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Biomedical subjects

F Bonnaire

Publications and source records attributed to F Bonnaire.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Ender nail with interlocking mechanism or dynamic hip screw in pertrochanteric fractures? A prospective study extending its limits].

In a prospective study on 148 patients with trochanteric fractures of the hip we compared the results of two implant-systems: the Ender-nailing modified by the dynamical interlocking method of Kempf and Bitar, and the dynamic hip screw (DHS) of the AO-ASIF. The Ender-method had the shorter operation time, earlier weight-bearing and less septic complications. Fracture consolidation was complete after three months in all cases. But in 8% reosteosynthesis because of hip joint perforations of nails was necessary. The method leads in less cases to anatomical reduction (85%), more often relevant varus (9%) and rotationary (14%) malpositions and functional deficits in hip (25%) and knee joints (9%), compared with the DHS. The DHS had less implant complications, reosteosynthesis was necessary in 4%. Technical failures were seldom. In 96% anatomical reduction could be achieved and the function of the hip was in 87% good to excellent. The Ender-nailing with dynamic interlocking is a system for internal fixation of trochanteric fractures in elder patients. The DHS-system has better functional results. Both systems need to be performed in a very careful, exact surgical procedure, to avoid complications.

Adult↗
PubMed1994

[Mechanical dynamic ankle passive motion for physical prevention of thrombosis? Changes in hemodynamics in the lower pressure system with new dynamic splints].

The use of mechanical ankle exercise devices with continuous passive motion (CPM) of the ankle joint can improve venous reflow in the lower limbs after operations. Duplex ultrasonography allows the observations of blood flow velocity and flow volume during continuous movement of the devices. We tested two different CPM devices for ankle movement in a preclinical study on 10 healthy, uninjured people and saw the following changes in the deep venous system in the common femoral vein: after 5 min of motion the velocity of the venous reflow was increased to 112.5% and the flow volume passing the femoral vein to 123% of the initial mean values. After 15 min of motion the devices led to an increase of the venous reflow velocity to 125% and of flow volume to 143% of the baseline values in the femoral vein. These positive effects were still evident even 15 min after the devices have been turned off.

Adult↗
PubMed1994

[Use of ultrasound in acute and follow-up diagnosis of septic accident surgery].

In 50 patients with infections of soft tissue, bone and joints, ultrasound examination was the first diagnostic procedure performed after clinical and X-ray examination. In 22 soft tissue infections the liquid portion of the infection area could be differentiated. Deep subfascial infections were detected in 7 cases before they were clinically apparent. The results of the ultrasound examination had an influence on the operation performed in 10 cases. In 18 patients with bone infections with abscesses the linkage of the fluid zone to the bone was demonstrable, and in 6 of these cases we saw extramedullary sequestrae as total reflecting parts. Empyema was diagnosed by ultrasound in association with clinical and laboratory parameters in 10 cases, including 3 in which clinical examination had not yet led to a firm suspicion. Real-time sonography influenced the operative treatment (time of intervention, approach) in 36% of all these cases was helpful in the diagnosis in all.

Abscess↗
PubMed1992

[Early and late results of 200 DHS osteosyntheses in the reconstruction of pertrochanteric femoral fractures].

We have treated more than 600 cases of trochanteric fractures by internal fixation with the dynamic hip screw. Between 1986 and 1988 we treated exactly 200 patients in this way, who were subsequently observed over follow-up times averaging 24 months. In 1% of this group we performed early revision osteosynthesis because of incorrect positioning of the lag screw; deep infections occurred in 2.5%; and in 6% revision interventions were necessary because of local hematomas. Late complications were necrosis of the femoral head (1%) and pseudarthrosis after head necrosis (0.5%). No reinterventions were necessary because of implant failure.

Aged↗
PubMed1991

Monitoring the response to injury.

Tissue trauma leads to a severity-dependent activation of plasma and cellular systems. This response can be recorded by determining parameters which represent the activation state of these systems. In severely injured patients with multiple trauma three out of 14 parameters measured at the time of admission proved to be indicators of subsequent septic complications with a high degree of accuracy: Fibrinopeptide A (FPA--the first split product of fibrinogen), the C3 split product C3a, and the elastase-alpha 1 proteinase inhibitor-complex (E alpha 1 PI). In a second series of multiple-injured patients with femoral fractures who did not develop clinical sepsis (N = 25) these parameters were measured continuously to evaluate the influence of injury severity and of therapeutic strategy on the further course. We found a strong correlation between injury severity (ISS) and the degree of activation. The signs of activation decreased rapidly following immediate operative fixation, and remained elevated or even increased after primary femoral traction and secondary stabilization. The operative procedure did not cause any additional activation. Complications such as infection or the formation of haematomas were reflected by raised parameter levels.

Adolescent↗
PubMed1991

[Traumatology in the elderly. Treatment concept in per- and subtrochanteric fractures in the elderly].

The aim of treatment of trochanteric fractures in the elderly patient is a prompt procedure, which allows early load bearing. Between 1986 and 1988 272 patients were treated with per- and subtrochanteric fractures: pertrochanteric fractures were stabilised by means of the dynamic hip screw (DHS), subtrochanteric fractures via the 95 degree condylar plate. With both methods an early mobilisation of the patients is possible. In 70 per cent of cases treated with DHS, early load bearing could be achieved within one week. 80 per cent of the patients were operated on within the first 24 hours after trauma. Complications of the methods (incorrect position of the lag screw, plate protrusion) were seen in one case in each group. The overall infection rate was 2.2 per cent. Hospital mortality was 10 per cent. On reviewing the results obtained, we approved of the concept of treatment.

Aged↗
PubMed1991

[Does covered tibial intramedullary nailing promote formation of a compartment syndrome? Perioperative and intraoperative continuous monitoring of compartmental pressure in covered tibial intramedullary nailing].

Between October 1988 and October 1989 we performed a continuously pressure monitoring with the infusion technique in the tibialis anterior and deep posterior compartment of the lower leg during the nailing of the tibia in complete fractures of the lower leg in 16 patients. We set up 2 groups of patients because of different pathophysiological conditions: patients, who were operated on a few days after trauma (Group A) and patients operated on months after the trauma (Group B) because of non-union of the tibia. The effects of the preoperative, intraoperative, and postoperative manipulations were recorded. In no case we saw a beginning compartmental syndrome, although very high pressures of 100 mmHg in Group A and 55 mmHg in Group B in the deep posterior compartment during reduction of the fracture were registrated. The registrated pressures correlated very well with the manipulations during the operation and were absolutely reversible after the ending of these manipulations. In our observation the closed tibia nailing does not favorize the development of a compartmental syndrome, if not done during the vulnerable phase after the first days after trauma, in blunt multiple trauma patients and during bleeding complications.

Adult↗