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Biomedical subjects

P Patka

Publications and source records attributed to P Patka.

At least 19 recordsLinked to original sources

Vascular injury from external fixation: case reports.

The incidence of vascular injury from external fixation of fractures was studied retrospectively in two surgical departments during the period 1985-1990. A total of 1231 fractures of the lower limb were treated. External fixation was used in the initial stabilization of 28 femoral and 93 tibial fractures. In this series of 121 fractures four iatrogenic vascular injuries were seen: two arterial thromboses with distal ischemia and two incidents of the formation of a false aneurysm with bleeding along a pin. The diagnosis was made by angiography. Surgical intervention was necessary in all four cases. In one patient the injury resulted in amputation of the distal portion of the foot.

Adult

Retrosternal dislocation of the clavicle.

Retrosternal dislocation of the clavicle is an uncommon injury which may affect the mediastinal structures in a life-threatening way. Therefore, computed tomography is mandatory. Manipulation in the acute situation is the treatment of choice. In case of failure or old dislocation, open reduction with stabilization of the joint is required. The literature on this subject has been reviewed and an additional two cases are reported.

Adult

Plasma-sprayed coatings of tetracalciumphosphate, hydroxyl-apatite, and alpha-TCP on titanium alloy: an interface study.

In order to study the interaction of calcium phosphate coatings with bone tissue, coated titanium cylinders with a standard size were implanted in dog femora. Coatings were made by plasma spraying powders of hydroxylapatite, beta-whitlockite, and tetracalciumphosphate particles. The plasma spraying process turns beta-whitlockite into alpha-TCP. Bone bonding and bone formation were evaluated by mechanical push-out tests and histological observations. Hydroxylapatite and tetracalciumphosphate coatings show an interface strength after 3 months of implantation of 34.3 +/- 6.5 MPa and 26.8 +/- 3.9 MPa, respectively, while alpha-TCP and blanco titanium lead to an interface strength of 10.0 +/- 3.5 MPa and 9.7 +/- 1.3 MPa, respectively. Histological examinations revealed that hydroxylapatite and tetracalciumphosphate give rise to an excellent bone formation, while alpha-TCP and blanco titanium evoked remodeling and less bone contact.

Alloys

Macroporous calcium phosphate ceramics for bone substitution: a tracer study on biodegradation with 45Ca tracer.

The value of artificial materials in bone replacement depends highly on their biocompatibility and biostability. Porous calcium phosphate ceramics have a good compatibility with natural bone. To study the biodegradation process of calcium phosphate bioceramics, labelled [45Ca]-beta-whitlockite and [45Ca]-hydroxyapatite were implanted in the femurs of dogs. The effects accompanying the ingrowth of new bone into the pores of these bioceramics and its replacement by natural bone were investigated. In vivo degradation of the implant material by biochemical dissolution processes was observed. The beta-whitlockite implants showed a conspicuous decrease in radioactive calcium, in contrast to the hydroxyapatite implants. 45Ca was absent in adjacent bones and locally newly formed bone in both beta-whitlockite and hydroxyapatite suggesting a restricted availability of the 45Ca liberated in these processes. Indications of minor mechanical degradation of the materials were also found; in the lymph nodes a very small amount of 45Ca with a high specific activity was detectable. Urine, blood or faeces contained no detectable amounts of 45Ca activity.

Animals

[The effect of flurbiprofen in acute ankle distortions].

The efficacy of flurbiprofen was studied by means of a double-blind randomized clinical trial involving 50 patients with an acute lateral ankle distortion (grade I). It could not be demonstrated that the NSAID shortened the duration of convalescence after this injury. Neither the pain nor the swelling showed a statistically significant decrease. Side effects were more frequent in patients treated with flurbiprofen. In view of these findings use of flurbiprofen in the treatment of acute ankle distortions is to be regarded as inadvisable.

Adolescent

Macroporous calcium phosphate bioceramics in dog femora: a histological study of interface and biodegradation.

This study examines the biodegradation behaviour of calcium phosphate macroporous bioceramics consisting of hydroxylapatite or beta-whitlockite implants. The implantations were performed in hard tissue of femora and muscular tissue of dogs for periods of 6 and 12 month. With microradiography and light microscopy, respectively, of ground and thin sections it was shown that hydroxylapatite remained unchanged and beta-whitlockite degraded within 6 month in bone tissue. In the muscular tissue, the biodegradation of beta-whitlockite was slower. In addition, beta-whitlockite gave rise to a cellular response of lymphocytes and plasma cells rather than hydroxylapatite in the soft tissue region. For tissue response hydroxylapatite is more suitable as an implant material than beta-whitlockite.

Animals

Results of dynamic hip-screw osteosynthesis for intracapsular fractures of the femoral neck.

Dynamic hip-screw osteosynthesis was carried out in 121 patients with fractures of the proximal femur and intracapsular fractures of the femoral neck. Five patients died (4%). The mean age of the 121 patients was 66.4 years, in the subcapital fracture group of 48 patients, the mean age was 58 years. In the 48 patients, treated for an intracapsular femoral neck fracture, good functional results were achieved in 36 patients (75%). Partial femoral head necrosis was seen in six patients. Fast and proper anatomic reduction and dynamic fixation with a central positioned hip-screw (sliding nail) for intracapsular femoral neck fractures, result in good fracture healing with a low incidence of segmental femoral head necrosis.

Adolescent

Immediate or delayed operative treatment of fractures of the ankle.

This study presents the results of the treatment of 92 unilateral fractures of the ankle. Of these, 72 patients were operated on immediately after the injury and 20 patients had delayed operations. Both groups are comparable in age, injury, fracture type and treatment. From the results it can be concluded that delayed open reduction and internal fixation 5-8 days after injury will give similarly good functional results. However, postoperative immobilization and the time spent in hospital by patients treated by delayed operation is significantly longer.

Adult

Magnetic resonance imaging of meniscal lesions of the knee.

In a prospective study of 25 patients, magnetic resonance imaging (MRI) was employed to detect meniscal tears in the symptomatic knee. All patients underwent arthroscopy and 21 underwent double contrast arthrography. When correlated with these two diagnostic procedures MRI produced no false negative results. There were, however, six false positive MRI findings all of which related to the posterior horn of the medial meniscus. MRI appears to be reliable in detecting meniscal tears but long examination times continue to limit its clinical usefulness.

Adolescent

Fractures of the sternum.

The records of 71 patients treated for sternal fracture were reviewed: 52 patients sustained isolated sternal fracture, 19 patients had a sternal fracture in combination with multiple other injuries, with in 12 patients only rib fractures. Forty-one patients were involved in a car accident, 29 of them used safety belts. Three patients (3/71, 4%) died, two multitrauma patients, in whom artificial ventilation was necessary, died of multiple organ failure. One patient with a sternal fracture and bilateral multiple rib fractures died of cardiac contusion and myocardial infarction. Three patients (3/71, 4%) showed signs of myocardial contusion. The morbidity in the patients with an isolated sternal fracture was very low. The prognosis of an isolated sternal fracture is good. Cardiac contusion was an uncommon complication of sternal fracture. Clinical observation for only a short period is advised.

Accidents, Traffic

Treatment of fractures of the shaft of the humerus accompanied by paralysis of the radial nerve.

This paper reports the results of treatment of 17 patients with fractures of the shaft of the humerus accompanied by paralysis of the radial nerve in a series of 111 patients with fractures of the shaft of the humerus. In early operative explorations in 14 cases the radial nerve appeared undamaged in 13 cases. In cases where spontaneous recovery of the function of the radial nerve failed to occur, no evidence has been found that the delay in exploration influenced eventual motor recovery. The high incidence of undamaged nerves at exploration suggests that a conservative approach by collar and cuff or Sarmiento bracing is justified in such cases of fractures of the shaft of the humerus. Paralysis of the radial nerve associated with fractures of the shaft of the humerus is, in our opinion, not an indication for early operative treatment.

Adolescent

Treatment of complicated or infected pilonidal sinus disease by local application of phenol.

This article reports on the results of conservative treatment of 48 patients with complicated pilonidal sinus disease. The treatment consisted of an injection of phenol 80% into the sinus tract after the patients had undergone depilation and excavation while under local anesthesia. The number of phenol injections in each patient varied from one to nine (mean: two injections). Patients were considered cured if no signs of recurrent pilonidal sinus disease occurred within 1 year after treatment. The mean follow-up period after cure was 3 years (range: 1 to 6 years). The recurrence rate was 6.3% (a 95% confidence interval of 1.3% to 17.2%), which was one of the lowest reported for different methods of treatment for pilonidal sinus disease. The good results in this study justify continuation of conservative treatment of pilonidal sinus disease, especially in view of the low costs and the high degree of patient comfort. Sclerosing therapy with phenol is thus recommended as a successful treatment for complicated pilonidal sinus disease.

Abscess

Shoulder injury caused by electric shock.

Shoulder injury and more in particular bilateral dislocation of the shoulder joint after electric shock is rare. Three patients are presented with dislocation and fracture of the shoulder and serious muscle contraction. After an accident involving electric current potential shoulder injuries should be considered. Early diagnosis improves the functional results of adequate treatment.

Adult