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At least 343 records · Page 19Linked to original sources
PubMed1990

Open fractures of the femur treated by the pin-in-plaster technique. Contribution to the art and practice of trauma surgery in the Third World.

In order to cope with the frequent lack of adequate and sufficient external fixator systems in Third World countries, the pin-in-plaster technique was adopted and used in the management of open fractures of the femur. It consists of the use of Steinmann and Schanz pins incorporated into a plaster of Paris cast. The technique was successful in 13 of 15 open fracture cases treated at the University Teaching Hospital in Calabar (86.6%). The advantages and disadvantages of the method are discussed. The method is recommended as an effective improvisation of the Hoffman apparatus for use in exceptional circumstances, such as war and adverse socioeconomic conditions as are found in most Third World countries.

Adolescent↗
PubMed1985

Fracture of the tibial tuberosity in adolescents.

Fracture of the tibial tuberosity is an uncommon injury and rarely occurs after closure of the proximal tibial epiphysis. Three cases of tibial tuberosity fracture over a period of 11 years were treated by open reduction, internal fixation, and immobilization for 6 weeks in plaster of Paris (1970-1980). The postoperative follow-up times were 5, 6, and 7 years. No subsequent deformities were detected. Two patients had secondary posttraumatic patella infera without any symptoms. All patients returned to normal activity. The results demonstrated that this injury in the adolescent knee heals without deformity of functional loss when adequate reduction and fixation of the fracture fragments have been achieved.

Adolescent↗
PubMed1981

[Fresh ligament injuries at upper ankle joint and foot (author's transl)].

Crush injuries and abnormal pronation and supination are the most common reasons for typical ligament tears in this region. Most of them should be treated conservatively by plaster of Paris and early weight-bearing after exact clinical and X-ray diagnosis. At upper ankle joint, suture of ruptured fibular collateral ligaments should be favoured. For dislocations and fracture dislocations of the Lisfranc type operative reposition and K-wiring is recommended. Our treatment results with fibular collateral ruptures and fracture dislocations of the Lisfranc type are presented.

Ankle Injuries↗
PubMed1985

[Fractures of the metacarpal bones II to V--conservative and surgical treatment].

Fractures of the metacarpals II-V can normally be handled conservatively. After reposition under local anaesthetic plaster of Paris is applied for a duration of 3 to 4 weeks. Open fractures usually with accompanying injuries, should be stabilized operatively. The functional results of conservative treatment are very good. Slight sidewards deviation of up to 1/3 of the width of the shaft and shortening of up to 6 mm don't interfere with good hand function. Palmar deviation of the distal fragment of up to 35 degrees following subcapitular fractures does not reduce hand function.

Adolescent↗
PubMed2002

Aspiration prevented by the ProSeal laryngeal mask airway: a case report.

PURPOSE: To describe a case of intraoperative passive regurgitation where the ProSeal laryngeal mask airway (PLMA) successfully protected the airway from the respiratory tract. CLINICAL FEATURES: A 32-yr-old man was electively scheduled for change of dressings and application of plaster of Paris to both legs. A size 5 PLMA was inserted on the first attempt and the patient allowed to breathe spontaneously. Twenty-five minutes into the procedure brown fluid was noticed in the drainage tube of the mask. There was no change in respiratory pattern nor any evidence of coughing retching or vomiting. Twenty-five millilitres of fluid were suctioned out of the tube which tested positive for acid. The PLMA was left in place and the procedure continued uneventfully. After removal of the mask pH testing showed the dorsum of the mask to have a pH of 7 and the ventrum/bowl of the mask to be dry with a pH of 7. The patient had no respiratory symptoms in the recovery room and the postoperative course was uneventful. CONCLUSIONS: This case illustrates that passive regurgitation can occur unexpectedly intraoperatively and shows that the PLMA can protect the airway during such an event by allowing the regurgitated fluid to pass up the drainage tube without leaking into the glottis.

Adult↗
PubMed1997

[Cleft foot with Y-shaped deformity of the third metatarsus. A case history.].

GOAL OF SURGERY: Correction of the deformity of the third metatarsus and of the malposition of the toes to improve form and function of the foot. INDICATIONS: Problems with shoe wear. Aesthetic appearance. (Limitation of function.) CONTRAINDICATIONS: None. PREOPERATIVE WORK UP: Drawing of surgery to be performed. POSITIONING AND ANAESTHESIA: Supine. General anaesthesia. SURGICAL TECHNIQUE: Excision of the distal half of the hypoplastic second metatarsus through a curvilinear dorsal incision. Osteotomy of the third metatarsus at the Y-junction and implantation of the mediodistal part into the proximal half of the second metatarsus. Corrective osteotomy of the third metatarsus at the Y-junction. Internal fixation of both metatarsi with transosseous, transarticular Kirschner wires. Four weeks later correction of the hallux valgus using the technique recommended by Kramer. POSTOPERATIVE MANAGEMENT: Below knee plaster of Paris. Removal of K'wires after consolidation of osteotomies. Progressive increase in weight bearing. Arch supports. POSSIBLE COMPLICATIONS: Injury to nerves, vessels or tendons. Wound infection. Delayed consolidation. Nonunion. Growth disturbances. RESULTS: 30 months postoperatively, when the patient was 13 years of age, both osteotomies had healed in good position: the foot looked nearly normal. At 21 years of age the patient has no problems. She is involved in sports and is satisfied with the result.

English Abstract↗
PubMed1999

[Correlation between epiluminescence microscopy characteristics of malignant melanomas and Clark's level of invasion].

Many epiluminescence microscopy (ELM) characteristics of malignant melanoma support the differential diagnosis of pigmented skin tumors. A preinvasive evaluation of level of invasion would be valuable for planning the excision margins. Since sonography for tumor thickness measurement is rarely available in a practice we searched for specific ELM criteria correlating with Clark's level of invasion. In our retrospective study of 120 malignant melanomas of 30 ELM features were studied for their correlation and the association was significant for 15 features.The following criteria were found only in level III-IV melanomas: intralesional horizontally elongated blood vessels, spontaneous microhemorrhages, plaster-of-Paris-like lacunae, grey-blue/yellowish-brown/reddish saccular pattern and eccentric nodes (reddish, livid, blue). 7 characteristics were predominantly found in level III-IV melanomas and seldom in "thin" melanomas (level I-II): deeply localized gray-blue/-brown fragmentary network, whitish-opaque septa, whitish- or bluish-opaque veil, negative pigmented network, areola with evenly arranged capillaries, polymorphic capillaries. Perivascular melanophages, eccentric dark blotches, pseudotrabeculae of melanophages and greyish-blue annular perifollicular pigmentations were the most significant association of ELM criteria in "thin" melanomas (level I-II). Epiluminescence microscopy is not only a tool for the differentiation of melanocytic lesions but also for a preinvasive evaluation of Clark's level of invasion.

Adult↗
PubMed2003

[Stress fractures of the tarsal navicular bone. Causality, diagnosis, therapy, prophylaxis].

Stress fractures of the tarsal navicular bone are a challenge in diagnosis and therapy. First and foremost you have to think about this fracture. The origin of the injury can be detected in a wrong or too heavy strain of the bone especially in long distance runners and recruits. The MRI is the diagnostic tool of first choice. Therapy of displaced or comminuted fractures as well as pseudarthrosis is best done with surgical procedures like direct screw fixation or interposition of autologous bone depending on the circumstances and the age of injury. Conservative treatment with a plaster of Paris is useful in non-displaced and non-comminuted fractures. Prophylaxis with technical aids and a changing habits is recommended.

Bone Screws↗
PubMed2004

[Botulinum toxin A in the treatment of infantile cerebral palsy. Taking into account multilevel, integrated treatment].

Botulinum toxin A represents a significant development in the management of children and adolescents with spastic cerebral palsy. Prerequisites for an adequate result are a correct indication, an exact injection technique and an intensive post-treatment programme. Spastic muscle overactivity and the constant tendency of the involved muscles to shorten with growth cannot be treated by only one method. Therefore a multilevel approach and an integrated treatment schedule including plaster of Paris, orthoses and physiotherapy are currently the best ways to modify the disease process. The inclusion of objective clinical documentation techniques combined with 3-D instrumented gait analysis allows the determination of the indications more exactly and for monitoring the post-treatment results. If started early and correctly, this integrated management approach has the potential to modify the natural history of the disorder, and to reduce the frequency of later surgery.

Adult↗
PubMed2001

Open fractures of the lower limb in Nigeria.

During an 18-month period we studied prospectively 63 consecutive patients (42 males, 21 females) with an open fracture of the lower limb. Their mean age was 32 years (range: 4-78 years) and 58 patients with 59 fractures were available until the conclusion of the study. Forty-seven had tibial fractures, 12 had femoral fractures and the majority of the patients were either students or traders. According to Gustilo and Anderson's grading, 21 fractures were of type II and 16 of type IIIA. On arrival all the wounds were irrigated and debrided and the patients also received tetanus prophylaxis and intravenous antibiotics. Of the 47 tibial fractures 39 were managed with an above-knee plaster of Paris cast which was windowed so as to allow wound care. Of the 12 femoral fractures ten were treated with skeletal traction on a Bohler frame. The time taken for soft tissue healing was not significantly different between the tibial and femoral fractures. There were, however, significant differences with respect to (1) the time interval between injury and debridement, (2) the incidence of wound infection, (3) the occurrence of osteomyelitis, (4) fracture union time, and (5) time spent in hospital. The most common complications were wound infections (27 cases) and delayed union (26 cases). The time interval between injury and wound debridement was a major prognostic factor.

Adolescent↗
PubMed2000

The changed preliminary report: a repeatedly missed paediatric tibial tumour.

This report describes a malpractice case involving a delayed diagnosis of a malignant bone tumour in the proximal tibia in a 10-year-old child. This was caused by a combination of factors. The final report on the first examination failed to reach the patient files, and two subsequent X-ray exams failed to diagnose the tumour, due to misinterpretation in one and obscuring plaster of Paris in the other.

Bone Neoplasms↗
PubMed2000

Fractionated stereotactic radiotherapy for pediatric brain tumors: the Chicago children's experience.

Thirty-three children with a total of 35 benign/malignant brain and eye neoplasms were treated with fractionated stereotactic radiotherapy. In the first 11 children immobilization for treatment was achieved with plaster of Paris casts or aquaplast masks. In the remaining 22 children the Laitinen stereoadapter was used. Radiation was delivered with noncoplanar static or rotational beams. The dose fractionation used was 50.4-60 Gy in 28-30 fractions in patients receiving treatment with curative intent, and 10-32 Gy at 2-4 Gy/fraction for reirradiation. The accuracy of daily treatment was < 2 mm. After a median follow-up of 27 months, 22 of the 25 children treated with curative intent achieved local control. One child had progressive brain necrosis following 54 Gy in 30 fractions for a pontine astrocytoma. The exact etiology of this complication is unknown. This series demonstrates that in children fractionated stereotactic radiotherapy using the Laitinen stereoadapter is well tolerated and accurate and results in good local control.

Adolescent↗
PubMed2003

Reconstruction of acute anterior cruciate ligament injuries: a prospective, randomised study of 40 patients with 7-year follow-up. No advantage of synthetic augmentation compared to a traditional patellar tendon graft.

BACKGROUND: In a prospective, randomised study, we compared the results of anterior cruciate ligament reconstruction using the conventional medial patellar tendon strip procedure with the Kennedy ligament augmentation device (LAD) over-the-top augmentation technique. The aim of the study was to see if the addition of this device, with its specific potential complications (infection, synovitis, mechanical failure) and increased costs, gave better functional stability and less donor site morbidity. METHODS: Forty patients ( n=20+20) with high physical demands, anterior cruciate ligament rupture less than 3 weeks old, and positive Lachman and pivot shift tests were included in the study. They were randomised by instructions in a sealed envelope that was randomly chosen. Postoperatively, they were immobilised in a plaster of Paris cast for 2 weeks. Full weight-bearing was not allowed until 6 weeks after the operation. Strength training on the operated side started when movement was restored to nearly normal, usually after 8-10 weeks. Return to full sport activity was allowed 1 year after the operation. Clinical and arthrometric follow-up was performed yearly using the Lysholm functional score, Tegner activity score, KT-1000 testing, Lachman and pivot shift tests. Follow-up lasted 3-9 years (mean 7 years). RESULTS AND CONCLUSIONS: At last follow-up we found no statistical difference in stability tests, functional or activity scores; both groups showed stable improvement concerning scores and arthrometry compared with the preoperative values. No advantages were associated with the use of the Kennedy LAD, and we do not recommend it or a similar device for uncomplicated cases. New augmentation devices are simply launched onto the market, and we recommend caution and thorough evaluation in prospective, randomised studies before they are adopted into use.

Acute Disease↗
PubMed2000

Traumatic spondylolisthesis of the axis: treatment rationale based on the stability of the different fracture types.

Thirty-nine consecutive patients, 22 male and 17 female with an average age of 37.6 years, with traumatic spondylolisthesis of the axis were reviewed. The cause of injury in 75% of the patients was a road traffic accident. The fractures were classified according to Effendi et al., the type II fractures were further divided into three subgroups: flexion, extension and listhesis injuries. There were 10 type I (25.7%) and 29 type II fractures (74.4%); of these, 12 (30.8%) were classified as flexion-type, 2 (5.1%) as extension-type and 15 (38.5%) as listhesis-type. We did not identify any case of type III injury. Overall, 43.5% of the patients had sustained a significant head or chest trauma, with the highest incidence for type II listhesis injuries. Significant neurological deficits occurred in four patients (10.3%); in all four,the fracture was classified as a type II listhesis. All ten type I injuries were successfully treated with a cervical orthosis. Ten of the 12 type II flexion injuries demonstrated significant angulation. Two were treated with internal stabilisation, in seven with a halo device and one with a minerva plaster of Paris (PoP). Healing was uneventful in all ten patients. For the remaining two stable type II flexion injuries, application of a hard collar was adequate, as was the case for the two stable type II extension injuries. Six of the 15 type II spondylolisthesis injuries underwent primary internal stabilisation, and healing was uneventful in all cases. In four (44.4%) of the nine injuries that were primarily treated with a halo device/minerva PoP, secondary operative stabilisation had to be performed. The classification of Effendi et al. provides a complete description of the different fractures. However, further distinction of the type II injuries regarding their stability is mandatory. Type II spondylolisthesis injuries are unstable, with a high number of associated injuries, a great potential for neurological compromise and significant complications associated with non-operative treatment. The majority of type II extension and type II flexion injuries can be successfully treated with nonrigid external immobilisation.

Adult↗
PubMed1986

Use of Orthoplast as nasal splint.

Nasal splintage is routinely employed in standard rhinoplasty. For 3 years one of the authors has used Orthoplast as an alternative to plaster of Paris, which has proved to have many advantages.

Humans↗
PubMed1979

A computer program for the analysis of dental models.

This paper presents the details and logic of a Fortran computer program which carries out routine clinical analysis of dental models resulting from impressions of the teeth and related structures, which are subsequently cast in plaster of Paris. The program is primarily intended for use by the orthodontist who is engaged in research or clinical practice, and is useful in studies related to changes in the dentition as a result of orthodontic treatment.

Computers↗
PubMed1980

Volkmann's ischaemic contracture of the forearm.

Twenty-three patients with established contractures of the forearm, which were treated by excision of all irreparably damaged muscles, lengthening of the tendons and neurolysis of the median and ulnar nerves, are reported. Fourteen patients were children. Supracondylar fractures of the humerus, all treated by plaster-of-Paris, were associated with 10 contractures. Twelve patients achieved good or normal function of the hand after treatment; 5 had obvious functional disability, 4 achieved only a support function and 2 required forearm amputations. Early treatment improved the functional result. Treatment of displaced supracondylar fractures by traction seemed to be an important prophylactic procedure.

Adolescent↗