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Biomedical subjects

M Postel

Publications and source records attributed to M Postel.

At least 55 records · Page 3Linked to original sources
PubMed1981

Capsular constriction of the hip: arthrographic and clinical considerations.

Orthodox radiological examination of patients presenting with disorders of the hip, usually on account of pain and limitation of movement, may vary in diagnostic value. As a supplementary study we have employed arthrography. During this procedure we have, since 1970, routinely assessed the capacity of the joint capsule. The normal capacity varies from 20 ml in a large adult male to 14 ml in a small adult female. Significant reduction of this volume has been observed as a secondary complication of certain organic lesions, including four cases of synovial chondromatosis, one case of an intra-articular loose body, and one case of osteoid osteoma of femoral neck. In these secondary cases, the only common feature visible on the plain film was regional osteopenia. In these patients symptoms persisted until adequate surgical measures had been performed. (Descriptive term proposed: secondary capsular constriction of the hip: SCCH). In another group of seven patients, in whom orthodox radiological studies were unrewarding, arthrography was undertaken on account of persistent pain and limitation of movement. Similar reduction in the capacity of the joint was found, but in each case spontaneous resolution of the symptoms took place, without surgical intervention, in periods varying from three to 18 months. This self-limiting syndrome appears to be analogous to that of the "frozen shoulder" and, like the latter, is associated frequently with barbiturism.

Adult↗
PubMed1981

[Total replacement of ankylosed hips (author's transl)].

31 patients were operated on using total hip replacement. Most of them had suffered an ankylosis of the hip in malposition, resulting in pain in the lumbar spine and knee. The average post-operative mobility was of 75 degrees of flexion. Stability returned to normal one year after operation. The pain in the lumbar spine was consistently improved, and could be completely relieved in cases without spinal arthrosis if it was of short duration. Pain in the knee was completely relieved in cases where the procedure restored a satisfactory bio-mechanical state. 29 patients were reviewed, of which 25 were satisfactory.

Adult↗
PubMed1981

[Acute chondrolysis following slipped capital femoral epiphysis. A study of 41 cases (author's transl)].

The authors have seen 41 instances of chondrolysis following slipped capital femoral epiphyses. Most of the cases were followed-up for more than five years. The main clinical features are reviewed. There is joint stiffness and generalised narrowing of the joint space during the year following the initial lesion. The evolution of the lesion is unpredictable. A number of possible radiological changes may develop including renewal of the joint space, modifications in the femoral head with a tendency towards protrusio, and osteophyte formation at the lateral margins of the acetabulum. In five cases a biopsy was performed which showed a non-specific dystrophy of the acetabular and femoral cartilage, with sub-chondral bony change different from that found in epiphyseal necrosis. The synovium did not show inflammatory change. The treatment should not be surgical at an early stage but the effectiveness of traction was uncertain. Later, corrective osteotomies may be indicated. Definitive surgical procedures such as arthrodesis or arthroplasty should not be made early because late clinical recovery has been noted. Cup arthroplasties gave deceptive results. The etiology of this disease is discussed.

Adolescent↗
PubMed1979

Clear-cell chondrosarcoma: a report of five cases including ultrastructural study.

Five cases of clear-cell variant of chondrosarcoma (Unni et al.) are reported. The tumors occurred in the epiphyseal region of long bones; three in the femoral head. Roentgenographically, the lesion was usually a well-defined and benign appearing one, either purely lytic (3 cases) or with central radiodensity (2 cases). Histologically, all five cases had areas of conventional chondrosarcoma; however, the greater portion of the tumor was made up of sheets of clear-cells intermixed with nonneoplastic bone trabeculae but devoid of chondroid matrix. Electron microscopic studies showed that these clear-cells possess cytoplasmic microvilli, abundant glycogen particles and prominent golgi complexes, like normal or tumorous chondroid cells usually have. In our experience, the best treatment seemed to be en bloc resection with joint replacement; indeed, despite the fact that they are true chondrosarcomas, these tumors usually have a very slow rate of growth.

Adolescent↗
PubMed1978

[Surgical treatment of osteoarthritis of the hip (author's transl)].

Surgery can improve function for one or more decades for patients with osteoarthritis of the hip, even though the operations may not be very invasive. The indications must be made by surgeons in collaboration with rheumatologists. There is no patent recipe, no 'common' intervention which gives a reliable result in all cases. The patient must be studied in all stages of development of his disease: his joint structure in the radiogram, the morphology of the bones, the functional requirements and his general state of health influence the decision regarding the possibility and modality of a surgical intervention. The patient's return to an active life which would not have been possible for him under medicinal treatment supports the importance of surgical treatment.

Adult↗
PubMed1978

[Clear-celled chondrosarcoma or chondroblastic sarcoma. A new type of chondrosarcoma (author's transl)].

The authors report five cases treated by wide resection. Pathological studies were made of the whole of the lesion. Three tumours were situated at the upper end of the femur, one at the upper end of the humerus and one at the level of the tibial plateau. The specific features were localisation in an epiphysis and histological areas of clear cells whose cytoplasm contained glycogen. From the anatomical and radiological points of view, these tumours were like chondroblastomata but their progress was more like that of chondrosarcomata. The author concludes that they should be distinguished from both types of tumour.

Adult↗
PubMed1978

[Correction of bowing in Paget's disease (author's transl)].

Thirteen tibiae and seven femora suffering from bowing due to Paget's disease have been streightened operatively. In the tibiae, the deformities were of metaphysial genu varum with bowing in the sagittal plane of an average of 30 degrees combined with some medial rotation. In the femora, the main curve was anterolateral with some medial rotation and coxa vara. Seventeen cases united uneventfully after osteotomy. In three cases, there were septic complications, union occurred after removal of the internal fixation. Bowing recurred in three cases. The recurrence appeared to be related to incomplete correction leading to persistent mechanical strain on bones affected by rapid bone turnover. Inadequate internal fixation may also be a factor. All other cases were functionally improved by correction. Oblique osteotomy is indicated for the correction of tibial deformity when there is moderate medial rotation. Transverse osteotomy with fixation by intramedullary nailing is indicated for correction of femoral deformities.

Aged↗
PubMed1978

[Surgical treatment of stiff knee following femoral sepsis and septic arthritis of the knee (author's transl)].

The authors have studied the results of attempts to restore joint movement in stiff knees after septic non-union of fractures of the femoral shaft or after septic arthritis of the knee by arthrolysis and quadriceps release. Fifteen procedures were done on fourteen patients with severe limitation of movements. The results were gratifying; eight very good and four good. No case was made worse. The technique is described in detail and operative and post-operative complications described. A long-term follow-up study showed that the results tended to improve after several years. The prognosis can be based on the degree of flexion obtained during operation, though free flexion should be distinguished from forced flexion. It is concluded that the procedures used are worthwhile in spite of previous sepsis.

Adolescent↗