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Biomedical subjects

Gerald E Wozasek

Publications and source records attributed to Gerald E Wozasek.

4 recordsLinked to original sources
PubMed2005

Surgical treatment of femoral bending deformity in a patient with vitamin D-resistant rickets.

Surgical treatment of patients with vitamin D-resistant rickets is reserved for management of severe deformities or pathological fractures of the lower limbs. This case report describes the operative management of a child with vitamin D-resistant rickets suffering from a pathological fracture and a bending deformity of the right femoral bone. A modified technique of fragmentation and realignment by intramedullary fixation was performed using an unreamed humerus nail. We corrected the anatomical proximal femoral shaft angle (aMPFA) from 68 degrees to 84 degrees and achieved three more centimetres of femoral length. The same procedure was performed on the left femur and corrected the aMPFA from 108 degrees to 89 degrees and gained 2.5 more centimetres of femoral length. Thus the legs were almost equal in length. We preferred the modified technique of multiple osteotomies and intramedullary fixation by nailing (originally described by Sofield and Millar) because the correction of angulation and rotation of the femoral shaft in one step appeared to be much easier than with plate fixation. Moreover, this method seems to reduce the number of refractures and enables the patients to approach the normal activities of growing children.

Adolescent↗
PubMed2003

[Occult scaphoid-lunate dissociation in distal radius fractures].

INTRODUCTION: The aim of this study was to investigate the clinical consequences of scapholunate dissociation associated with fractures of the distal radius and the impact on wrist function. Fractures of the distal radius and scapholunate dissociation overlap in pathomechanics. The diagnosis however is frequently missed initially. PATIENTS AND METHODS: We reviewed 45 consecutive patients with closed distal radius fractures with a mean follow up of 48 months. Ten patients underwent surgery and 35 patients were treated by fracture reduction and cast immobilization during 4.5 (range 3 to 8) weeks. All patients were re-examined clinically and radiographs of both wrists were compared. RESULTS: Four patients showed evidence of SLD in the scapholunate joint region based on specific criteria (scapholunate gaps > 2 mm on anterior-posterior radiograph and the scapholunate angle > 60 degrees on lateral radiograph). All patients with SLD showed a poor radioulnar deviation. Three patients reported mild to moderate pain. DISCUSSION: The difficulties in management of SLD may be avoided by early detection and treatment. In all investigated patients the diagnosis was missed after the initial trauma. Untreated SLD can lead to carpal collapse and arthrosis of the wrist, and ultimately to scapholunate advanced collapse.

Adolescent↗
PubMed2003

Mid- to long-term clinical findings in nailing of distal femoral fractures.

The purpose of the study was to evaluate clinical long-term results after nailing of distal femoral fractures. The first 22 consecutive cases of distal femoral fractures in 22 patients (2 males and 20 females, age 65 years, range, 16-97 years) treated with retrograde femoral nailing from October 1994 to May 1997 are reported. Indications were AO 33 A1 (n = 7), 33 A2 (n = 2), 33 A3 (n = 3), and 33 C2 (n = 7) fractures. In 11 cases these were periprosthetic fractures of either total hip arthroplasty or hemiarthroplasty of the hip (five) or dynamic hip screw (six), four patients were polytraumatized, one patient had a floating-knee injury. No infections or thrombosis were observed postoperatively. In 17 cases primary union was achieved within 11 weeks (8-17 weeks); five patients died before consolidation. Patients returned to full weightbearing after 5 weeks (4-12 weeks); active knee motion ranged from 80 degrees to 130 degrees. In five patients slight malalignment < 10 degrees was radiographically assessed, with two showing incipient degenerative joint disease. Patients younger than 60 years returned to full preoperative activity level. Eleven patients surviving an average of 5.2 years (4.3-6.9 years) were available for long-term follow-up. As a subgroup they were evaluated according to the Leung score for distal femoral fractures with seven excellent and four good results and an average score of 84.3 points (70-92 points). The mid- to long-term results confirm retrograde femoral nailing to be a good alternative to plate osteosynthesis for AO 33 A- and C2-type fractures. In young patients (< 60 years) postoperative clinical performance was highly satisfying; however, the effects of postoperative hemarthros and anatomic malalignment on the cartilage surface remain major issues for further investigation.

Adolescent↗