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Biomedical subjects

R Verdonk

Publications and source records attributed to R Verdonk.

At least 73 records · Page 4Linked to original sources
PubMed1994

Treatment of unstable fractures, dislocations and fracture-dislocations of the cervical spine with Senegas plate fixation.

The results of the anterior approach to the cervical spine for the treatment of fractures and dislocations by arthrodesis and Senegas plate fixation are described. Twenty-two patients underwent a one- or two-level arthrodesis of the cervical spine. Their mean age was 42 years. The injuries were subdivided using the radiological classification described by Harris. In the group of patients who presented with a complete neurological deficit below the level of injury, there was only one patient who deteriorated. X ray examination 1 year after surgery showed fusion in 17 patients (100%). In contrast to some recent cadaveric and animal studies in which the anterior approach and fixation were found to be less stable than posterior fusion, our results obtained with this method are excellent, despite the fact that post-operative immobilization was limited. Problems with the anterior approach did not arise in these 22 patients. Alignment was always acceptable and fusion was achieved within one year in all cases.

Adolescent↗
PubMed1994

[Viable meniscus transplantation].

The integrity of the semilunar cartilages has proved to be the best safeguard against mechanical degenerative changes. One can postulate that restoring normal congruency between the femur and tibia with intact menisci would be the ideal solution to many mechanical knee problems. Several semilunar cartilages have been transplanted with good functional results in medial and lateral compartmental meniscal disease. However, this form of chondroprotection in the load-bearing area of the femur and tibia can only be properly evaluated after 10 to 20 years of follow-up. In order to obtain functional results, meniscal allografts have to be incorporated in the knee joint by intimate meniscofemoral synovial bonding. The synovial fibroblasts must grow into the collagen meshwork of the meniscal allograft. Such ingrowth has been shown in freeze-dried and deep-frozen meniscal allografts. However, in a small number of transplants shrinking has been observed on repeat arthroscopy at 6 months. Satisfactory incorporation of meniscal allografts has been obtained with fresh allografts, but availability remains a problem when this method is used for meniscal substitution. For this reason viable meniscal allograft implantation was initiated in a series of 25 patients and the value of this method studied. The meniscal allograft can be kept in an adequate semisynthetic nutrient medium for approximately 2-3 weeks without apparent loss of viability, during which period the appropriate recipient can be selected and prepared, a thorough laboratory screening can be conducted, and the culture results and disease transmission factors can be evaluated. In this way, live transplant hazards can be avoided, resulting in a higher success rate.

Adult↗
PubMed1993

Treatment of tibial shaft fractures by interlocking nailing.

Between 1982 and 1986, 60 tibial shaft fractures were treated by interlocking nailing. Of these, 10 were complicated by a pseudarthrosis. The results were assessed after a minimum follow-up of 2 years and were found to be good both in patients with fresh fractures and with pseudarthroses; in only 3 out of 60 cases was the outcome poor. The advantages of the techniques include: its suitability for virtually all types of shaft fractures ease of surgery early mobilization and weightbearing, with a low risk of infection rapid consolidation. Relative drawbacks are: radiation exposure longer preoperative preparation involvement of the entire shaft if infection develops irritation of the patellar tendon.

Adolescent↗
PubMed1993

Internal fixation of pathologic fractures. A retrospective study.

The records of 44 patients who underwent internal fixation for metastatic fractures between 1970 and 1989 were studied. Excluded were pathologic fractures involving the spine, pelvis, ribs and clavicles. None of the patients was still alive at the time of the study.

Adolescent↗
PubMed1992

The fibula pro tibia procedure in the treatment of nonunion of the tibia.

We reserve the fibula pro tibia procedure for infected nonunions or for cases that already have been subjected to one or more other methods of treatment. The fibula pro tibia procedure is a technically simple one-stage procedure. The site of the pseudarthrosis is not exposed; hence there is less risk of recurrent infection. Consolidation was achieved in 75% of our cases. The objective findings are positive: consolidation after an average of one year. Knee mobility is normal in most cases, and ankle mobility is only slightly decreased. In most cases the angular deformities are clinically acceptable. All infections have cleared.

Fibula↗
PubMed1991

[Bone-patellar tendon-bone ligamentoplasty for the substitution of the posterior cruciate ligament].

The authors describe a technique in which a free patellar tendon graft is used for intraarticular reconstruction of the posterior cruciate ligament through an anterior and posterior approach. Only patients under 50 years of age with functional instability not responding to exercise therapy were elected for this type of surgery. Between November 1982 and May 1988, 12 patients were operated upon. In 9 patients the follow-up averaged 34 months. The subjective results were evaluated following the Lysholm rating system; the objective results were assessed by means of a clinical examination which was always performed by the same physician. The results were very encouraging and warrant a continued use of the technique with proper indications.

Adult↗
PubMed1991

Prosthetic versus tendon allograft replacement of ACL-deficient knees.

ACL reconstruction is still controversial. Between November 1985 and October 1987, 57 ACL reconstructions were performed using a Dacron graft. Evaluation was done using the Lysholm rating system and Tegner scale. The Lysholm score averaged 84.2. Regarding the level of performance, the patients had lost an average of 2.1 points on the Tegner scale. 18 of the 57 patients developed a synovitis. In 11 patients (19 per cent) the implant had to be removed. CT scan of the operated knee proved the Dacron graft to be nonfunctioning in as many as 40 per cent of the patients. Because of this high complication rate, the authors started to use deep-frozen (-70 degrees C) tendon allograft material. Both Achilles and Tibialis Posterior tendons were implanted using the over-the-top technique with or without an additional extra-articular procedure. Complications as seen with the rigid synthetic ligaments were absent. The preliminary results seem satisfactory in that the functional demands placed on the knee are not restricted.

Adolescent↗
PubMed1991

CT scan of the knee: correlation with clinical and arthroscopic findings.

CT was performed in a series of 150 consecutive clinically diagnosed meniscal lesions of the knee. Six to 12 contiguous slices, each 1 mm thick, were obtained starting from the tibial plateau and proceeding cranially to the intercondylar fossa. The medical imaging team was not informed of the medical history of the patients nor of the relevant clinical diagnosis. Arthroscopic findings were subsequently correlated with the CT findings. With the arthroscopic diagnosis defined as correct, a CT sensitivity rate of 80% was obtained. The specificity of the test was 93%. This study of 75 consecutive meniscal tears was designed to evaluate arthroscopic meniscal suturing using an inside-out technique.

Adolescent↗
PubMed1990

Surgical treatment of tibial pseudarthrosis using the Ilizarov apparatus. A critical analysis.

Since November 1985 the authors have added the Ilizarov procedure to their armamentarium for the treatment of tibial pseudarthrosis. The results of a first clinical study of 10 patients are reported. The mean duration of follow-up is 17 months. The consolidation rate is higher with a transverse than with an oblique pseudarthrosis. The Ilizarov procedure combined with a corticotomy offers new perspectives in the management of massive bone defects. In the presence of severe malalignment, a gradual reduction can be carried out. The main complications are pin tract infections and algodystrophy.

External Fixators↗
PubMed1989

Flucloxacillin compared with cefazolin in short-term prophylaxis for clean orthopedic surgery.

Two-hundred and fifty-two patients were included in a prospective, randomized, double-blind trial comparing the efficacy of flucloxacillin with that of cefazolin for clean orthopedic surgery. The preventive antibiotic regimen consisted of three 1-g injections perioperatively. There were 126 patients in each group, and the follow-up period was at least 6 months. Two deep (1.6%) and five superficial (4.0%) infections occurred in the flucloxacillin group. Three deep (2.4%) and five superficial (4.0%) infections developed in the cefazolin group.

Adolescent↗
PubMed1987

Diagnostic arthroscopy of the hip joint in pigmented villonodular synovitis.

A case of pigmented villonodular synovitis of the hip is presented. The delay between the onset of symptoms and the histopathologic confirmation of this condition generally accounts for the massive local bone invasion, frequently necessitating a total hip arthroplasty. Earlier diagnosis through arthroscopy and subsequent chemical synoviorthesis might reduce the need for more aggressive surgery and improve the prognosis of this rare condition.

Adult↗
PubMed1986

Corynebacterium JK (Johnson-Kay strain) infection of a Küntscher-nailed tibial fracture.

A slow-growing Corynebacterium was isolated in pure culture from pus of a Küntscher-nailed tibial fracture. The strain was identified as Johnson-Kay strain or corynebacterium JK (CJK). This bacterium has been discovered recently and recognized as the cause of serious infections, especially in immunocompromized patients, polytraumatized patients, and patients with cardiac valve replacement. Superficial wounds can be colonized and hemocultures contaminated with CJK. Nosocomial spreading can occur. This microorganism is usually highly resistant to antimicrobial agents and requires therapy with vancomycin. This case was different from classic infections with "CJK" in several aspects. The infection occurred in a patient without underlying disease and the strain was sensitive to the antibiotic. The patient responded well to cephazolin treatment. Being part of the normal skin flora, Corynebacteria are often discarded as contaminants. A critical review of all clinical and laboratory data is necessary for the recognition of the infections and is important especially when a resistant strain is encountered.

Bone Nails↗
PubMedDate not supplied

A known technique for meniscal repair in common practice.

In this retrospective study, we calculated the healing rate of meniscal repairs performed with an outside-in technique. We describe complications encountered and evaluate some known criteria used in the decision to perform a meniscal repair instead of partial meniscectomy. Included is a brief description of the surgical technique and of the trauma type and the meniscal lesions that were repaired. The technique has a high degree of success (74% of the meniscal repairs survived during a mean follow-up of 3.5 years). Although there is a 25% complication rate, no serious or permanent complications were added by repairing menisci instead of performing a partial meniscectomy. For this reason we think saving even a relatively low percentage of menisci may be worthwhile. We can also conclude that an anterior cruciate ligament-deficient knee that is stable can still have a good result in meniscal repair, without performing cruciate reconstruction. In each case, however, individual patient issues such as age, activity level, and associated lesions have to be considered.

Adolescent↗