ABSTRACT
Three latin fragments (about 1050), included in the envelope of a manuscript, written about 1530 in Cologne, could be identified as parts of the latin version of an Alexandrian commentary (probably written by Johannes Alexandrinus) on Galen's book 'De sectis'. C. D. Pritchet edited this text in 1982, but he thought that he was printing a translation of this commentary on Galen's book, written by Burgundio de Pisa in the year 1185. By means of an exact comparative analysis of the fragments with Galen's original Greek text, we were able to show that these fragments offer almost the same text as Pritchet. But it is remarkable that there are some differences between our version and the text of Pritchet. It seems that our version proves the existence of an until now unknown medieval revision of the Galen-commentary by Johannes Alexandrinus.
Subject(s)
History, Medieval , Manuscripts, Medical as Topic/history , GermanySubject(s)
Fetal Death/history , Gynecology/history , Manuscripts, Medical as Topic/history , Female , Germany , History, Medieval , Humans , Infant, Newborn , PregnancySubject(s)
Existentialism/history , Life , Philosophy/history , History, Ancient , History, MedievalABSTRACT
A study of the data on 1,318 consecutive non-cemented total hip-replacement arthroplasties revealed thirty-nine intraoperative fractures of the femur (3 per cent), only half of which were diagnosed intraoperatively. The fractures occurred in the proximal region of the femur or at the tip of the stem of the prosthesis. Most were incomplete and minimally displaced, and they did not jeopardize the stability of the femoral component. All complete proximal fractures were stabilized with a four-fifths-coated or fully coated prosthesis to provide distal fixation, and, when diagnosed intraoperatively, were fixed with cerclage wiring. When an incomplete fracture near the tip of the stem was discovered postoperatively and the posterior part of the femoral cortex was intact, a spica cast was applied, and the patient was instructed in protected weight-bearing. For a complete fracture at the tip of the stem, we recommend open reduction and internal fixation. No statistical difference was found with respect to residual pain, the score for walking, or the stability of the implant when we compared the results for the patients who had a fracture with those for the patients who did not. Modifications in surgical technique resulted in a decrease in the incidence of fractures (p less than 0.05).
Subject(s)
Femoral Fractures/etiology , Hip Prosthesis/adverse effects , Intraoperative Complications , Cementation , Female , Femoral Fractures/diagnostic imaging , Femoral Fractures/therapy , Hip Prosthesis/methods , Humans , Intraoperative Complications/diagnostic imaging , Intraoperative Complications/therapy , Male , Middle Aged , Radiography , ReoperationABSTRACT
The goals of revision total hip arthroplasty (THA) are to reestablish and maintain stable implant fixation. Based upon promising early results in primary THA, porous-surfaced implants designed for bone ingrowth fixation are being increasingly used in hopes of more successfully achieving these goals than has been the case using cement. One hundred and sixty such revisions were followed for a mean of 4.4 years, with specific reference to implant fixation. Roentgenographic evaluation of implant fixation suggested four categories of femoral and acetabular components: (1) bone ingrown, (2) stable fibrous encapsulation, (3) questionable, with signs of impending instability, or (4) definitely unstable implant migration, indicative of the need for rerevision. Not surprisingly, success in achieving and maintaining stable implant fixation following revision THA is dependent upon component design, surgical technique, and preexistent bone stock damage. This classification according to bone stock damage should be borne in mind when critically evaluating the results from various revision series.
