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Biomedical subjects

H Towfigh

Publications and source records attributed to H Towfigh.

27 records · Page 2Linked to original sources
PubMed1981

[Isolated trapezium dislocation fracture after a serious traffic accident].

Fractures and luxations in the area of the carpal bones are in comparison with other fractures of the upper and lower extremities comparatively rare. Isolated fractures of luxations of the distal row of the carpal bones, by comparison with those of the proximal row, are still rarer incidents. Because of tight ligamentous unions between the carpal bones on the one hand and between the distal row of the carpal and the metacarpal bones on the other hand, a luxation or fracture is connected with a violent contusion or sprain. In the case of seriously or multiply injured persons the carpal injuries might be failed to be noticed. This may also occur in the case of insufficient auxiliary diagnostic measures. Crush-fractures as well as irreducible luxations should be immobilized by combination of adaptation-osteosynthesis and external fixation. An example is presented of an isolated fracture-dislocation of the trapezium after violent multiple trauma, with healing of the trapezium by adaptation-osteosynthesis and plaster immobilisatioi. The function was recovered after 10 weeks.

Accidents, Traffic↗
PubMed1980

[Primary repair of soft tissue injuries (author's transl)].

The primary treatment of an injured hand has great influence on later results, and also on secondary measures in reconstruction. In contrast to adults, children show a good healing of distal-pedicle flaps, after removal of fat and sparing the subdermal plexus. The choice of skin replacement must be made under careful consideration of site, function and the possibility of further measures for rehabilitation. Where several structures in the child's hand are injured, good results can be attained by combining an adaptation-osteosynthesis with Kirschner wires, and a plaster cast. Several cases are demonstrated, with examples.

Child↗
PubMed1980

[Severe necrotic inflammation after human bite injuries].

Human bites are highly infected wounds and must, therefore, be treated either under hospitalization or strict and regular ambulatory control. An X-ray should be taken to detect any foreign body or pathological bone changes. Exact bacteriological sampling for aerobic as well as anaerobic bacteria, surgical wound toilet, immobilisation of the extremity and the application of combined broadspectrum antibiotics are necessary measures. Surgical debridement should take place under regional or general anaesthesia and tourniquet. In neglected cases it may be necessary to sacrifice a fingertip or even an entire finger to prevent excessive and uncontrolled spread of the infection to the neighboring tissue.

Adult↗
PubMed1978

[Results of enteral antibiotic preparation prior to colon surgery].

Of the 108 patients explored, all received four days preoperatively dietary and mechanical preparation and were given one of the two antibiotic combinations according to their date of birth (58 patients, group I--Neomycin-Bacitracin; 50 patients, group II--Cephaloridin-Colistinsulfate). Bacteriologic studies of stools from the day before beginning of preparation, preoperatively and from the day of operation (intestinal mucous membrane of 70 patients) revealed that the fecal flora of the majority of the patients was abnormal. After antibiotic treatment the bacteriologic studies of stools showed a significant reduction of bacteria. In group II, full asepsis was reached in 42.4% of patients, in group I, in only 13.5%. The price of antibiotics and the preoperative intestinal bacteria should be used as criteria in choosing the preparation for colon operations.

Anti-Bacterial Agents↗
PubMed1976

[Effectiveness of antibiotic premedication in colonic surgery].

The value of preoperative bowel preparation with antibiotics in colon surgery was studied in a prospective randomized trial: 58 patients received only mechanical and dietary preparation and 50 patients were treated additionally with a combination of neomycin and bacitracin 4 days preoperatively. Bacteriologic studies of stools from the day before beginning of preparation and from the day before surgery which were done quantitatively per 1 gram stool revealed that the fecal flora of 90% of the patients with colonic disease is abnormal. After antibiotic treatment a significant reduction of Escherichia coli, Bacteroides, Bifidus, Clostridium, and Proteus was obtained in more than 70% of the patients. The effect on Klebsiella was poor. Candida were increased in 86% of the cases without resulting in a systemic candida infection. In the stool samples of 16 patients no bacteria were found after antibiotic treatment. If there was a high bacterial count in the preoperative stool infectious complications followed postoperatively. The rate of infectious complications was 28 (48.7%) in the control group and 7 (14%) in the antibiotic group. This significant lower rate of complications speaks in favor of preoperative bowel preparation with neomycin and bacitracin, especially in the absence of adverse side-effects.

Anti-Bacterial Agents↗
PubMed1975

[The postoperative vomiting after pyloromyotomie (author's transl)].

Following pyloromyotomy vomiting may persist for several hours or days in a high percentage of children due to a loss of gastric tone. If this is the suspected cause the feedings must be adjusted individually. Other causes for postoperative vomiting are incomplete pyloromyotomy and surgical complications, associated anomalies of the gastrointestinal tract and nonsurgical diseases. A correct diagnosis can usually be made by the assessment of the beginning and the type of vomiting and the other symptoms. To shorten the period of hospitalization is advantageous for decreasing the occurrence of additional diseases.

Child↗
PubMedDate not supplied

[The treatment of deep hand infections].

Thirty patients with deep infections of the hand presented between 1982 and 1986 in our Department of Traumatology. Twenty infections were caused by neglected cut- or stab-wounds or animal bite injuries. Mostly Staphylococci or Streptococci were isolated from the wound culture. Only twelve patients could be operated upon ambulatory basis. Postoperative treatment was necessary for more than two months in half of the patients. The patients had a moderate or severe diminution of hand function. All cut- or stab-wounds and human or animal bite injuries of the fingers and hand must be considered as infected wounds. In patients with deep hand infections, surgical debridement and exploration should be performed urgently. Postoperative daily cleaning of the wound, washing out of the infected tendon sheath and passive mobilization of the fingers should be done. The active mobilization starts when infection is regressed and is continued for several weeks. Nevertheless we have to accept a significant loss of hand function in many patients.

Adolescent↗
PubMedDate not supplied

[Carpal tunnel syndrome].

The carpal tunnel syndrome is the most frequent entrapment syndrome of peripheral nerves. Either a diminution of the volume of the whole carpal tunnel or increasement of the intracarpal structures can enhance the pressure on the median nerve and so develop a carpal tunnel syndrome. Fibrosis or thickening of the synovia of the wrist joint is the most common cause of the syndrome, that appears usually in women more than 50 years old. Irradiating pain and sensory disturbances are the most frequent subjective complaints. Motoric changes appear in a minority of patients with the syndrome. The operative procedure is done ambulatory with brachial plexus anesthesia. The subcutaneous 'ramus palmaris nervi mediani' should be treated carefully when releasing the transverse ligament. After a mean time of 24.1 months, 28 of carpal tunnel syndromes treated operatively had a significant amelioration. Seven patients had recurrent sensible or motoric complaints, one of them was operated on a second time. Postoperative recurrent carpal tunnel syndrome mostly is due to inadequate technique or fibrous proliferations.

Adult↗