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Biomedical subjects

M Salai

Publications and source records attributed to M Salai.

At least 37 records · Page 2Linked to original sources
PubMed1999

Preoperative angiography and embolization of large pelvic tumors.

BACKGROUND AND OBJECTIVES: Pelvic tumors are often large and difficult to excise with appropriate surgical margins due to their size, proximity to neurovascular structures, and major intraoperative bleeding. The purpose of this study is to evaluate the yield of preoperative angiography and embolization so as to facilitate achievement of good surgical results. METHODS: Eighteen patients who suffered from large pelvic tumors (average size, 10.7 cm x 8.3 cm x 3.7 cm), 15 primary and 3 metastatic, underwent surgery at our institution between 1990 and 1995, after preoperative angiography and embolization of the tumors. RESULTS: The efficacy of the procedure was high. In all but one patient, the grade of vascularity of the tumor was reduced by at least two levels (based on our new tumor vascularity scale. In most patients, appropriate surgical margins were achieved. The average perioperative blood loss was only 750 cc. Procedure-associated complications were negligible. CONCLUSIONS: The results of this study call for the use of angiography and embolization in the management of patients with large pelvic tumors.

Angiography↗
PubMed1999

Revision hip arthroplasty in patients with a history of previous malignancy.

BACKGROUND AND OBJECTIVES: The potential association between implants and malignancy has been discussed in the literature, but never as a cause of loosening of joint arthroplasty. METHODS: The records of all patients who underwent revision arthroplasty at our institution between 1992 and 1995 were reviewed. RESULTS: Among 93 patients who underwent revision hip arthroplasties, 11 (11.8%) had a history of previous malignancy. At surgery, in 2 of these patients, metastasis was found to be the cause of loosening in the affected hip. CONCLUSIONS: When revision hip arthroplasty is considered, patients with a history of malignancy require attenuated pre-, intra-, and postoperative workup. Management algorithm in such cases is proposed.

Aged↗
PubMed1999

Primary reconstruction of traumatic bony defects using allografts.

We retrospectively reviewed 207 patients suffering from traumatic bone defect who had been treated at our institution between 1973 and 1993. Three types of traumatic bone defects were identified: I, minor; II, major cortical; III, major articular. Each type was further subdivided into: A, open injury; B, closed injury. The proposed treatment modality of each type was included within each classification. Types II and III posed the greatest difficulties in management. However, massive bone allografts can be successfully used in these situations, even in the early phases of treatment, but only given specific prerequisites.

Accidental Falls↗
PubMed1999

Hydatid cyst presenting as a soft-tissue thigh mass in a child.

We report a rare case of intramuscular hydatid cyst in a boy who presented clinically as having a soft-tissue thigh mass. A high level of awareness concerning the occurrence of these cysts is important, especially in regions where Echinococcus is endemic. Surgical treatment follows the principles of malignant tumour, namely, wide surgical resection.

Adolescent↗
PubMed1999

Effect of changing the saddle angle on the incidence of low back pain in recreational bicyclists.

OBJECTIVE: According to the literature, 30-70% of cyclists suffer from cervical, dorsal, or lumbar back pain. This study was conducted to evaluate one of the possible causes of low back pain and to suggest a solution by appropriate adjustments to the bicycle. METHODS: Serial fluoroscopic studies were performed while cyclists sat on different types of bicycle (sports, mountain, and city). Pelvic/spine angles were measured at different seat angles, and the related force vectors analysed. RESULTS: There was a tendency towards hyperextension of the pelvic/spine angle which resulted in an increase in tensile forces at the promontorium. These forces can easily be reduced by appropriate adjustment of the seat angle--that is, by creating an anterior inclining angle. The findings of the biomechanical analysis were then applied to a group of cyclists who were members of a cycling club and who complained of low back pain. After appropriate adjustment of the saddle angle, most of the cyclists (>70%) reported major improvement in the incidence and magnitude of their back pain. CONCLUSIONS: The incidence and magnitude of back pain in cyclists can be reduced by appropriate adjustment of the angle of the saddle. It is important that these findings be conveyed to cyclists, bicycle salesmen, trainers, and members of the general public who engage in cycling, in order to decrease the prevalence of back pain.

Adult↗
PubMed1999

Twenty-five years of clinical experience with bone banking in Israel.

BACKGROUND: Bone banking and the clinical use of banked tissue are the most common forms of allopreservation and transplantation in modern medicine. OBJECTIVES: This article reviews 25 years (1973-98) of experience in bone banking in Israel. METHODS: A nationwide survey on the clinical application of the banked musculoskeletal tissues during 1996 was conducted by means of a written questionnaire sent to all orthopedic departments in Israel. RESULTS: The response rate to the questionnaire was 84%. A total of 257 cases were allocated bone allografts: the majority comprised 225 spongy bones, 26 were massive bone allografts and 6 were soft tissue allografts. CONCLUSION: Improvement of quality control and quality assurance of the banked tissues, together with development of skills in the use of osteoinductive and osteoconductive materials, cast the future of musculoskeletal tissue banking.

Bone Banks↗
PubMed1998

[Closed intramedullary nailing of forearm fractures in young patients].

Forearm bone fractures are commonly the result of falling on the outstretched hand or of direct injury. The preferred treatment is debated. The possible modalities are: application of a cast, often necessitating repeated manipulations; open reposition and fixation by plates and screws; or closed manipulation and closed intramedullary nailing. We present our favorable results in treating these fractures in young patients by closed intramedullary nailing, and compare them with the unfavorable results of this method in mature adults.

Adult↗
PubMed1997

[Orthopedic ward policy in introduction of new types of total hip implants].

The use of different types of total hip implants in medical centers in Israel was surveyed. Questionnaires were sent to all orthopedic ward directors in Israel requesting information on the number of total hip arthroplasties performed between the years 1984-1993, the types of implants used, and whether attending physicians or residents perform the operations. 22 of 24 orthopedic wards responded but 1 ward was excluded because only the results for 1993 were reported. 5 wards reported more and 16 fewer than 50 operations a year. 15 different types of implants were in use in Israel in that period, and in 5 wards 5 or more types of implants were used. Only 1 of the wards performed more than 50 operations a year. We conclude that the indiscriminate use of multiple technologies in wards performing few operations can lead to the long "learning curves" previously associated with poor results. Orthopedic surgeons should resist the impulse to introduce new implants, thus improving results and lowering expenditure. The need for regulating the introduction of new implants is emphasized.

Arthroplasty, Replacement, Hip↗
PubMed1997

[Multidisciplinary approach to the treatment of musculo-skeletal tumors].

Tumors of the musculoskeletal system are relatively rare. They occur mostly in the young, while in older age groups metastases and myeloma are more prevalent. Treatment has undergone major change in the past 20 years with the introduction of neoadjuvant treatment protocols. According to recent reports 5-year survival rates have increased from 20% to 60-70%. These new protocols involve the use of modern imaging modalities, immunohistochemical pathological analysis and improved surgical technics. This has required establishment of multidisciplinary teams of experts to escort the patient through all the steps of current treatment.

Bone Neoplasms↗
PubMed1997

Massive bone allografts in the treatment of pathologic fractures due to bone metastases.

BACKGROUND AND OBJECTIVES: Pathologic fractures due to disseminated metastases are common and often involve major long bones, where the metastasis is responsible for wide bone erosion that is equivalent to major bone loss. Stabilization of these fractures necessitates tumor excision and reconstruction of the destructive metastatic process. METHODS: Massive allografts were used either as intercalary or "composite" grafts (allografts and regular prostheses) in 17 patients. RESULTS: Fourteen patients could ambulate independently after surgery, and nursing of the remaining three became feasible and less painful. CONCLUSION: In the event of pathologic fractures due to metastatic bone diseases associated with major bone involvement, massive bone allografts offer an inexpensive, adjustable, simple, solution.

Adult↗
PubMed1997

The "learning curve" of total hip arthroplasty.

Total hip arthroplasty (THA) is one of the major breakthroughs in modern orthopedics this century. Since its introduction in the early 1960s by Sir J. Charnley, it has become the most common form of arthroplasty. The art of performing THA has developed to a large extent, yet with the inevitable "price" of a learning curve. The rates of early and late complications reported in the orthopedic literature have been decreasing gradually, along with improved short- and long-term results. We report the results of two similar series of THA performed with an interval of 15 to 20 years, which show that the improvement of the results that form the learning curve of THA at our institution is statistically significant.

Aged↗