Abstract:
:When inserting screws into a vertebral pedicle, the surgeon usually exposes the back part of the vertebra and uses his or her anatomic knowledge to align the drill in the proper direction. A slight error in direction may result in an important error in the position of the tip of the screw. This is done with no direct visibility of crucial structures (spinal cord, pleura, vessels). Statistical analysis of a series of surgical procedures has shown that 10% to 40% of the screws are not installed correctly. To reduce the risk of complication, a computer assisted method is proposed that enables the surgeon to place a screw at a position preoperatively defined in 3 dimensions using computed tomography images. This allows the surgeon to align a standard surgical drill with the optimal position and direction. The depth of the pilot hole during drilling also is monitored by the system to prevent penetration of the anterior cortex of the vertebral body. Using this procedure, in vitro tests were performed and showed that an accuracy of less than 1 mm can be obtained. Clinical trials were done in 10 patients who suffered severe scoliosis or spondylolisthesis. The trajectory of the holes drilled in L2, L3, L4, and L5 vertebrae were checked for all clinical tests. Postoperative radiographs and computed tomography scans showed that the screws were well inserted in each plane for each pedicle. This technique also can be used to perform osteosynthesis at the thoracic and cervical levels.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Merloz P,Tonetti J,Eid A,Faure C,Lavallee S,Troccaz J,Sautot P,Hamadeh A,Cinquin Pdoi
10.1097/00003086-199704000-00011subject
Has Abstractpub_date
1997-04-01 00:00:00pages
86-96issue
337eissn
0009-921Xissn
1528-1132pub_type
临床试验,杂志文章abstract::Although the physeal cartilage is considered resistant to invasion by metaphyseal osteosarcoma, no objective clinical proof exists to support this view. Fourteen cases of osteosarcoma of long bones in patients ranging in age from ten to 19 years with open physes were reviewed to determine the incidence of transphyseal...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-07-01 00:00:00
abstract::Preventive measures in orthopedic surgery are best accomplished by full knowledge of potential complications, thoughtful preoperative planning, the careful and precise execution of the operative procedure, meticulous hemostasis, and the implementation of appropriate measures in the postoperative period. ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1987-09-01 00:00:00
abstract::Magnetic resonance venography is a recently developed, noninvasive means of visualizing the proximal veins of the lower extremity and pelvis. Magnetic resonance venography is compared with standard contrast venography in the diagnosis of proximal deep vein thrombosis after total joint arthroplasty. Two hundred seven e...
journal_title:Clinical orthopaedics and related research
pub_type: 临床试验,杂志文章
doi:10.1097/00003086-199610000-00029
更新日期:1996-10-01 00:00:00
abstract:BACKGROUND:Osteosarcoma is a rare complication of Paget's disease with a very poor prognosis. Treatment is controversial: the older age of the patients affected by Paget's disease may limit the use of chemotherapy and axial involvement may limit the practicality of surgery. QUESTIONS/PURPOSES:The purposes of this stud...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1473-7
更新日期:2010-11-01 00:00:00
abstract::Nodules of fibrocartilage, calcified fibrocartilage, or bone may be found in the adult ligamentum nuchae. These are generally asymptomatic but may mimic fractures or, as in the case presented here, tumors. ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1978-10-01 00:00:00
abstract::Observations of the knee joint made at surgical synovectomy in young children with the chronic synovitis stage of hemophilic arthropathy permitted description of the evolution of the subchondral cyst in this disease. Beginning as a subchondral hematoma beneath the load-bearing surfaces of the joint, the subchondral cy...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1984-05-01 00:00:00
abstract::This is a review article of the past 40 years of research in Britain on the etiology of developmental disorders of the skeleton, covering both rare unifactorial diseases (chondroosteodystrophies) and common localized disorders (e.g., clubfoot and congenital dislocation of the hip) of multifactorial inheritance. ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-09-01 00:00:00
abstract::The Total Condylar Prosthesis is a non-hinged unit designed to: replace the patellofemoral articulation; improve fixation of the tibial component by means of a stout central peg; permit accurate and reproducible insertion. The cruciate ligaments are excised to obtain better tibial fixation. Instability has not been a ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1976-10-01 00:00:00
abstract::The overall biocompatibility characteristics of metallic implants are important considerations in orthopedic surgery. A review of the literature shows very few reports of neoplasms in association with metallic implants. This case report demonstrates osteogenic sarcoma at the site of a Smith-Petersen nail that had been...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1990-03-01 00:00:00
abstract::Six cases with neurovascular complications, previously unreported as a complication of the Hauser procedure, have been presented. The salient features were unrelenting pain during the first 24 hours postoperatively, completely out of proportion to that which might be anticipated, and with concurrent or subsequent numb...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-197511000-00013
更新日期:1975-11-01 00:00:00
abstract::Eleven patients with Legg-Calvé-Perthes disease (LCP) were examined ultrasonographically for their femoral head deformity. The outline of the cartilaginous femoral head was well demonstrated, and the image obtained corresponded to that observed by arthrography. Using ultrasonography, a simple method was developed to d...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-07-01 00:00:00
abstract:UNLABELLED:Information on the microbiology of infections after operative ankle fractures, on the details of a treatment protocol used when the ankle joint is preserved, and on the outcome of this protocol will be helpful for the physicians managing patients with this complex problem. We therefore determined the most co...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-009-0743-8
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:Long-term evaluation of knee arthroplasty should provide relevant information concerning the durability and performance of the implant and the procedure. Because most arthroplasties are performed in older patients, most long-term followup studies have been performed in elderly cohorts and have had low patien...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-014-3744-1
更新日期:2015-01-01 00:00:00
abstract::A prospective study was performed of 115 patients without previous history of thromboembolic disease undergoing 117 total hip arthroplasties. No prophylactic anticoagulants were used; two patients developed physiologically significant thromboembolic disease. No deaths were encountered. This incidence of 1.7% is signif...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1982-11-01 00:00:00
abstract::Although peripheral metastases of many malignancies to bone are common, metastases to the hand and carpus are rare. This is the first report of a silent primary malignancy of the lung presenting as a metastasis to the carpal navicular bone. Only eight instances of carpal bone metastases secondary to all tumor sources ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1984-09-01 00:00:00
abstract:BACKGROUND:Adverse local tissue reactions (ALTR) around metal-on-metal (MOM) hip arthroplasties are increasingly being recognized as a cause of failure. These reactions may be associated with intraoperative tissue damage and complication rates as high as 50% after revision. Although MRI can identify ALTR in MOM hips, i...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-013-2788-y
更新日期:2014-02-01 00:00:00
abstract::Although bone stress injuries are common in male military trainees, it is not known how common they are in female trainees. It also is unclear whether asymptomatic bone stress injuries heal if intensive training is continued. We prospectively followed 10 female trainees of a military Reserve Officer Course. The subjec...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-009-0851-5
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Pasteurized autograft is regarded as a biologic reconstructive option for managing bone defects after tumor resection; however, reports on long-term outcomes from large patient series are scarce. Contrary to previous favorable reports, we have observed many patients with failures, in particular as the durati...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999.0000000000000100
更新日期:2018-09-01 00:00:00
abstract::Pelvic osteotomy for symptomatic hip dysplasia usually is performed for young and adolescent females. Delivery after pelvic osteotomy is a concern for patients of childbearing age. We asked whether the clinical results differed before and after pregnancy, whether eccentric rotational acetabular osteotomy alters the bo...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/BLO.0b013e31803b8d82
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Socioeconomic variables influence various healthcare issues in different ways. The effect of socioeconomic variables on the shoulder has not been well studied. Because activity level, defined by how much a patient actually does, is an important patient outcome measure and prognostic factor for the shoulder, ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-016-4946-5
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:De novo malignancies are serious complications in the late postoperative period after liver transplantation. The most common de novo tumors are skin malignancies, posttransplantation lymphoproliferative disorder, tumors of the head and neck, and Kaposi's sarcoma. Such posttransplant de novo malignancies are ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-2236-9
更新日期:2012-04-01 00:00:00
abstract::Managing tumors of the proximal fibula may require en bloc resection of the fibular head with the attachment site for the lateral collateral ligament. These resections of the proximal fibula cause unavoidable knee instability. We describe a reconstructive technique intended to minimize that instability. We retrospecti...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000238781.19692.16
更新日期:2007-01-01 00:00:00
abstract::A spectrum of medical problems, including self-limited acute mountain sickness, high-altitude retinopathy, and the potentially fatal high-altitude pulmonary and cerebral edemas, may afflict residents and sojourners at higher elevations. However, appropriate prevention and prompt recognition will minimize the impact of...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-03-01 00:00:00
abstract::Abduction contracture of the hip (frog-leg deformity) is caused by contracture of the gluteus maximus muscle. A simple operation consisting of complete detachment of involved fibrous portions of the gluteus maximus from the greater trochanter to the ischial tuberosity is sufficient to release the contracture and enabl...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1982-01-01 00:00:00
abstract::An analysis of the patellofemoral joint based on experimental determinations of pressure distributions on the patellar cartilage and vectorial calculations is presented. The extension torque of all quadriceps muscles is similar. The force transmitted to the patella by the retinacula is small in all knee positions. Bec...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1990-09-01 00:00:00
abstract::Nineteen patients had a severe neurologic deficit and persistent dysesthetic pain after total hip replacement. During surgery their limbs had been lengthened by 1.3 to 4.1 cm. Patients with other reasons for nerve injury such as hematoma, dislocation, or direct operative trauma were excluded. Also excluded were patien...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200401000-00027
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Wide variation exists in reported prevalence estimates and management standards of developmental dysplasia of the hip (DDH). Discrepancies in diagnosticians' opinions may explain some of this variation. QUESTIONS/PURPOSES:We sought to determine (1) the consistency with which pediatric orthopaedic surgeons r...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-013-2846-5
更新日期:2013-06-01 00:00:00
abstract::The effect of electromagnetic field stimulation was investigated in a group of 40 consecutive patients treated with valgus tibial osteotomy for degenerative arthrosis of the knee. All patients were operated on by the same author and followed the same postoperative program. After surgery, patients were randomly assigne...
journal_title:Clinical orthopaedics and related research
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1993-03-01 00:00:00
abstract::Nonunion of allograft-host junction after bone transplantation is not uncommon, and its treatment frequently is problematic. To improve the understanding of these nonunions, a retrospective review was performed of 163 nonunions in 945 patients who underwent allograft transplantation (17.3%) for various benign and mali...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200101000-00014
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:The choice of surgical approach for THA remains controversial. Some studies suggest that the direct anterior approach (DAA) leads to less muscle damage than the miniposterior approach (MPA), but there is little high-quality evidence indicating whether this accelerates recovery, or whether this approach-which...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11999.0000000000000112
更新日期:2018-02-01 00:00:00