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Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_III | Pages 253 - 253
1 Mar 2004
Efstathopoulos N Lazarettos J Papachristou G Tsifetakis S Panousis K Nikolaou B
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Aims: The evaluation of the results becoming from the use of demineralized bone matrix (DBM) in the bone defects. Methods: In the present study the above substance was implanted during the period 2000-2002 (28 months) to 24 patients, 11 males and 13 females average age 39,1 for the males and 60 for the females. As a cause was referred in 12 patients the fall, in 3 patients the car crash, in 5 patients the following the removal of osteosynthesis materials, in 2 patients the bone cysts, in 1 patient fracture of ankle joint following fusion and in 1 patient a pseudarthrosis. The implantation of DBM concerned 8 hips, 4 femurs, 6 knees, 1 humerus, 1 forearm, 1 ankle, 2 metacarpal and 1 phalanx. All the fractures as well the fusion were treated through internal fixation. There was a regular post op follow-up and concerned the clinical and x-ray examination per month until the total incorporation of the graft (12 weeks). Results: In all patients the total incorporation of the DBM was accomplished in a brief period of time, depended on the place of implantation without having local or systemic side effects. We have to remark the early signs of bone shadow around the 3rd week, as well the incorporation of the matrix around the 12th week in the x-ray findings. Conclusions: The use of DBM in bone defects could play an important role to the filling of bone defrects due to fractures or benign cysts as a result of its incorporation and without inducing local or systematic side effects.


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 168 - 168
1 Feb 2004
Panousis K Goutzanis G Velentzas P Fandridis E Kokalis Z Gianoulis F Tsifetakis S Pilichos I
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Aim: The purpose of this study is to determine the outcome in patients with acetabular fractures treated either conservatively or surgically

Method: From 1990ā€“2000, we treated 152 patients with 158 acetabular fractures. 63 patients were treated nonoperatively and 95 operatively. According to Tile classification there were 70 type A, 52 type B, 36 type C fractures. Mean follow up was 90 months (23ā€“151 months). Indications for surgery were fracture displacement of more than 2mm, hip joint instability, intrarticular fragments and ipsilateral femoral fracture. Surgical approaches used included the kocher-Langenbeck and the triradiate approach. Follow up consisted of radiological examination and functional assessment using Merle dā€™ Aubigne score.

Results: 53 conservatively treated patients followed up. 39 (73.6%) had excellent and good results and 14 (26.4%) fair and poor results due to excessive fracture comminution, severe osteoporosis, or they were too sick to be operated on.

83 operatively treated patients with 85 fractures were followed-up. Anatomic reduction was achieved in 57 fractures, satisfactory in 18 and poor in 10 fractures.

Functional outcome was excellent or good in 60 (72.3%) patients and fair and poor in 23 (27,7%).The complications were 3 wound infections, 4 cases of femoral head osteonecrosis, 3 cases of secondary loss of reduction and 5 cases of significant ectopic ossification.

Conclusion: The outcome of these difficult fractures depends on restoration of hip joint congruity and stability and correlates closely to radiographic result.