[Surgical treatment of comminuted fractures of the lower part of the femur].
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to Y Gerard.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The specific properties of Stomahesive tested in 116 stomal and 20 fistulous patients render it really useful in stomatherapy where it increases the comfort of the patients: 1. it offers an excellent peristomal skin protection whatever the nature of the stoma or origin of the fistula; 2. it promotes rapid healing of skin lesions, even in ileostomy, transverse colostomy, ureterostomy and fistula patients; 3. it ensures an effective degree of impermeability; 4. it provides a large base for adhesion of the collecting bag; 5. it can be kept on for about 6 days in most cases; 6. The local tolerance is excellent (Acta chir. belg., 1977, 76, 533-537).
The aim of this prospective study is to acquire clinical experience with a single high dose of tobramycin in prophylactic use. Sixty three patients undergoing elective colorectal surgery, were assigned to receive antibiotic prophylaxis (24 hours perioperatively) in the form of a single high dose of tobramycin and a classically recommended thrice-a-day (TID) administration of clindamycin. The planned dose for tobramycin was 3.3 mg/kg/day. Adjustment was made in case of impaired renal function. Serum levels of the drug were monitored. The results showed well predictable levels. Six out of fifty five evaluable patients (10.9%) presented postoperative infectious complications within the follow up period. No renal nor otovestibular toxicity was recorded.
From January 1986 until December 1988 twenty two patients entered a prospective trial comparing primary closure versus T-tube drainage after exploratory choledochotomy for lithiasis, giving 11 primary closures (P) and 11 on T-tube (T). Both groups were well matched for age and risk factors. Preoperative values of alkaline phosphatase on day 2 and 7 were significantly lower in case of primary closure (p less than .025). In case of primary closure there was 1 bile leakage without peritonitis. In 9 T-tube biles additional micro-organisms appeared without clinical importance. In each group 1 infectious complication occurred. Post-operative hospital stay was 12 days (P) versus 14 (T) (p less than .05). There was 1 residual lithiasis (P), without detrimental effect on the healing of the primary closure. Endoscopic sphincterotomy and stone extraction was performed. Within the given exclusion criteria closing a choledochotomy primarily is a safe and attractive procedure.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A total hip surface arthroplasty consisting of matching cups and uncemented prosthetic components is a noteworthy operation. The femoral cup obtains cylindrical support from the femoral head which is reamed in the shape of a cylinder. The acetabular cup is metallic with a polyethylene liner. It is mobile over the bone but its position is constrained by contact with the femoral cup and therefore "self-centering." On the femoral side, the cup must be placed strictly in the axis of the femoral neck. The main consideration in femoral head surface replacement is the vitality of the underlying bone. Necrosis was observed in the earliest clinical trials but there have been no cases of necrosis in the past 3 1/2 years. This is attributed to a more limited surgical approach in which only the anterior part of the gluteus medius is divided and all the posterior elements of the hip are preserved. The acetabulum is sufficiently reamed to receive the cup, which protrudes beyond the external margins of the acetabulum in all positions. Errors have been committed while perfecting the prosthetic material, but the results as determined by a 6 1/2 year follow-up on purely metallic cups are encouraging. Metal-polyethylene cups presently under investigation have almost a 2 year follow-up. The reaction of the acetabulum to an uncemented cup is not yet known. However, the existence of 2 sliding surfaces and the fact that the acetabular cup moves only during the extremes of hip movement, is reason to assume that if the acetabulum is not reamed to expose cancellous bone, the risks of protrusion are minimal or delayed. Total surface arthroplasty by concentric cups has been performed in 335 hips to date. The operation is especially recommended when osteotomy is no longer possible and disabling coxarthrosis is present in relatively young patients.