Of 54 patients with posterior dislocations of the hip of type I and type II (Stewart and Milford 1954), 47 were followed for a mean period of 6.7 years (2 to 11). Of these, 23 had dislocation with minimal lesions of the acetabulum (type I) and 24 had an avulsed dorsocranial fragment (type II). All were reduced by closed methods within six hours. The subsequent treatment of type I dislocations was conservative. At the beginning of the period type II injuries were treated conservatively, but surgery was increasingly chosen for later cases. Type I dislocations had significantly better results (p < 0.05) than type II fracture-dislocations, regardless of the method of treatment. There were no essential differences between the results of surgical and conservative treatment in type II dislocations.
A nonrandomized prospective clinical study was undertaken to evaluate the technique and efficacy of in vitro endothelial cell lining of synthetic grafts. Twenty-six patients (10 men and 16 women with a mean age of 68.4 years; range, 49 to 80 years) with end stage chronic peripheral vascular disease requiring reoperation were entered into the study. In 13 patients venous endothelial cells were harvested 4 to 7 weeks before operation, grown to confluency in culture flasks, and seeded onto the inner surface of expanded polytetrafluoroethylene grafts. Thirteen patients received untreated expanded polytetrafluoroethylene grafts and served as a control. A scoring system with use of intraarterial angiography was used to assess disease severity. No statistically significant differences in angiographic score were seen between the two groups, indicating comparable severity of disease. Early secondary graft patency (0 to 30 days) was 92% for the in vitro endothelial cell lining group and 53% for control patients. The amputation rate after 18 months for the in vitro endothelial cell lining group was 15%, with a 31% rate in the control group. The functional performance of the in vitro endothelial cell lining bypasses was superior to that of untreated bypass grafts during the observed follow-up period. These early results suggest that in vitro endothelial cell lining is a method that can reduce the early occlusion rate now seen after repeat reconstruction of crural vessels.
In this paper the results of operative and conservative intervention of acetabulum fractures are analysed. It was possible to re-examine 80 of 146 Patients after a period of 5.46 years in mean. 23 patients were treated by osteosynthesis. Time from accident to operation was 13 days in mean. Posterior wall fractures seemed to be the most frequent (classified by Letournel). Results were evaluated according to the following criteria: clinical status (classified by the scheme of Merle d'Aubigne), X-ray, and subjective well-being. In the surgically treated group total hip prosthesis had to be implanted in five patients because of aseptic necrosis of the femoral head, 52.9% of the patients in this group had good results. In the conservative treated cases no total hip prosthesis had to be implanted. 77.8% of the patients had good results. A main aspect is that the average age of the patients who underwent a treatment by osteosynthesis is lower although the fractures were more severe.
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