The scaphoid fat stripe in the diagnosis of carpal trauma.

During a ten-year period scaphoid fracture was suggested in 541 wrists, but in 283 cases could not be confirmed at the initial radiographic examination. These cases were immobilized in plaster of Paris and examined clinically and radiologically 10 to 14 days later. A total of 274 additional radiographic examinations revealed 32 scaphoid fractures not initially recognized. Two fractures were at the retrospective analysis found to have been neglected. In the 249 cases where a fracture was never demonstrated, the immobilization and resulting sick leave were in retrospect considered not to have been indicated. In a retrospective analysis of case records and radiographic material including the configuration of the scaphoid fat stripe (SFS) at the initial radiographic examination the SFS was found to be useful in diagnosing scaphoid fractures. The use of the SFS in differential diagnosis would result in reduction of costs and inconvenience for patients without scaphoid fracture.

Deformation and loosening of the tibial component in knee arthroplasty with unicompartmental endoprostheses.

Roentgenological signs of deformation and loosening of the tibial component in knee arthroplasties with unicompartmental endoprostheses occurred in one-third of 87 rheumatoid (RA) knees within 2 years and in one-fifth of 107 osteoarthritic (OA) knees within 3 years after the operation. Compared with thicker components significantly more 6 mm components in RA, and 6 and 9 mm components in OA became deformed and loose. There was no difference in the clinical assessment of the knees with and without deformed tibial components. Reoperations were recorded during an extended follow-up. In the group with initially asymptomatic loosening twelve RA knees within four and a half years and three OA knees within four years developed pain on weight-bearing and had to be reoperated. One patient (OA) had loose components without any roentgenological signs; the loosening was first discovered when the unoperated compartment was revised because of secondary osteoarthrosis. Knees fitted with 6 mm components more often required reoperation because of loosening than did those with thicker components.