Diaphyseal fractures of the tibia in 80 patients were treated by external skeletal fixation using a unilateral frame, either in a fixed mode or in a mode which allowed the application of a small amount of predominantly axial micromovement. Patients were allocated to each regime by random selection. Fracture healing was assessed clinically, radiologically and by measurement of the mechanical stiffness of the fracture. Both clinical and mechanical healing were enhanced in the group subjected to micromovement, compared to those treated with frames in a fixed mode possessing an overall stiffness similar to that of others in common clinical use. The differences in healing time were statistically significant and independently related to the treatment method. There was no difference in complication rates between treatment groups.
We have made a restrospective comparison between the results of 49 high tibial osteotomies and 42 unicompartmental replacement arthroplasties performed for the treatment of osteoarthritis of the knee, assessed S to 10 years after operation. The type of operation depended on the policy of the consultant responsible for treatment but analysis of the pre-operative findings showed that the two groups were
We report a prospective case-controlled study which compared the outcome of knee replacement in seriously deformed and slightly deformed knees. There were 51 knees with varus or valgus deformity greater than 20#{176} matched for age, gender, disease, type of prosthesis and time of operation with a control group in which the alignment of the leg was within 5#{176} of normal. The clinical outcome at a mean 5.5 years was similar in the two groups. Some deformity persisted in 14 patients in the first group, 13 of whom were initially in valgus. These patients had a significantly poorer mean clinical outcome. Lateral dislocation or subluxation of the patella was found in four knees, all of which had had valgus deformity of 30#{176} or more.
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