2006 - UZ Leuven

Fifth ray involvement in Dupuytren’s disease remains a surgicalchallenge, especially at the proximal interphalangeal joint. Residualdeformity and recurrence rate remain high, irrespective of the surgicaltechnique used.VAN LOON P., DE MUNNYNCK B., BELLEMANS J.: Periprostheticfracture of the tibial plateau after unicompartmental knee arthroplasty.Acta Orthop. Belg., 2006; 72: 369-374.The authors report three cases of unicompartimental knee arthroplasty(UKA), complicated with peri-operative periprosthetic fracture of thetibial plateau. The surgical technique was held responsible in allcases. The initial treatment was different in every case; all patientsultimately underwent revision total knee arthroplasty with a goodfunctional outcome.The authors emphasise the importance of careful preparation of thetibial plateau during UKA, adequate sizing of the tibial component andcaution when using a hammer during implantation of the tibialcomponent. When a tibial plateau fracture occurs, the treatment ofchoice should be immediate revision total knee arthroplasty.VAN TONGEL A., FABRY G.: Epiphysiodesis of the greater trochanter inLegg-Calvé-Perthes disease: The importance of timing. Acta Orthop.Belg., 2006; 72: 309-313.Patients with Legg-Calvé-Perthes disease (LCP) often exhibit relativeovergrowth of the greater trochanter and shortening of the femoralneck. Biomechanically, this corresponds to a shorter lever arm and adecreased muscle tension which may result in a Trendelenburg gaitand pelvic instability. This is a retrospective study of 31 patients (32hips) with LCP disease and relative overgrowth of the greatertrochanter who were treated with an epiphyseodesis. The averageage at operation was 10 years and 6 months. We evaluated thepatients clinically with the Trendelenburg sign and analysed onradiographs the growth of the greater trochanter and the neck-shaftangle of the normal hip and the pre- and postoperative growth andangle of the involved hip. We did not find any significant differencesbetween the pre-and postoperative values. After a mean follow-up of 4years and 2 months, however, 27 patients presented with a negativeTrendelenburg sign (versus 14 patients preoperatively).70