[Pharmacokinetic studies following 2 and 4-week Felbinac gel administration to the knee joint]. / Pharmakokinetische Untersuchungen nach zwei- bzw. vierwöchiger Felbinac-Gel-Applikation am Kniegelenk.

Twelve patients with osteoarthrosis were locally treated with Felbinac Gel (biphenyl acetic acid (BPAA) 3%) three times daily for 14 days (five patients), 28 days (six patients) or 42 days (one patient) before elective knee joint surgery. BPAA plasma concentrations as of the seventh day of treatment were steady at between 423 and 1040 ng/ml. In surgery, synovial and tissue samples were taken to determine BPAA concentrations. Moderate and sometimes higher synovial BPAA levels in the treated knee joint compared to the contralateral knee seem to indicate a combined direct and systemic absorption. The highest BPAA concentrations (1497-13939 ng/g) were measured in the skin. Drug levels in the synovial membrane (36-994 ng/g), the synovia (104-768 ng/ml), tendon (less than 10-197 ng/g), cartilage (less than 10-109 ng/g), muscle (12-101 ng/g), and subcutis (16-97 ng/g) were lower. BPAA neither accumulates in the skin, nor in any other peri-articular tissue. A steady state was reached as of the 14th day of treatment at the latest. None of the patients reported any local or systemic side effects.

[Treatment of splayfoot with prolapse of the metatarsal heads by Helal's Oblique Metatarsal Osteotomy (author's transl)]. / Die Behandlung des durchgetretenen Spreizfusses mit der schrägen Metatarsalosteotomie nach Helal.

The authors describe the technique of oblique osteotomy of the distal metatarsals after Helal, for treating splayfoot with prolapse of the metatarsals heads. It was performed on 189 metatarsals in 76 patients. The operation is technically straightforward, inexpensive and, with the appropriate indication, an efficacious intervention with a high success rate.

[Treatment of segmental ischemic necroses of the head of femur with intertrochanteric flexion-osteotomy (author's transl)]. / Die Behandlung segmentaler, ischämischer Hfkkopfnekrosen mit der intertrochantären Flexionsosteotomie

We call conditions with focal necroses in the head of femur "segmental necroses". Where possible we prefer to treat this condition with intertrochanteric displacement osteotomy, either with flexion- or varus displacement. As with arthrosis of the hip-joint the effects of displacement osteotomy are: reduction of tension of the muscles acting on the joint and increase in the leverage of the abductors reduce the work-load of the joint. An intact sector of the femoral head is placed into the weightbearing position and the necrotic segment is relieved. Immediate freedom from pain is supposed to be due to a normalization of the internal pressure in the marrow-cavity. For radiologic examination of segmental necroses of the femoral head tangential films (after Schneider) in addition to AP and axial films have proved useful. Early results of 16 flexion osteotomies for segmental necrosis of the head of femur, followed up for 6-34 months after operation (and further for up to 54 months), are encouraging. Impressive improvement of pain occurred in 14, of gait in 11 patients. The range of movement of the diseased joints, however, was not essentially increased.