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At least 469 records · Page 26Linked to original sources
PubMed1999

Orthopedic management in autosomal recessive spastic ataxia of Charlevoix-Saguenay.

OBJECTIVE: To review the orthopedic management of choice in patients having autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS). DESIGN: A retrospective study from April 1978 to April 1997. SETTING: Centre hospitalier de la Sagamie, Chicoutimi, Que. PATIENTS: A review of the records of patients having ARSACS who were identified in the registry of the Neuromuscular Diseases Clinic at the Centre hospitalier de la Sagamie revealed 26 patients who received surgical orthopedic treatment. Initially, the patients were offered conservative treatment, which consisted of physiotherapy sessions, the wearing of an ankle-foot orthosis or serial casting. When this was unsuccessful, foot surgery was considered. RESULTS: During the study period, 49 orthopedic procedures were done, including 24 triple arthrodeses; of these, 9 were combined with lengthening of the Achilles tendon. Most triple arthrodeses were done in patients between the ages of 30 and 49 years. The surgical options evolved during the study from Lambrinudi arthrodesis through arthrodesis of the ankle to triple arthrodesis with lengthening of the Achilles tendon. CONCLUSIONS: As a complement to conservative treatment, surgery has a place in the care of patients with ARSACS. Clinically, the most effective surgical procedures are triple arthrodesis with percutaneous lengthening of the Achilles tendon and adductor and psoas tenotomies combined with neurectomy of the obturator nerve for perineal hygiene.

Achilles Tendon↗
PubMed1999

[New findings in orthopedic pathology].

The term orthopedic pathology refers to bone- and joint-affecting diseases which are important for the orthopedic surgeon. In the report presented here, emphasis is placed on the membrane-associated proteolysis, which is essential for the degradation of the extracellular matrix. Matrix-degrading processes play a role not only in arthrosis but also in rheumatoid arthritis. Moreover, they are strongly associated with the problem of loosening of protheses, which is of utmost importance for the orthopedic surgeon. In these processes, major roles are played by the plasminogen activator system, plasmin, different matrix metalloproteinases, including the membrane type matrix metalloproteases and different cathepsins. A deeper insight into the function of these proteins and their influence on the matrix degradation in joint diseases will open the way for new diagnostic and therapeutic strategies. Investigations into a large number of chondrosarcomas have shown that for this type of bone lesions, urokinase plasminogen activator and cathepsin B are prognostic parameters that are independent of the differentiation grade. Also, in this context, investigations into the membrane-bound proteases will be of great practical and diagnostic value.

Arthroplasty, Replacement↗
PubMedDate not supplied

[Reduction of blood transfusion need with aprotinin in orthopedic surgery. Spanish Study Group on the Use of Aprotinin in Hip Arthroplasty (GEEEAAC)].

Aprotinin is a protease inhibitor of interest for its antifibrinolytic effect of reducing perioperative bleeding in certain types of surgery, with wide use in heart surgery, liver transplantation and vascular surgery. The application of aprotinin during orthopedic surgery has recently been suggested. Such use is controversial, as there is lack of consensus as to the type of patient for whom aprotinin administration would be indicated, the surgical procedure during which it would be most effective (hip or knee arthroplasty, spinal arthrodesis, major tumor or septic surgery), the doses to administer, its safety and its real efficacy for conserving homologous blood. That is to say, there is no agreement as to the cost/benefit relation of aprotinin for the various types of orthopedic surgery. This critical review of the literature leads to the conclusion that aprotinin is a promising drug for use in orthopedic surgery, given that published studies have established the benefit in blood product savings and decreased blood loss during surgery.

Aprotinin↗
PubMed2001

Relationship between duration of therapy services in a comprehensive rehabilitation program and mobility at discharge in patients with orthopedic problems.

BACKGROUND AND PURPOSE: The purpose of this study was to examine the relationship between duration of physical therapy and occupational therapy and mobility at the time of discharge from a comprehensive rehabilitation program in a group of patients with orthopedic diagnoses. SUBJECTS: Subjects were 116 consecutive patients with orthopedic diagnoses (mean age=72.6 years, SD=12.0, range=21-99) who were admitted to a comprehensive inpatient rehabilitation program. METHODS: This retrospective cohort study utilized the Uniform Data Set, social service records, and quality assurance records to provide demographic and medical information. The Functional Independence Measure (FIM) provided information regarding mobility at admission and discharge. The duration of physical therapy and occupational therapy was measured in hours. RESULTS: Subjects received an average of 40.8 hours of therapy and showed an average change in FIM mobility subscale scores of 24.5. Multiple linear regression was used to demonstrate that duration of therapy was a predictor of FIM score at the time of discharge (partial correlation=.069) after controlling for length of stay, number of diagnoses, FIM cognitive subscale score at admission, and FIM mobility subscale score at admission. Duration of therapy accounted for 6.9% of the variance in the model. CONCLUSION AND DISCUSSION: This study indicates that the amount of physical therapy and occupational therapy that patients with orthopedic diagnoses receive during enrollment in an inpatient comprehensive rehabilitation program is related to the FIM mobility subscale score at the time of discharge. The authors suggest that increasing the hours of therapeutic intervention that a patient receives in inpatient rehabilitation could improve functional outcomes at discharge.

Activities of Daily Living↗
PubMed2001

Pulmonary embolism after minor elective orthopedic procedure.

The occurrence of pulmonary embolism, in spite of thromboprophylaxis after a minor elective orthopedic surgery (release of m. rectus femoris tendon) is reported. In case of this severe complication, an early diagnosis is of outmost importance to enable optimal therapy introduction. Deep vein thrombosis and pulmonary embolism are frequent complications after total joint replacement, however, they may also develop after minor surgical orthopedic procedures. The possible causes of pulmonary embolism after release of m. rectus femoris tendon included the history of varicose veins and sclerozation of calf veins, and operative procedure with intraoperative pressure upon large veins of the iliofemoral region, which may and is expected to occur during this procedure. The importance of thrombopropylaxis in orthopedic surgical procedures is emphasized by this case presentation.

Adult↗
PubMed2000

[Effects of maxillary growth of Wistar rats with bilateral artificial cleft palate after premaxillary orthopedic treatment on expression of proliferating cell nuclear antigen(PCNA)].

OBJECTIVE: Being based on the principle of Latham's appliance, this experiment is designed to detect activity of osteoblasts in the maxillary sutures of Wistar rats with bilateral artificial cleft palate by immunohistochemistry technique, and evaluate the effects of this appliance on the growth and development of the maxilla. METHODS: The animal models of male infant Wistar rats with bilateral cleft palate were made by removing some palatal bones, splitting a "V" gap of 1.5 cm wide at the line between premaxilla and segments of maxilla. A sort of appliances, which could be fixed in the mouth of Wistar rats with bilateral cleft palate for correcting protrusion premaxilla was constructed basing on the principle of Latham's appliance. Then the diferent pathological changes of osteoblast proliferation between the experimental group and the two controlled groups were examined. The jugomaxillary sutrues, temporomalar sutures and sphenoipalatine suture were harvested 7, 14 days after premaxillar orthopedic treatment, followed by 4% paraformaldehyde fixing about 1 hour, demineralization with 15% EDTA and 0.5% paraformaldehyde for 48 hours, distilled water washing for a night, dimethylbenzene transparant dealing, and paraffin wax embeding. Proliferating Osteoblasts in all these sutures were investigated using immunohiostochemical technique with monoclonal antibodies of proliferating cell nuclear antigen (PCNA). RESULTS: Seven days after orthopedic treatment, no significant difference was observed between the experimental group and the two controlled groups. While after fourteen days, obvious PCNA-positive expression were observed in cells of all these sutures of the experimental group. CONCLUSION: The distribution of proliferating cells and the degree of cell proliferation change after premaxillary orthopedic treatment. And significant cell proliferation is observed in the experimental group, but there are no significant differences between the two controlled groups.

Animals↗
PubMed2000

[Cephalometrical analysis of effects of premaxillary orthopedic treatment on maxillary growth of Wistar rats with bilateral artificial cleft palate].

OBJECTIVE: To measure the differences between the experimental group and the two controlled groups by using the cephalometric radiography technique to study the effects of premaxillary orthopedic treatments on the growth and development of maxilla. METHODS: To make an animal model with bilateral cleft palate by surgery operation: General anesthesia was carried on by injecting 2.5% pentobarbital (25 mg/kg) into abdominal cavity, then almost the same bone of rats' palate were removed from bilateral palate. An appliance, based on the principle of Latham's appliance was made and designed for premaxillary orthopedic treatment. It was fixed in rats' palate using pins under the condition of general anesthesia. After 20 days of orthopedic treatment, the rats were anesthetized by ether, and cephalometric films were taken under self-designed cephalometer and analysed aided by computer. RESULTS: The distances that represented the maxillary position in the posterior-anterior (PA) direction significantly increased (P < 0.05), while the angles that represented the direction of premaxillary growth significantly decreased (P < 0.05) between the experimental group and the two controlled groups. There were no significant difference between the two controlled groups. CONCLUSION: Premaxilla of rats can be effectively moved backward and rotated downward and backward on the PA direction by appliance. The appliance can move the segment palate forward during the premaxillary backword. The appliance can stimulate maxillary growth.

Animals↗
PubMed2003

Efficacy of telemedicine in the initial management of orthopedic trauma.

In order to determine the clinical usefulness of teleradiology in the initial treatment of musculoskeletal injury, a panel of orthopedic trauma surgeons developed a survey that was presented to participants at the annual meeting of the Orthopedic Trauma Association. Selected orthopedic trauma cases from a level-1 trauma and a tertiary care center were presented orally (including a description and interpretation of the radiographic findings) to volunteer participants. Questions related to treatment and patient management were then asked prior to and following the participants' viewing of digital radiographic images. Overall, 90% of respondents found telemedicine useful. They disagreed with the verbal radiographic report 49% of the time. Respondents changed their mind with regard to the need for admission 17% of the time; surgical indications, 22% of the time; and need for more information, 30% of the time.

Decision Making↗
PubMed1992

Effects of lip adhesion and presurgical orthopedics on facial growth: an evaluation of four treatment protocols.

Differences in craniofacial morphology in uni and bilateral cleft lip and palate were studied by roentgenocephalometry: 35 American children, treated with a lip adhesion procedure, and 26 Dutch children treated with a preoperative orthopedic procedure, both followed by a lip and/or palatal repair, were compared. A multivariate statistical approach was used to study the effects of the surgical procedures and of the age of the child when operated upon. The variables affected by the type of operation were: the relative length of the maxilla (PNS-ANS); the SNA angle; and the relative length of the mandible (Go-Po). The length of the maxilla was on average longer for those treated with preoperative orthopedics and the maxilla was largest for children whose hard palate had yet to be closed. This was also the case for the SNA angle except for children treated with the combined lip-soft palate closure procedure. The mandible followed pattern displayed by the maxillary length; it was larger for those treated with preoperative orthopedics. Significant effects of the timing of the surgery on the variables studied were also found. Postponement of the definitive lip closure resulted in a reduction of the maxillary length, whereas delay of soft palatal closure resulted in an increase of the maxillary length.

Activator Appliances↗
PubMed1975

Investigation of the relation between low back pain and occupation. VII. Neurologic and orthopedic condition.

Neuro-orthopedic examination was carried out on 429 patients suffering from LBP, and on 271 controls. Neurological deficit was found in 49 LBP but in none of the controls. Of the orthopedic signs, the most significant indicators of LBP were hypolordosis, scoliosis, limitation of movement and contracted paraspinal muscles. Various degrees of affection of the hip joints were found in 49 LBP as against 4 controls; the majority of these patients complained of LBP and not of hip disorders. It is stressed that an early and thorough neuro-orthopedic examination is essential for diagnosis and therapy and has important legal implications, mainly with regard to the time factor.

Back Pain↗
PubMed1999

[Presurgical infant orthopedics in complete bilateral cleft lip and palate reconstruction]

OBJECTIVE:This study want to effects on using intraoral-appliance treatment of complete bilateral left lip and Palate in clinic.METHODS:Using Lisson's method preliminary evaluated to effect of presurgical infant orthopedics complete bilateral cleft lip and palate.A sample of 4 cases of 18 weeks infant complete bilateral cleft lip and palate.2 of they are males, others are females.All of they had received presurgical infant orthopedics,Using intraoral appliance. comparison of before and after cast analysis.Evaluate anteiro posteior I, tranverse,oblique degree of the lateral segment, pretrusion premaxilla position change.RESULTS:Every patients after orthopedics treatment had retracted premaxilla come back,corrected of oblique of premaxilla,had lateral segments growth equally on both side,their inclination should be similar.CONCLUSION:Intraoral-appliance can successfully improved malarrangement maxilla of bilateral cleft lip and palate.

Journal Article↗
PubMed1979

Self indentified personality patterns of children with facial or orthopedic disfigurement.

This study compared personality characteristics of children with cleft lip and palate to another group of children with different observable physical impairment (orthopedic disability) and speech difficulties. It was hypothesized that different types of observable physical stigmata may result in different personality adaptations. Forty-five children from each of two groups (25 males and 20 females) were matched for sex, age, and intelligence. They were compared using the Missouri Children's Picture Series, a non-verbal personality test, on the following dimensions: Conformity, Masculinity/Femininity, Maturity, Agression, Inhibition, Activity Level Sleep Disturbance and Somatization. The results indicate that males with cleft lip and palate are significantly higher on Maturity and Inhibition while Orthopedically Disabled males are higher on Agression, Activity Level, and Somatization. Cleft lip and palate females are significantly higher on Maturity and Inhibition while Orthopedically Disabled females are higher on Masculinity. The results indicate differential personality adaptations in the two different types of observable physical impairments. Results are discussed in terms of their relationship to selected psychosocial variables.

Aggression↗
PubMed1976

Comparison of 18F and 99mTc-polyphosphate in orthopedic bone scintigraphy.

To compare 99mTc-polyphosphate and 18F for use in orthopedics, 79 patients were examined with both. Fifty cases were suitable for analysis. While the extraskeletal uptake of 18F was found to be negligible, 99mTc-polyphosphate may accumulate considerably in pathologic soft tissue, e.g., in soft-tissue tumors and in inflamed synovial tissue. This soft-tissue Tc accumulation may obscure the osseus uptake, notably in the examination of joint regions, commonly the regions of interest in orthopedics. After simultaneous administration of both agents, quantitative measurements were performed on specimens of bone and synovial tissue from diseased joints in human patients and in rabbits. The uptake of 99mTc-polyphosphate in synovial tissue was shown to be about seven times that of 18F, while their uptakes in bone were equal. In short, 99mTc-polyphosphate, a valuable tracer in general, is hardly the agent of choice in orthopedics.

Adult↗
PubMed1991

[Orthopedic devices for footwear in flatness of the anterior part of the foot].

The work is dedicated to the problem of orthopedic supply of patients with flatness of the anterior part of foot. There is proposed a number of footwear orthopedic devices made of foam rubber. There is described the technology of their production with application of modern polymeric materials. There has been studied prosthetics of 50 patients with flatness of foot and revealed the positive result of application of footwear orthopedic devices made of foam rubber.

Flatfoot↗
PubMed1991

The effect of chronic orthopedic infection on quality of life.

The patient with chronic orthopedic infection presents a unique challenge to the orthopedic surgeon. The orthopedic surgeon must not only possess an expertise in constantly evolving diagnostic and treatment techniques but also be able to identify numerous related problems and direct the patient in receiving the most appropriate treatment. This demands a commitment of time by the treating surgeon to the individual patient to properly assess the need for support, the extent of psychologic distress, the intensity of pain, and the requirement for medication management. The effective utilization of a multidisciplinary team of health care providers (e.g., specialists in infectious disease, physical medicine and rehabilitation, psychiatry, nursing, pharmacology) can provide an optimal treatment program for this multifaceted problem and maximize the potential for a favorable outcome.

Chronic Disease↗
PubMedDate not supplied

Routes of infection. A study of using "tracer particles" in the orthopedic operating room.

Wound irrigates and tissue samples were cultured from clean orthopedic wounds at the conclusion of 280 orthopedic operations. The surgeons used a laminar flow unit and took extra precautions against wound contamination although personnel exhaust systems were not used. It was possible to culture residual organisms but difficult to trace the source of these by bacteriological methods. Artificial or "tracer" particles which could be applied to patient or surgeon were retrieved from the wound and suitably stained. Using albumin microspheres it was possible to identify and differentiate "patient-derived particles" from "surgeon-derived particles" in the majority of all wounds. Contamination from the surgeon was significant even under near optimum operating room conditions. These techniques are useful for development of control measures for residual wound contamination in orthopedic operating rooms.

Bacterial Infections↗
PubMed1984

A genetic study of an orthopedic referral center.

There is a substantial genetic component in the orthopedic population studied. Twenty-five percent of the new patients and 46% of the specialty clinic populations had a genetic disorder. The single-gene component was 7.2% and 13% in these two patient populations studied. In comparison to the previously studied pediatric populations, the single-gene component was almost double that found in the inpatient pediatric population, and seven times greater than that in the outpatient pediatric population. Our results suggest that genetic counseling should play an important part in orthopedic care and management, especially at the orthopedic and tertiary referral centers.

Bone Diseases↗
PubMed1995

Orthopedic complications.

This overview of the complications encountered in orthopedic cases focuses on, among other things, complications of spinal surgery. The incidence of infection in spinal instrumentation and other orthopedic procedures is discussed and followed by a review of the complications of total joint replacement. Finally, a few words on the radiologist's responsibility for the reporting of orthopedic complications are given.

Humans↗