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PubMed1990

Stress fractures of the femoral neck following strenuous activity.

Stress fractures of the femoral neck following sustained strenuous physical activity are uncommon. In 194 military recruits in elite basic training who had sustained 257 stress fractures, most of them in long bone diaphyses, nine such fractures were located in the femoral neck. Seven of these fractures were transverse and undisplaced, and were treated successfully by bed rest and non-weight bearing for 6-8 weeks. The other two fractures displaced into a varus position. One of them was treated successfully by manipulation and plaster of paris spica immobilization. Solid union of the fracture followed within 3 months. The second displaced fracture was treated by two successive procedures of internal fixation because it did not unite after the first intervention and slipped again into varus position. It is therefore suggested that unstable stress fractures of the femoral neck should be initially operated on and stabilized by rigid internal fixation, in order to avoid displacement and severe disability.

Adolescent↗
PubMed1989

Fibrin glue osteosynthesis of epiphyseal injuries in children.

The osteosynthesis of epiphyseal injuries by a two-component fibrin glue was performed in five children. Three of them had finger fractures, two patients had slightly displaced distal tibial and fibular fractures. All children recovered without sequelae. They have been followed for three to twelve months after surgery and did not show any negative consequences. The glue osteosynthesis of physeal injuries will be appropriate only in more stable fractures where the fragments are not exposed to greater dislocating power because this type of synthesis is not very firm. In open injuries it is possible to add antibiotic to the glue, which represents a great advantage compared with the use of metal. It is essential to combine the osteosynthesis with plaster of Paris during the whole healing period.

Adolescent↗
PubMed1989

[Effect of the extent of spondylodesis on the status of the lumbar vertebrae after surgical treatment of idiopathic scoliosis].

Fifty-five patients with primary thoracic dextral idiopathic scoliosis treated by the Harrington method were studied. Posterior spondylodesis involved 8-14 vertebrae. Immobilization by a plaster-of-Paris jacket after operation was employed for 7-11 months. The mean follow-up was 14 years and 8 months. The studies were based on the clinical, radiological, and photogramometric evaluation of patients before operation, at one year after operation, and at least 5 years after operation. Two groups of patients were considered: with spondylodesis involving 8-10 vertebrae (25 patients) and 11-13 vertebrae (29 patients). In the analyzed material, better compensated posture occurred in the patients with posterior spondylodesis of 8-10 vertebrae and in whom the lower distractor hook rested on the L1-L2 vertebral arches, and when biological maturity of the spine was medium or advanced, and the age at operation ranged from 14 to 18 years and 4 months.

Adolescent↗
PubMed1977

A prototype articulator for planning orthognathic and craniofacial surgery.

Current techniques and hinge-type articulators do not provide sufficient information and versatility for the planning of orthognathic and craniofacial surgery. Dental articulators either require plaster of paris for mounting or they do not accommodate movement of both casts in all directions of space. A prototype articulator that satisfies movement of both casts in all directions of space is successfully being used as an adjunct in planning orthognathic and craniofacial surgery. There is a need for future development of sophisticated and accurate armamentarium that can be used as an aid in planning and designing surgical procedures.

Dental Articulators↗
PubMed1989

[Chemonucleolysis as a method of treatment in lumbar and thoracolumbar scoliosis: errors, complications and indications for use].

The authors summarize their experience in the treatment of 106 patients with dysplastic lumbar and thoracolumbar scoliosis. Already 24 hours after closed chemonucleolysis there was considerable correction of the curvature and an increase in the stability index. The method may be recommended for the treatment of lumbar and thoracolumbar scoliosis at stages II and III if the curvature angle does not exceed 50 degrees. In severe curvatures the efficiency of chemonucleolysis is low. Observation of the patients showed that the method causes little traumatism, is easily endured by the patients and allows for reliable discontinuation of the progress of deformation. The complications after closed chemonucleolysis may be avoided by employing the technique of discography, the application of the plaster-of-Paris jacket and by making use of adequate anaesthetic and dehydration therapy during the immediate post-manipulation period. The complications after chemonucleolysis did not deteriorate the results of the treatment.

Adolescent↗
PubMed1989

[Pediatric injuries in the lower extremities caused by insertion of the foot into the spokes of a bicycle].

The authors describe the injury of the lower extremity caused by putting the child's leg between the spokes of bicycle wheel during ride. The result is contusion of soft tissues of the leg and ankle or the fracture of the shin in a typical place. The injury requires a through treatment of soft tissues and sometimes also reduction of the fracture under total anaesthesia with subsequent fixation by plaster of Paris. On the basis of the group of 52 patients it has been proved that the mentioned injuries but for exceptional cases heal without sequelea. The authors emphasize the importance of the prevention of this injury by the installation of a plastic cover over the bicycle frame.

Bicycling↗
PubMedDate not supplied

The scaphoid fat stripe in the diagnosis of carpal trauma.

During a ten-year period scaphoid fracture was suggested in 541 wrists, but in 283 cases could not be confirmed at the initial radiographic examination. These cases were immobilized in plaster of Paris and examined clinically and radiologically 10 to 14 days later. A total of 274 additional radiographic examinations revealed 32 scaphoid fractures not initially recognized. Two fractures were at the retrospective analysis found to have been neglected. In the 249 cases where a fracture was never demonstrated, the immobilization and resulting sick leave were in retrospect considered not to have been indicated. In a retrospective analysis of case records and radiographic material including the configuration of the scaphoid fat stripe (SFS) at the initial radiographic examination the SFS was found to be useful in diagnosing scaphoid fractures. The use of the SFS in differential diagnosis would result in reduction of costs and inconvenience for patients without scaphoid fracture.

Carpal Bones↗
PubMed1988

Supracondylar fractures of the humerus in children; a long-term follow-up study.

The late anatomical and functional results of the conservative treatment of supracondylar humerus fractures were retrospectively studied in 87 children. The average follow-up was 14.5 years; 59 percent of the patients were treated with overhead traction and 32 per cent with a plaster of Paris. The average hospitalization time was 17 days. Rereduction was necessary in 23 patients; 16 of them were primarily treated with overhead traction. The overall results according to Høyer's criteria were good to excellent in 83 per cent of all cases. These results were comparable with other series with long-term follow-up. Cubitus varus was the most common late complication. Incomplete reduction seems to be the most important cause of this complication.

Adolescent↗
PubMed1988

[Successful conservative treatment of severe congenital camptodactyly. Case report].

A three year old girl with a severe type of camptodactyly of 100 degrees in the right little finger was successfully treated conservatively. A well tolerated circular below elbow plaster of Paris with the PIP joint in maximal extension was applied and changed at short intervals. Gradually after eight weeks complete extension and full return of function as well as a marked radiographic remodelling of the PIP joint were obtained. A slight relapse to 25 degrees of contracture at 2 years follow-up was soon corrected the same way.

Casts, Surgical↗
PubMed1987

[Hannover synthetic moulages. A singular collection of dermatologic teaching models].

Dermatological moulages rapidly lost their importance during the 1950s. The disadvantages of the classical moulage materials, plaster of Paris and wax, are pointed out. In the 1960s and 1970s modern plastics were introduced to moulage technology at the Linden Dermatological Clinic in Hannover. Silicon-caoutchouc and Vestolit-PVC were the substances used. This paper describes how the Hannover collection of plastic models was assembled and presents its current status. Wax and plastic models are set against each other in the illustrations.

Animals↗
PubMed1988

Soleus muscle atrophy in rats induced by cast immobilization: lack of effect by anabolic steroids.

To test the hypothesis that an anabolic steroid such as nandrolone decanoate (ND) will ameliorate or abolish disuse-mediated alterations resulting from five weeks of hindlimb immobilization, female Sprague-Dawley rats were divided into six groups: control, control + ND, shortened-immobilized, shortened-immobilized + ND, stretched-immobilized, and stretched-immobilized + ND. Immobilization was accomplished by wrapping hindlimbs with plaster of Paris. Nandrolone decanoate in sesame oil was administered via weekly intraperitoneal injection (7 mg/kg) while nontreated rats received equivalent volumes of the vehicle. After five weeks selected morphometric, biochemical, and mechanical parameters were examined in the slow-twitch soleus muscle (SOL). Muscle wet weight fell from a control value of 145 +/- 19 mg to 70 +/- 8 mg (p less than .05) in the immobilized-shortened group where ND had no effect (81 +/- 11 mg). Muscle stretch alone prevented weight loss (159 +/- 31 mg). The addition of ND resulted in significant SOL hypertrophy (200 +/- 42 mg), p less than .05. Immobilization resulted in a significant shift in muscle protein distribution toward sarcoplasmic protein, a change unaltered by ND but abolished by stretch. Muscle strength, as indicated by peak tetanic tension, fell 45% (p less than .05) as a result of shortened immobilization. Nandrolone decanoate had no effect on this condition, although the ameliorating effect of stretch was abolished when in combination with ND treatment. The elevation observed in maximal shortening velocity (shortened-immobilized) was unaffected by ND alone, but abolished by stretch with or without ND treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

Surgical treatment of acute, massive lung embolism. Results and follow-up.

Between 1970 and 1984 the diagnosis of acute, massive lung embolism was made 30 times in our department. In 29 patients the clinical diagnosis was correct and a Trendelenburg operation under extra-corporeal circulation was performed. In 18 cases there was an operation in the immediate preoperative course. In 1 case there was a combination of operation and the use of contraceptives. 3 cases were immobilized by a plaster of Paris cast. In 4 cases the use of oral contraceptives and in 3 patients the history of chronic recurrent lung embolism were evident. The mean immobilisation time was 15 days. In 24 cases the diagnosis was made only on the base of the clinical anamnesis, and examination, E.C.G. and chest radiography. In 4 cases angiography and in 1 patient the scintigraphy confirmed the diagnosis. Preoperatively 28 patients were in severe shock. One patient was operated electively. 14 patients needed external cardiac massage. In all cases clots were found in the left pulmonary artery, 28 in the right pulmonary artery, in 3 cases clots in the right atrium, 3 in the right ventricle and three in the inferior caval vein. Nine De Weese caval vein clips were inserted and one Mobin-Uddin filter. Postoperatively 18 patients were alive and well without sequelae. Two patients developed a cerebro-vascular accident (CVA) with one complete recovery. Ten patients died. Postoperative treatment consisted of I.V. heparin administration immediately after surgery and 6 months of oral anticoagulants. Except for chronic recurrent lung embolism the pulmonary function tests were excellent postoperatively without recurrence of the disease.

Acute Disease↗
PubMed1986

[Therapy of enchondroma with a plaster implant--renaissance of a treatment principle].

The treatment of tuberculous osteitis, osteomyelitis or bone tumors by filling the cavity with plaster of Paris implants after complete removal of the focus or tumor tissue by curettage is a method, nearly 100 years old, practised successfully again and again but little noted. Finally Richter et al. gave an account of 25 cases of tuberculous osteitis, osteomyelitis and bone tumors treated by this method. We have practised this method since 1984 in the treatment of enchondroma. Careful scraping-out with a sharp curette, milling the sclerosed wall and rinsing the cavity with dehydrated alcohol is followed by immediate reconstruction, filling the cavity with a gamma-ray-sterilized CaSO4-paste mixed with the local antibiotic Nebacetin siccum. As observed by other authors, this implant clearly stimulates osteogenesis. It is not necessary to take spongiosa fragments out of the iliac crest and we need no general anaesthesia. There were no complications and no tumor recurrences thus far.

Bone Neoplasms↗
PubMed1986

[Treatment of a growth plate fracture of the distal tibia in a calf].

Case report of a post-partum type II epiphyseal fracture of the distal tibia in a calf. Following open reduction, the fracture was stabilised by cross-pins. A plaster of Paris cast was used as an additional support for four weeks. A clinical and radiological follow-up for five months after surgery did not reveal any complications.

Animals↗
PubMed1982

[Treatment of distal fractures of the radius (author's transl)].

Distal fractures of the radius are more common than other types of fracture. The methods of treatment vary greatly, but cure is not always satisfactory. The article subdivides these fractures into flexion and extension types. These two main types are subdivided further. The next chapter deals with conservative repositioning, including the plaster of Paris cast. Surgical treatment is recommended if the fracture cannot be repositioned and if it is unstable. Indication and technical management of percutaneous drill wire fixation are described. Another section of th article deals with plate osteosynthesis in Smith's fractures. Finally, the article goes into the details of stabilization via the external fixator in open fractures, especially fractures involving soft parts.

Bone Plates↗
PubMed1977

[Results of conservative treatment of transverse fracture of the distal tibia and fibula in children].

66 children who were admitted to the Surgical Department of the University Children's Hospital in Zurich because of transverse fracture of the distal tibia and fibula were followed up. They were treated conservatively by reduction followed by immobilization in a plaster of Paris cast reaching to the upper thigh; the foot was placed in the equinus position. Perfect axial reposition should be aimed at. If this cannot be achieved, a varus deformity of up to 6 degrees, a valgus deformity of up to 10 degrees and antecurvation of up to 10 degrees are permissible, as this malposition usually cures itself in time. If the malformation exceeds the limits described above, operative reduction and fixation should be carried out in children over 12 years of age. All children with malposition must be followed up for a long time to observe whether the malposition will gradually disappear and to ascertain whether static difficulties will occur and may have to be corrected by osteotomy.

Adolescent↗
PubMed1983

[Follow-up examinations of patients with isolated fractures of the bony nasal pyramid].

Follow-up examinations in 92 patients with fractures of the bony nasal pyramid showed that repositioning had led to a functionally and cosmetically satisfying result in 38% of all cases only. Groups of patients were identified in which an increased number of therapeutic failures occurred and who, therefore, require exceptionally careful treatment in future. Therefore, --more emphasis must be placed on correct repositioning of the fractured nasal septum, --general anaesthesia permits a more exact correction of the nasal bones, --the nasal skeleton should be stabilized with plaster of Paris in addition to a tamponade, --finally, X-ray pictures in two directions make it easier to recognize the fracture and to control the success of repositioning.

Adolescent↗
PubMed1983

Post-traumatic osteomyelitis. Delay in appearance after infection and prognostic value of radiological signs.

Only 24 patients with post-traumatic osteomyelitis were found from records covering a period of five years. Twenty-two of them with complete medical histories are reviewed here. The radiographs were usually taken through plaster of Paris, and therefore the radiological diagnosis was established later than the clinical one in half of the cases. There were only four cases with a true delay. The primary radiological signs leading to the osteomyelitis diagnosis appeared on average 4.3 months after the assumed time of infection. It is our feeling that the current widespread use of antibiotics causes the diagnosis to be delayed even more than it was in the days of haematogenous osteomyelitis. Continuous formation of periosteal new bone layers indicated poorer prospects for healing of the osteomyelitis.

Adolescent↗