Abstract:
:Spondylitis/spondylodiscitis is still an uncommon diagnosis often with a delay in diagnosis and treatment due to the uncharacteristic symptoms. The aim of this study is to increase the awareness and outline a pattern of investigation and treatment. We present six children with an average age of 23 months (19-33 months) at time of diagnosis, conservative treated and with a mean follow-up of 31 months (12-65 months). The evaluation included past medical history, clinical symptoms, X-rays, MRI-investigations and laboratory studies [CRP, erythrocytes sedimentation rate (ESR), white blood count (WBC) and blood cultures] during the course of treatment and follow-up. The predominate clinical findings were: limp, refusal to walk and/or back pain. The mean duration of symptoms until presentation at our clinic was 24 days (4-42 days), the final diagnosis was set after an average of 12 days (7-14 days). Laboratory findings were unspecific but ESR best correlated with the clinical symptoms during the therapy. Five patients were treated by parenteral antibiotics for a minimum of 3 weeks, followed by oral antibiotics adapted to the clinical and laboratory findings. One child received a combined antituberculous chemotherapy after positive skin test for tbc. All six children were immobilized with a body-plaster-cast for an average time of 15 weeks (5-26 weeks). Four patients additionally were treated by further corset therapy for an average of 10 months (3-18 months). Radiological findings on plane X-rays (a.p. and lateral views) at time of diagnosis were decreased height of the disk space and erosions of adjacent vertebral endplates and residues of these radiological changes with signs of bony healing (sclerotic vertebral endplates or partial fusion) were seen at the latest follow-up. There was no case of instability or deformity like scoliosis or kyphosis. The MRI showed the earliest detectable typical vertebral bone involvements and confirmed the diagnosis in combination with laboratory findings and clinical symptoms. Spondylitis/spondylodiscitis should be considered as diagnosis in children with refusal to walk or gait disturbances especially in combination with elevated ESR. MRI is the tool of choice to set the diagnosis early. With an adequate and early therapy of bracing (body-plaster-cast), antibiotics and clinical monitoring good long-term result without spine instability or deformity can be achieved.
journal_name
Arch Orthop Trauma Surgjournal_title
Archives of orthopaedic and trauma surgeryauthors
Waizy H,Heckel M,Seller K,Schroten H,Wild Adoi
10.1007/s00402-007-0316-9subject
Has Abstractpub_date
2007-08-01 00:00:00pages
403-7issue
6eissn
0936-8051issn
1434-3916journal_volume
127pub_type
杂志文章abstract:INTRODUCTION:Hospital volume has been suggested to be a significant determinant of the outcome of joint replacement surgery. We updated previously published data on the effect of hospital volume on length of stay, re-admissions, and reoperations for total hip replacement (THR) at the population level in Finland. MATER...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-013-1860-0
更新日期:2013-12-01 00:00:00
abstract::Tibia valga following fracture in the proximal metaphysis of the tibia in children was previously attributed to various mechanisms. This case report offers an additional explanation based on bone scintigraphy 10 months after injury. Decreased radionuclide uptake at the lateral proximal tibial physis without evidence o...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00571065
更新日期:1991-01-01 00:00:00
abstract:INTRODUCTION:Several reports indicated that interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF- alpha) play important regulatory roles in bone remodeling and homeostasis. In addition, receptor activator of nuclear factor-kappaB ligand (RANKL) and osteoprotegerin (OPG) have been shown to be important regulators o...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-008-0632-8
更新日期:2009-05-01 00:00:00
abstract:INTRODUCTION:Cervical spine metastases are relatively rare entities. Only about 10 % of all spinal metastases can be found in this localization. Magnetic resonance imaging and computed tomography are routinely used for early detection. The initial, clinical examination and patients' complaints may not always be very pr...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-015-2266-y
更新日期:2015-09-01 00:00:00
abstract:PURPOSE:Only few prognostic factors for progression of knee osteoarthritis are well established, including varus malalignment. The purpose of this study was to evaluate whether coronal tibiofemoral subluxation is a predictor for total knee arthroplasty. METHODS:Patients from the progression subcohort of the longitudin...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-017-2777-9
更新日期:2017-10-01 00:00:00
abstract:INTRODUCTION:The purpose of this study is to analyze the mid-term outcomes of a modular monopolar type of radial head arthroplasty in the treatment of complex fractures associated with acute elbow joint instability. We postulated that radiographic changes are related to the development of clinical complications. MATER...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-019-03273-w
更新日期:2020-01-01 00:00:00
abstract::Implanted bovine apatite is highly osteoconductive, since it serves the host tissue as a "guide-line" for the deposition of newly developing bone tissue. It is well tolerated, but it showed no signs of being resorbed during the course of the experiment. Previous impregnation of the bovine hydroxyapatite with a low mol...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00452964
更新日期:1993-01-01 00:00:00
abstract:INTRODUCTION:Inferior survival of cemented total hip arthroplasty has been reported after previous femoral osteotomy. The purpose of this study was to evaluate the long-term survival of uncemented stems after femoral osteotomy. MATERIALS AND METHODS:Forty-eight hips in 45 patients had undergone conversion THA for a fa...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-005-0800-z
更新日期:2005-06-01 00:00:00
abstract:BACKGROUND:Despite its wide use in clinical outcome measurement, there is yet no validated German language version of the AOFAS-AHS available. After finishing cross-cultural adaption of the AOFAS-AHS according to the AAOS guidelines, an analysis of agreement was carried out. METHODS:This was done by means of the 18-it...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-014-2046-0
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Either one- or two-stage revision arthroplasties can be used for the treatment of chronic periprosthetic joint infection (PJI) after total hip arthroplasty (THA). We report our results following two-stage revision surgery performed through the direct anterior approach (DAA) interval using a custom-made artic...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-019-03317-1
更新日期:2020-02-01 00:00:00
abstract::There is little information available regarding the sagittal mechanical axis of the lower extremity of normal subjects under weight-bearing conditions. The purpose of this study was to determine the sagittal alignment of the lower extremity under such conditions. Anteroposterior and lateral radiographs were taken of t...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-007-0528-z
更新日期:2008-04-01 00:00:00
abstract::Between 1973 and 1988, 108 patients with a preoperative diagnosis of spinal tuberculosis were treated by anterior extirpation and interbody fusion at Ankara University Medical Faculty, Orthopedic Surgery and Traumatology Department. In 96 cases the operations were performed intrapleurally, as Hogston described. For 12...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00932444
更新日期:1989-01-01 00:00:00
abstract:INTRODUCTION:Open-wedge high tibial osteotomy (OWHTO) is a well-established surgical option for medial compartment osteoarthritis of the varus knee. The initial strength of the fixation plate is critical for successful correction maintenance and healing of the osteotomy site. This study was conducted to verify if a new...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-018-2918-9
更新日期:2018-07-01 00:00:00
abstract:INTRODUCTION:Failed total knee replacement with compromised bone and soft-tissues can be challenging. In these situations, arthrodesis remains a treatment option of a limb-saving procedure. METHODS:We investigated the outcome of treatment with an intramedullary cemented knee arthrodesis nail implanted in 22 consecutiv...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-012-1534-3
更新日期:2012-08-01 00:00:00
abstract::Twenty-four beagle dogs underwent a lower leg lengthening on the right side of 2.5 cm at a distraction rate of 2 times 0.5 mm per day using a circular fixator system. After a latency phase of 5 days and a distraction phase of 25 days, 12 dogs (30-day dogs) underwent electromyography (EMG) of the gastrocnemius muscle o...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/pl00021221
更新日期:2000-01-01 00:00:00
abstract::One hundred sixty-two neonates with sonographically diagnosed developmental dysplasia of the hip (200 hips) according to the method of Graf were treated with a Pavlik harness until sonographic maturation was reached. Eight patients (12 hips) treated with closed reduction and retention in a bilateral hip spica cast wer...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00443818
更新日期:1994-01-01 00:00:00
abstract::We studied a rare case of old dorsal displacement fracture of the trapezoid. Favorable results were obtained with sugical reduction, despite the fracture being old. ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s004020050427
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:Anteroposterior (AP) whole leg radiographs (WLR) in the standing position for assessment of the mechanical leg axis are generally performed preoperatively for the planning of total knee replacement (TKR) and postoperatively to assess the leg axis. The objective of the present study was to investigate whether...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-019-03256-x
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Biomaterials, acting as scaffolds for cell migration and differentiation, may be used to improve outcomes after microfracture. Three mechanisms determine the success of such procedures and are tested herein: the general capacity of adult femoral mesenchymal progenitor cells (MPC) to differentiate into cartil...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-010-1079-2
更新日期:2010-05-01 00:00:00
abstract::In patients with persistent localized pain at the level of a sesamoid bone of the thumb not obviously related to trauma, sesamoidectomy gives excellent results. Often no X-ray or histological abnormalities are found, leaving the origin of pain problems still unsolved. ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00431360
更新日期:1990-01-01 00:00:00
abstract:INTRODUCTION:Synovial hemangioma is a rare intra-articular benign tumor that is difficult to diagnose because of its nonspecific symptoms. Patients are generally children or young adults with a nontraumatic recurrent swollen painful knee. CASE PRESENTATION:A 24-year-old woman presented with a 20-year history of recurr...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-004-0735-9
更新日期:2004-10-01 00:00:00
abstract:PURPOSE:In the present study, we aimed to evaluate the impact of two-dimensional multi-planar computed tomography (2D-MP-CT) scans and three-dimensional surface rendering computed tomography reconstruction (3D-SR-CT) on the inter- and intra-observer reliability of four commonly used classification systems for tibial pi...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-019-03259-8
更新日期:2020-02-01 00:00:00
abstract:INTRODUCTION:Controversy exists on optimal operative treatment of vertically unstable Neer IIB lateral clavicle fractures. Aim of this study was to analyse and compare clinical and radiological results and complications of locking plate osteosynthesis (LPO) versus hook plate osteosynthesis (HPO) with acromioclavicular ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-017-2645-7
更新日期:2017-05-01 00:00:00
abstract:INTRODUCTION:Posterior selective thoracolumbar or lumbar (TL/L) fusion with pedicle screw constructs for adolescent idiopathic scoliosis (AIS) has been studied in a few researches. However, few studies have discussed the indication for selective TL/L fusion and the behaviors of its adjacent disc angle. The present stud...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-016-2570-1
更新日期:2017-01-01 00:00:00
abstract:PURPOSE:To evaluate the current status of scientific research on the natural history of frozen shoulder as published in the literature. MATERIALS AND METHODS:This systematic review was carried out on PubMed data and was guided by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Articles had...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章,评审
doi:10.1007/s00402-015-2341-4
更新日期:2016-01-01 00:00:00
abstract::This study quantifies changes in bone mineral density (BMD) in the opposite hip and in both proximal tibiae and the correlation with the use of walking aids for patients with two types of hip fracture during the 1st year after surgery. In all, 26 women and 15 men aged 42-88 years (median 71 years) were included. Twent...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s004020050291
更新日期:1998-01-01 00:00:00
abstract:INTRODUCTION:Outerbridge-Kashiwagi ulnohumeral arthroplasty is an effective method in treating elbow osteoarthritis; however, distal humerus fracture after surgery can become a critical issue. A previous biomechanical study has shown that the failure load of the distal humerus decreases after a fenestration, but the si...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-018-2876-2
更新日期:2018-05-01 00:00:00
abstract:PURPOSE:Comparison of conventional radiographs (CR) of distal tibial growth plate fractures [Salter-Harris (SH) fracture types I-V/triplane fractures I-III] with computed tomography (CT) as the reference standard and assessment of diagnostic benefit of CT imaging in the affected patients. MATERIALS AND METHODS:We retr...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-010-1140-1
更新日期:2010-11-01 00:00:00
abstract::The paper describes a rare fracture of proximal femur, classified by Delbet (Am J Surg 6:793-797, 1929) as type I (transepiphyseal type) combined with a fracture of the midshaft of ipsilateral femur in a 2-year-old child. Immediate operation with open reduction and internal fixation was successful. During the postoper...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章,评审
doi:10.1007/s00402-005-0028-y
更新日期:2006-07-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to identify factors contributing to outcomes after severe traumatic brain injury (TBI) associated with epidural hematoma (EDH). METHODS:Between 02/2002 and 4/2010 17 Austrian centers prospectively enrolled 863 patients with moderate and severe TBI into observational studies. Data on...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-012-1652-y
更新日期:2013-02-01 00:00:00