Biomedical subjects

J Poul

Publications and source records attributed to J Poul.

At least 37 records · Page 2Linked to original sources

PubMed1992

Early diagnosis of congenital dislocation of the hip.

In this prospective study, 35,550 neonates were examined shortly after birth by a team of orthopaedic surgeons. They diagnosed 775 unstable or dislocated hips in 656 babies; there were two teratological dislocations. Treatment was first with a Frejka pillow and, if this failed to give a normal hip, a Pavlik harness at three months. Early clinical examination did not identify 21 infants who were found to have subluxation or dislocation of the hip at the three-month review. The number of missed cases declined during the study, however, reflecting the increasing experience of the examiners. One case of avascular necrosis occurred in the group treated from birth and one in the late-diagnosed group. Open reduction was necessary only in the two teratological dislocations. Experienced examiners are needed for accurate clinical diagnosis; and treatment should be started before the baby is discharged from the maternity ward.

Czechoslovakia↗

PubMed1991

[Neonatal osteomyelitis is still a reality].

The authors draw attention to the fact that it is essential to consider osteomyelitis of children under 1 year as a separate nosological unit with regard to the anatomical features of the vascular supply of epimetaphyses. The authors discuss the diagnostic difficulties. In addition to the basic examination they emphasize also the importance of whole-body scintigraphy and examination by ultrasound. They indicate surgery where clinical symptoms do not recede within 24-48 hours after the onset of antibiotic treatment and where on probatory puncture pus is revealed and if during establishment of the diagnosis the X-ray finding is already positive. As to antibiotics they use Oxacillin first. The authors evaluate the results of treatment of 25 neonates after a 2-10-year interval following the onset of the disease. The process was found most frequently in the proximal and distal metaphysis of the femur (56%) and in the proximal metaphysis of the tibia (24%). They operated 18 patients in the acute stage (72%). Staphylococcus aureus was cultivated in 60% from pus and in 50% from haemocultures. The authors found a satisfactory state in 17 patients (68%) and an unsatisfactory one in 8 patients (32%).

Female↗

PubMed1990

[Clinical and ultrasonic diagnosis of congenital hip dislocation (dynamics of changes in early therapy)].

The authors present part of their prospective epidemiological study of congenital dysplasia of hip joints within which newborns were examined by ultrasonogram prior to the beginning of the therapy. Apart from the standard examination in the frontal plane after Graf they examined on principle also the ultrasonographic stability by the dynamic test after Schuler as well as by the application of the probe anteriorly with the simultaneous provocation according to Palmén. The authors have processed pathological ultrasonographic findings in 53 newborns (64 hip joints). The technique of the examination by ultrasound from the anterior approach is explained in detail. The comparison of both dynamic tests has shown that the examination from the anterior approach is considerably more sensitive than Schuler's dynamic test and also fully correlates with the clinical finding. It is a fact that the shift of the head in the flexion dorsally represents the most important component of the movement in unstable hip joint during provocation, it is far more noticeable than the lateralization of the head or the shift in the cranial direction. After achieving ultrasonographic stability the classical Graf method is sufficient for the registration of residual changes on the acetabular rim. The follow-up of patients until their complete healing has shown a surprisingly rapid remodellation of hip joints. The whole complex of clinically unstable hip joints has been divided into subgroups according to Graf classification. In type IIc or IId on the basis of ultrasonographic examination from the anterior approach the stable joints from the ultrasonographic viewpoint have been distinguished from unstable ones. The follow-up carried out in short intervals has shown that of longest duration is the remodellation of total dislocation and, on the contrary, of shortest duration is the healing of joints in the IIc or IId type. An absolute majority of affected hip joints have become normal until 3rd month of the age. The complex does not include two patients with teratological dislocation, the incidence of which has been determined in our study by the ratio of 2 cases in 35,550 of timely examined newborns. The role of the factor of spontaneous stabilization cannot be in this part of the study completely discounted. However, herewith we present part of an accomplished epidemiological study where the number of timely diagnosed patients including late diagnoses corresponds to the number of dislocations and subluxations determined within the conventional late diagnosis.

Female↗

PubMed1987