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PubMed1989

[Practical method of fabrication and application of Delaire-Verdon type orthopedic face-mask].

The Delaire-Verdon type face mask is an efficient extra-oral orthopedic appliance used in protraction of the maxilla. In our clinic, we use this orthopedic face mask in order to stimulate maxillary development, especially in cleft palate cases. The main purpose of this article is to introduce a practical and economical fabrication technique which we have developed by taking impressions from the individual. This technique consists of an extra oral appliance which is custom-made for each patient and an easily applied anchorage system. We feel that these make the treatment more tolerable for the patient.

Child↗
PubMed1989

Orthopedic assessment of young children: developmental variations.

Parents often seek orthopedic evaluation of their young children because of apparent abnormalities. However, many of these are simply developmental variations that are part of normal growth and development. Pes planus, or flat foot, is one of the earliest and most common concerns. Torsional variations are also often seen; the presenting complaint may be intoeing (metatarsus adductus, tibial torsion and increased femoral anteversion) or out-toeing (pes calcaneovalgus and external rotation contractures of the hips). Angular variations (genu varum and genu valgum) are also seen frequently in young children. In assessing each finding, consideration must be given to the age at which the finding may be considered within normal limits, methods of examination and documentation, the expected course, findings that may signify abnormality, and appropriate follow-up and referral. An understanding of these common developmental variations in the orthopedic assessment of young children will enable the health care provider to respond to parents' concerns with accurate information and counseling.

Child↗
PubMedDate not supplied

Traditional and orthopedic relator systems for constructing dentures with monoplane occlusion.

Two sets of complete dentures with monoplane occlusion were constructed for each of eight patients. One set was made by using techniques and protocols of traditional systems; the other was constructed with the technology of the Orthopedic Relator. Using the Orthopedic Relator system reduced the number of separate steps required and provided greater standardization than was possible with traditional techniques.

Dental Articulators↗
PubMed1989

Computed tomography solves problems in orthopedic radiology.

One of the most important developments in orthopedic diagnostic radiology in the past 50 years has been that of computed tomography. The cross-sectional display, the capacity to reformat in other planes, the extreme sensitivity to differences in X-ray beam attenuation, the ability to manipulate the contrasts of the images, and the ability to produce blurless tomographic sections of varying thicknesses while the patient, even in a heavy plaster cast, does nothing more than lie still, are some of the capabilities that have enabled computed tomography to improve the way radiology can help the orthopedic surgeon care for patients.

Adolescent↗
PubMed1978

Early maxillary orthopedics in CLP cases: guidelines for surgery.

Two samples of complete cleft cases between five and seven years of age are compared (11 UCLP + 9 BCLP versus 21 UCLP + 12 BCLP). The same early orthopedic procedures were applied to all cases, but surgical management differed for the two groups: "classical" surgery (lip 3 months, palate 2--2 1/2 years) versus delayed conservative surgery (lip 6 months, soft palate 18 months, hard palate 6--8 years). It is evident that early maxillary orthopedic treatment is of little consequence for long-term development unless concomitant surgery complies with growth and functional requirements. In contrast to "classical" surgery, palatal closure in two steps is more favourable to skeletal growth and does not interfere to any relevant degree with speech development.

Activator Appliances↗
PubMed1989

Extracorporeal hemolysis in orthopedic patients. Report of two cases.

Two patients who had extracorporeal hemolysis of their blood transfusions are reported. In both cases, accidental overheating and hemolysis of the transfused blood caused a gross hemoglobinuria. Because the etiology of the hemolysis was not readily apparent at the time, both patients were managed as though they had had an acute hemolytic transfusion reaction. Because there was no activation of the complement cascade by antigen-antibody complexes, both patients suffered no ill effects. Differentiation of extracorporeal hemolysis from hemolytic transfusion reactions requires a careful inspection of all blood administration equipment, as well as an analysis of the untransfused blood in both bag and tubing. Patients undergoing orthopedic procedures account for 15% of all blood transfused in the United States. Awareness of adverse effects of transfusion is therefore important to orthopedic surgeons.

Adult↗
PubMed1986

Orthopedic disorders in school children with Down's syndrome with special reference to the incidence of joint laxity.

Thirty-nine school-age children with Down's syndrome (trisomy 21) were examined for orthopedic problems and evidence of joint laxity. Of these, 10.3% had required orthopedic surgery for feet and hip problems, and 13% had disorders not yet requiring surgery. Only two children could be regarded as showing unequivocally abnormal generalized joint laxity. Twenty-three of the children had one or more lax joints, and one had a dislocated hip without laxity of other joints. Six children had hypermobility of the patella, but this did not correlate with joint laxity. Fifteen children had no evidence of joint laxity. Laxity does not appear to be a major etiological factor in joint problems occurring in Down's syndrome.

Adolescent↗
PubMed1987

[Crural arterio-venous fistula due to orthopedic surgery. A report of a case].

A rare case of crural arterio-venous fistulae due to orthopedic surgery was presented. A 60-year-old female patient received a corrective fibulotomy just below the fibular head under the diagnosis of osteoarthropathy of the left knee joint 3 years ago. Intractable pain and swelling of the left leg appeared shortly after operation, probably due to deep vein thrombosis. A faint thrill on the left saphenous vein afforded a clue for detecting a co-existing arterio-venous fistula. Confirmative cine-angiography revealed a few a-v-fistulae at the level of crural trifurcation, which might have exacerbated the symptoms of deep vein thrombosis. On entering the trifurcation, which was embedded in scar tissues, there were two a-v-fistulae, originating separately from the peroneal artery and the posterior tibial artery. These fistulae were closed directly, one from the peroneal artery through the lateral approach resecting the upper one third of the fibula, and the other from the posterior tibial artery through the standard medial approach. Postoperative course was uneventful, and the swollen leg subsided rapidly with remarkable improvement of symptoms such as pain, dullness, night cramp of the calf and etc. Concerning to the medical literature on iatrogenic arterio-venous fistula due to orthopedic surgery, no similar case has been reported at least in these ten years on crural arterio-venous fistula after corrective fibulotomy.

Arteriovenous Fistula↗
PubMed1987

Salvage of lower extremities following combined orthopedic and vascular trauma. A predictive salvage index.

A retrospective review of 676 tibial-fibular fractures and 985 femoral fractures treated over a 71-month period yielded associated major vascular trauma in 12 (1.7%) tibial-fibular fractures and in five (0.5%) femoral fractures. Vascular trauma combined with orthopedic trauma was also identified in four other cases--two disruptions of the pubic symphysis and two dislocations of the knee without fracture. Nine (43%) of the 21 involved limbs were eventually amputated. Limb survival was not related to the temporal relationship of vessel repair to skeletal stabilization; the presence or absence of shock on admission; the presence of associated but repaired venous injury; or the presence of unrelated injuries. Limb survival was related to the interval from injury to arrival in the operating room; the level of arterial injury; and the quantitative degree of muscle, bone, and skin injury. By combining these variables a limb salvage index was established that identified lower extremities likely to require amputation after combined orthopedic and vascular trauma (sensitivity 78%, specificity 100%). Use of this predictive salvage index may prevent the trauma surgeon from attempting to salvage a doomed or useless lower extremity and may thus permit early prosthetic rehabilitation to follow definitive primary amputation.

Adolescent↗
PubMed1979

Oral orthopedics and movement of maxillary segments. A roentgen stereophotogrammetric study.

An infant with a complete unilateral cleft of the lip and palate underwent maxillary expansion treatment using an oral orthopedic appliance. Movement of the maxillary bone segments was studied by means of metallic implants and roentgen stereophotogrammetry, and intra-oral changes were recorded by measuring transverse dimensions on casts. Expansion treatment had almost no influence on the positions of the maxillary segments, and movements of the segments showed little agreement with measures on casts. The findings suggest that the appropriate use of the term oral orthopedics and the evaluation of treatment effects would benefit from evaluating the movement of the segments by methods other than measurements of casts.

Cleft Lip↗
PubMed1979

[Experiences with clindamycin in orthopedic surgery and traumatology].

60 cases of orthopedic surgery and traumatology were treated 64 times altogether with an average dose of clindamycin of 3 X 300 mg/day. 40 patients were given clindamycin as preventive treatment. 12 patients were treated for acute infections of the locomotor system and other 8 patients 12 times for chronic osteitis. In the group having received preventive trqatment, infection occurred bu 1 out of 40 patients. As to the 12 cases of acute infections, 10 recovered, 1 improved and 1 patient got worse. Concerning the 12 treatments of 8 patients with chronic osteitis, in 1 case the inactivation of the infection was obtained. 9 cases showed significant improvement whereas in 2 cases an aggravation was noticed. In 5 patients the following side effects occurred: 2 cases of allergic exanthema, 2 cases of mild diarrhoe and 1 case of pyrosis. This study shows that clindamycin is an antibiotic with a broad field of application in orthopedic surgery.

Abscess↗
PubMed1985

[Proglumetacin: possible first choice in the treatment of orthopedic- traumatologic disorders].

Ninety-seven patients (44 males and 53 females of mean age 42.6 +/- 12,9 years) with orthopedic-traumatologic disorders (osteoarthritis, 38; painful joints, 26; fibrositis, painful shoulder, 20; peri- and extra-articular disorders, 13) had been treated during 7 to 30 days with two suppositories (400 mg) or three capsules (450 mg) proglumetacin (Proxil Rorer). Most patients responded well to very well to the treatment with significant improvement of pain and inflammatory symptoms as well as restoring of limited function. Such a response resulted proportional to the dose (53% of good responders among those given the lower dose and 82% among those at the higher dose) and to the kind of pathology. The patients with acute disorders (7) responded all very well in 7 days; those with subacute disorders (57) responded well to very well in a proportion of 57% within 15 days; those with chronic disorders responded to a proportion of 48% within 30 days. Tolerance resulted very good anyway: in no case had the treatment to be withdrawn, nor allergic or C.S.N. reactions were observed, so that the overall tolerance was defined excellent to good in 90% of patients. Thirty-three patients complained of accessory symptoms, mainly epigastric pain and nausea, almost always mild and anyway transient. Proglumetacin can therefore be properly defined as a firstchoice treatment for the management, also ambulatory, of orthopedic-traumatologic disorders.

Administration, Oral↗
PubMed1985

[Air decontamination and preventive antibiotic therapy in orthopedic surgery].

In a private 160-bed orthopedic hospital, the effect of air decontamination and antibiotic prophylaxis on postoperative infections was studied. From 1971 to 1978, 5 016 orthopedic procedures were performed without antibiotic prophylaxis. Postoperative infection rate was 2% with the conventional operating room and 1.9% with the sterile room. The beneficial effect of vertical laminar air flow thus appears doubtful. From 1979 to 1982, prophylactic therapy with a cephalosporin was used for total hip replacements. Rate of postoperative deep infection fell from 3.3% in 811 hip replacements without antibiotics to 0.5% in 1 172 replacements with antibiotic prophylaxis. Our findings suggest that cephalosporin prophylaxis is more effective than vertical laminar air flow for preventing postoperative hospital-acquired infection.

Air Microbiology↗
PubMedDate not supplied

The orthopedic aspects of the fetal alcohol syndrome.

Eight cases of the fetal alcohol syndrome are presented with emphasis on their frequent orthopedic anomalies, i.e. hypoplastic toenails (100%), shortened fingers, usually the fifth (75%), radioulnar synostosis, camptodactyly of fingers, clinodactyly of toes, and flexion contractures of the elbow (all 50%). These are in addition to 7 other orthopedic anomalies observed less frequently and some 18 general characteristics had an extensive endocrine, biochemical and genetic work-up and no abnormalities were found to explain the snydrome other than the teratogenicity of the maternal alcohol abuse. Since the orthopedist may be the first physician to see these patients, diagnosis of these musculoskeletal anomalies should include a social history and investigation for fetal alcohol syndrome.

Child, Preschool↗
PubMed1983

[Proglumetacin: analgesic anti-inflammatory treatment for orthopedic and traumatologic pathology].

Twenty-three patients with orthopedic and traumatic disorders, mostly hospitalized, were treated with proglumetacin, 450 mg/day, during 5-45 days. Proglumetacin resulted to be a good analgesic and anti-inflammatory drug. Tolerance was good or excellent in all patients but one. Proglumetacin appears to be drug particularly suitable for the treatment of orthopedic and traumatic disorders, also in the postoperative course.

Adult↗
PubMed1983

Osteoarticular abnormalities and orthopedic complications in children with chromosomal aberrations.

Chromosome abnormalities may result in a great number of osteo-articular anomalies. Little documentation concerning these anomalies is available. The main orthopedic problems encountered in 67 children with chromosomal abnormalities are reported here. Patients should be evaluated at regular intervals in order to detect osteoarticular involvement. Gradual deterioration results in disabling conditions which are difficult to manage. Orthopedic management should be mainly preventive. It's purpose is to delay or to avoid the onset of disabling complications.

Adolescent↗
PubMed1981

Orthopedic disorders in patients with Down's syndrome.

We have contrasted 161 patients with Down's syndrome admitted to three acute care centers with 107 patients in an institutional setting, outlining their major orthopedic problems and suggesting methods of management based on acute care experience. Severe hallux valgus, metatarsus primus varus, subluxation an dislocation of the patella, severe pes planus, atlantoaxial subluxation, femoral head epiphysiolysis, and dislocation or subluxation of the hips remain the most critical problems against a background of other less common orthopedic abnormalities.

Down Syndrome↗