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Biomedical subjects

O Russe

Publications and source records attributed to O Russe.

At least 19 recordsLinked to original sources

[Complications in the use of the halo fixator].

50 patients out of a total of 88 who underwent treatment using a halo-fixateur between 1987 and 1997 were available for a follow-up interview reviewing local complications and quality of life. Marginal discomfort was observed in 54% of patients, moderate complaints/transitory pain in 30%, prolonged and severe discomfort and pain in 16%. 62% of patients took no analgetics, 22% infrequently, and 16% continuously throughout treatment. In pin-tract infection local treatment was successful in 6 patients, in 3 patients the screws needed to be relocated. Complaints of dysphagia due to extended forced lordosis of the cervical spine could be corrected by adjusting the position of the halo ring in 3 out of 8 patients. 3 patients developed pressure sores which could be managed without surgical intervention. Proper fixation and placement of the pin-tracts are crucial in the application of the halo fixateur if complications are to be avoided. Superficial infections must be treated locally. If the infection persists immediate pin relocation and systemic antibiotic therapy have to be initiated.

Adolescent↗

Management of odontoid fractures in the elderly.

Odontoid fractures are frequent in patients over 70 years of age, and in patients over 80 years of age they form the majority of spinal fractures. In a retrospective analysis of 23 geriatric (> 70 years) patients with a fracture of the odontoid, we compared some of the clinical features to a contemporary series of patients younger than 70 years of age. Whereas in the younger patients high-energy trauma accounted for the majority of the fractures, low-energy falls were the underlying cause in 90% of the odontoid fractures in the elderly. In contrast to the younger age group, in elderly patients predominantly type II fractures (95%) were identified. Anterior and posterior displacement were recorded with equal frequency on the first postinjury radiograph in the younger age group, whereas in geriatric patients displacement was mainly posterior. The number of associated injuries was significantly higher in younger patients. There was no difference in the occurrence of neurological deficits (13%) between the two age groups, and neurological compromise was mainly related to posterior dislocation of the odontoid in both groups. The overall complication rate was significantly higher in elderly patients (52.2% vs 32.7%), with an associated in-hospital mortality of 34.8%. Loss of reduction and non-union after non-operative treatment, a complicated postoperative course and complications due to associated injuries accounted primarily for this high complication rate. Elderly patients with a fracture of the odontoid are a high-risk group with a high morbidity and mortality rate. An aggressive diagnostic approach to detect unstable fractures and application of a halo device or early primary internal stabilisation of these fractures is recommended.

Adolescent↗

[Accident-induced pseudarthroses of the dens axis. Etiology, follow-up and therapy].

In a retrospective analysis the significance of internal fixation of unstable and symptomatic non-union of the odontoid was evaluated. In all but one cases a type II fracture of the odontoid was the underlying cause for the pseudarthrosis. The time interval between trauma and definitive diagnosis varied between 6 months and 30 years. All patients asked for medical advice because of acute neck pain; in three cases additional neurological deficits were notified. In all but one case the pseudarthrosis was classified as unstable on flexion-/extension views. The occurrence of neurological deficits showed a positive correlation with the amount of dislocation of the pseudarthrotic odontoid. Nine out of 10 patients underwent internal stabilisation of the non-union. Reoperation because of persistent instability/failure of stabilisation had to be performed in two cases (22.2%). At follow-up all 9 patients were pain-free. The neurological deficits in two patients had improved significantly. According to our experience internal stabilisation in unstable non-union of the odontoid is recommended to achieve significant reduction of the pain level. Also improvement of the neurological deficits can be expected depending on the duration of the symptoms.

Adolescent↗

Playground accidents.

To study the causes and sequelae of playground accidents we analysed, in a retrospective study, 374 playground accidents. Questionnaires were sent to the parents and 103 parents (28%) provided detailed information on the playground accidents of their children. Thirty-one percent of the children injured in playground accidents sustained fractures of the extremities or concussion of the brain. Swings, slides, climbing frames, metal bars and merry-go-round accidents accounted for 71% of the 338 playground equipment-related accidents, whereas 36 accidents (10%) occurred without the use of playground equipment. The majority of these accidents were caused by children fighting. Rope-plank-type swings were frequently involved in backward falling accidents and 86% of the slide accidents were fall accidents. Climbing frames should not be taller than 1.6 m. Further efforts are mandatory to create and maintain playgrounds which help children develop their skills with a minimal risk to injury.

Accident Prevention↗

[The recognition of osteofibrous dysplasia Campanacci. Morphology, radiology, clinical picture and therapy].

Radiologically osteofibrous dysplasia of the tibia is characterized by an eccentrically localized osteolytic lesion in the diaphysis with the appearance of ground glass. However, this is a very rare lesion, making a correct diagnosis difficult, especially since fibrous dysplasia and adamantinoma of the tibia have to be taken into account in the differential diagnosis of the disease. A definitive diagnosis can only be made histologically. The rather aggressive growth pattern of osteofibrous dysplasia as compared to fibrous dysplasia that has been reported in literature should not be generalized and it must be taken into consideration that surgery may be performed too early during the growth phase.

Child↗

[Complications after surgical management of scaphoid pseudarthroses].

The Matti-Russe technique yields a 95% success rate in treating scaphoid non-unions diagnosed in the first years after trauma and without osteoarthrosis of the radiocarpal joint. Between October 1981 and December 1989, 215 patients were treated by Matti-Russe procedure at the University Hospital of "Bergmannsheil" Bochum. In ten cases, this operation did not lead to osseous consolidation. The results are presented and discussed.

Bone Transplantation↗

[Dorsal fixation of the thoracic and lumbar spine with grooved plates in combination with the Universal Spine Instrumentation System. A short stretch, angle-stable alternative].

In the Department of Surgery in the University Hospital "Bergmannsheil" in Bochum, 67 patients with unstable injuries of the thoracic and lumbar spine were analyzed in a retrospective study. The sagittal correction loss was greatest about 6 months after dorsal stabilization--6 degrees on the average--after stabilization with a plate alone. The correction loss after stabilization with plates combined with the Universal Spine Instrumentation System (USIS), which was developed for ventral derotational spondylodesis or after implantation of an internal fixation device, however, amounted to 3 degrees on the average. The clinical results show that by combining the plate and USIS the injuries can be stabilized for short stretches and without correction loss. The main advantage of this combination over internal fixation is the smaller amount of metal used, which means the soft tissue in loss compromised and there is a possibility of fitting the implant more directly. In 10 patients (15%) the implants broke at the place of maximum shear stress between 4 and 8 months postoperatively after consolidation of the fracture and without spoiling the result. This occurred equally often with all types of implants. Efficient use of the three systems is discussed with regard to the different pathomechanical modes of injury. A causative scheme of treatment is presented.

Adolescent↗

Intermittent catheterisation versus percutaneous suprapubic cystostomy in the early management of traumatic spinal cord lesions.

Spinal injury patients initially treated by intermittent catheterisation (IUC) and those who received a fine-bore suprapubic catheter (SPC) have been reviewed. The results show that fine-bore suprapubic catheterisation seems to be superior to intermittent catheterisation because the rate of urinary tract infections is significantly lower in the SPC-group (50%) than in the IUC-patients (71.9%), and the first infecting organisms in the SPC-group differ from those in the IUC-group and are much more easily treated by antibiotic therapy.

Adolescent↗

[Standard operative technic in fresh fractures of the thoracic and lumbar vertebrae].

Undesirable sequelae of spinal column injuries are chronic instabilities and decompensated axis shifts. If a poor functional result can be expected after the initiation of conservative treatment, indication for surgery should be considered as early as possible. The authors describe a surgical technique which can be employed both in emergencies and electively on account of its standardization; it consists of dorsal repositioning manoeuvres that result in short-distance fusioning of the spinal column to achieve stable functioning. However, repositioning via the dorsal approach can be effected with maximum success only if it is done within the first 10 to 14 days.

Bone Transplantation↗