternal end of the clavicle. The results were good in only four patients, three treated with a tendon graft and one by fascial loops. Another four patients had fair results, but all four treated by resection of the medial end of the clavicle had poor results, with pain and weakness of the upper extremity. In our opinion resection of the sternal end of the clavicle should not be used in old traumatic dislocation.
Total rupture of the ulnar collateral ligament of the first metacarpophalangeal joint is a common injury and it needs to be operated on, otherwise the injured joint will be unstable and it will cause disability due to loss of pinch grip. A special absorbable device--self-reinforced poly-L-lactide mini tack--was used to stabilise this ruptured ligament. 140 patients were operated on because of this ligament injury. The preliminary results after six months' follow-up were good. Normal movement was regained in 118 out of 140 patients (84.3%) and stability in 138 patients (98.6%). Five reoperations (3.6%) were needed--one because of scar pain, one because of local infection nine months postoperatively, one because of instability and two because of late loosening of the tack six and nine months postoperatively. Overall the preliminary results were good. On the basis of these findings we consider this new absorbable fixation method suitable for clinical use for reinserting the ruptured ulnar collateral ligament of the first metacarpophalangeal joint of thumb.
SummaryBiopsy material from the iliac bone adjacent to the sacroiliac joint was studied by histological, microradiographical and tetracycline fluorescence methods in three male cases of ankylosing spondylitis and in three female cases of osteitis condensans ilii. Microradiography was also performed in two control cases. Histological examination revealed bone areas indicating osteonecrosis in one case each of spondylitis and osteitis condensans and also regenerative areas in one case of both groups. Thickened blood vessels were found in the bone in one case of spondylitis and in the outer part of bone in osteitis condensans. Microradiography revealed both thick and narrow trabeculae in roentgenologically sclerotic areas in both groups. In two cases of either group there were regenerative areas. Tetracycline fluorescence was found in both groups, but was somewhat more marked in the osteitis condensans cases.
Polylactic acid (PLA) is a synthetic biodegradable material. The self-reinforced implants made of poly-L-lactic acid (SR-PLLA) were manufactured of biodegradable polymeric matrix reinforced with fibres of the same material. The purpose of this study was to find out the effect of an intramedullary SR-PLLA implant on growing bone and its applicability to the fixation of a femoral shaft osteotomy in a growing rabbit. In seven rabbits 6 weeks of age a SR-PLLA implant 2.0 mm in diameter and 50 mm in length was introduced into the intramedullary cavity of the right femur. A proximal femoral shaft osteotomy of the right femur was made in another ten 6-weeks-old rabbits. After accurate reduction, fixation of the osteotomy was achieved with an intramedullary 2.0 mm by 50 mm SR-PLLA-rod. The follow-up times were 6 and 28 weeks. An intramedullary SR-PLLA-rod neither caused any disturbance of the bone growth nor abnormalities of the peripheral blood cell counts. Solid union of the osteotomy was seen in six weeks after fixation with SR-PLLA implant.
