[The preoperative plan in orthopedics (case reports)].
キーワード
概要
At present due to the development and availability of different types of implants for orthopaedic surgery the orthopaedic surgeon must resort to static and biomechanical thinking. Therefore he does not always appreciate the metabolic function of osseous tissue. This fact is demonstrated on three case-histories. In the first case, after well performed Küntscher osteosynthesis of a femoral fracture, the surgeon did not take a sample for histological examination. A subsequent complicated clinical course and histological examination revealed a pathological fracture associated with an osteosarcoma. Another case-history describes the difficulties associated with creating sufficient space for inserting the shaft of the femoral component for Looser's zone. In case-history no. 3 after rapid weight loss because of overweight the patient developed osteoporosis. The authors reflect whether it is justified to indicate strictly weight reduction before implantation of a total endoprosthesis without evaluation of metabolic aspects of weight loss. When the metabolic function of osseous tissue will be taken into account, the authors assume that the late postoperative results will be better.