Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “PLASTER CASTS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 847 records · Page 47Linked to original sources

The value of the Hoffmann skeletal fixation in the management of cross-leg flaps, particularly those injuries complicated by open fractures of the tibia.

The Hoffmann external fixator has been used to immobilize lower limbs for the application of cross-leg flaps in the presence of tibial fractures. The legs and the fracture are held rigidly in the optimal position during and after the operation, with ease of adjustment and excellent access to the flap. There is relatively less weight on the legs than when using a plaster cast, and with the joints free, the patient is much more mobile in bed.

Adult↗

A comparison of plating and traction in the treatment of tibial shaft fractures.

A consecutive series of fractures of the tibial shaft was studied over a 4-year period. A total of 115 fractures in 115 patients were found to be unstable and therefore unsuitable for immediate treatment in a plaster cast. Sixty-three fractures were treated by internal fixation using AO dynamic compression plates and 52 patients were treated by calcaneal traction. The two treatment groups were compared and it was found that overall each spent a similar time in hospital but the surgically treated group required a minimum of two admissions. The surgically treated group healed 6 weeks sooner than the conservatively treated group but there was an overall complication rate of 30 per cent related to the internal fixation. One hundred and three patients were seen for clinical review, and the incidence of joint stiffness is discussed.

Fracture Fixation, Internal↗

Functional taping of fractures of the 5th metacarpal results in a quicker recovery.

Fractures of the fifth metacarpal can be treated non-operatively by plaster immobilisation or functional taping. In order to evaluate the better treatment policy, the two methods were compared in a prospective randomised series. We treated 25 patients with an ulnar gutter plaster-cast splintage and 25 with functional tape. Functional recovery was evaluated after one week and four weeks, three months and six months. Mobility, power-grip, pulling- and torque strengths were measured. The change in fracture angulation was calculated at the one and four-week follow-up. Residual symptoms were evaluated after six months. The functional tape group showed significant earlier functional recovery. After six months, there were no significant differences between the groups with regard to functional and anatomical results or the number of patients with residual symptoms. In both groups, we noted a change in fracture angulation only in those fractures that had been reduced. We conclude that fractures of the 5th metacarpal are better treated by functional taping than by cast immobilisation.

Adolescent↗

Tibial spine fractures: an analysis of outcome in surgically treated type III injuries.

We analysed the outcome of open reduction and internal fixation of type III tibial spine fractures, assessing treatment and determining a treatment protocol. A total of 10 patients presented over 3 years to our institution with a mean age of 15 years (range 10-21), a male-to-female ratio of 8:2. left to right 6:4 and anterior to posterior spine fracture 9:1. Only one patient had associated meniscal injury noted at arthroscopy (no treatment required). The mode of injury was road traffic accidents four, sports injuries three and falls three. The mean follow-up was 9 months. There were seven excellent results and three good results. Those patients with good results exhibited either minimal quadriceps weakness, extensor lag (< 10 degrees) or antero-posterior laxity. This reflects the experience of other authors in dealing with these injuries in younger patients. There is widespread agreement that types I and II should be treated by plaster cast alone and that is also the policy at our institution. We recommend a routine treatment protocol in type III injuries of (1) examination under anaesthesia, (2) arthroscopy (evaluating the fracture, cruciate integrity and other associated injuries), (3) open reduction and screw fixation and (4) vigorous physiotherapy/rehabilitation of all type III fractures, as we feel this provides the best possible outcome in these injuries.

Adolescent↗

Structural complexity in mussel beds: the fractal geometry of surface topography.

Seafloor topographic complexity is ecologically important because it provides habitat structure and alters boundary-layer flow over the bottom. Despite its importance, there is little agreement on how to define and measure surface complexity. The purpose of this investigation was to utilize fractal geometry of vertical cross-section profiles to characterize the surface topography of the soft-bottom mussel bed (Mytilus edulis L.) at Bob's Cove, ME, USA. Mussels there have been shown previously to have spatially ordered fractal characteristics in the horizontal plane. Two hypotheses were tested. The first was that the bed surface is fractal over the spatial scale of 1.44-200 mm, with fractal dimension less than or equal to 1.26, the value for the Koch curve, our model for bed profiles. The second was that bed surface topography (i.e., in vertical profile) is less complex than the mussel bed spatial pattern (i.e., aerial view in the horizontal plane). Both hypotheses were supported. Cross-sections of plaster casts of the bed produced 88 surface profiles, all of which were fractal over the entire spatial scale of more two orders of magnitude employed in the analysis. Fractal dimension values (D) for individual profiles ranged from 1.031 to 1.310. Fractal dimensions of entire casts ranged up to mean (1.242+/-0.046) and median (1.251) values similar to 1.26, the theoretical value of the Koch curve. The bed surface was less complex than the bed spatial pattern because every profile had D<1.36, the smallest value previously obtained from aerial views of the bed. The investigation demonstrated for the first time that surface topography of a soft-bottom mussel bed was fractal at a spatial scale relevant to hydrodynamic processes and habitat structure important for benthic organisms. The technique of using cross-section profiles from casts of the bed surface avoided possible underestimates of fractal dimension that can result from other profiling methods reported in the literature. The results demonstrate that fractal dimension can be useful in the analysis of habitat space and water flow over any irregular seafloor surface because it incorporates the size, shape, and scale of roughness elements into a simple, numerical metric.

Journal Article↗

[Trauma-induced tears of the quadriceps tendon: 47 cases].

PURPOSE OF THE STUDY: A torn quadriceps tendon is an exceptional finding generally observed after high-energy knee trauma in patients over 40 who present a sprain-like syndrome or after low-energy trauma in elderly subjects who experience knee instability. We reviewed a series of 47 cases of traumatic quadriceps tendon tears treated between 1976 and 1996 in order to evaluate outcome after surgical repair. MATERIAL AND METHODS: Clinical diagnosis was the rule. Forty-two patients, mean age 55 years (range 17-92) were treated for tears of one or both quadriceps tendons subsequent to low-energy trauma (40 tears) or high-energy trauma in younger subjects. The diagnosis was established early in all cases except eight (diagnosis at three weeks to one year). Surgical repair was performed in all cases except one. After surgery, the knee was either immobilized with a plaster cast or held in a removable splint to allow early mobilization. RESULTS: Average time to recovery compatible with daily life or occupational activities was four months. Recovery was not complete at this time. Long-term follow-up revealed that complete recovery with very good or good subjective results was achieved in 90% of the cases. Complete joint motion and normal quadriceps force was achieved in 80% of the cases. Patients who started rehabilitation exercises early generally achieved less satisfactory results although no significant correlation was identified with objective clinical variables. DISCUSSION: Quadriceps tendon tear is a clinical diagnosis which does not require complementary exploration for confirmation. Plain x-rays may be useful to identify associated bony lesions and specific signs of tendon tears. Early surgical repair followed by complete immobilization appears to be preferable for functional recovery allowing better recovery of muscle force without compromising flexion.

Activities of Daily Living↗

[Posterior spinal fusion for kypho-scoliosis associated with osteogenesis imperfecta: long-term results].

PURPOSE OF THE STUDY: A survey was conducted at the Necker-Enfants-Malades Hospital in Paris and the Roscoff Helio-Marin Center in Roscoff, France to document results of posterior spinal fusion for scoliosis associated with osteogenesis imperfecta. MATERIAL AND METHODS: The cases of 27 patients who underwent posterior spinal fusion and Harrington (n = 2) or CD (n = 23) instrumentation performed by one senior orthopedic surgeon were reviewed. Two patients had posterior arthrodesis without instrumentation and were left in halo-traction together with a plaster cast until bone healing was achieved. RESULTS: The series included eleven males and sixteen females. Mean age at fusion was 13 y 4 m. The average curvature before surgery was 77 degrees and the average correction was 37 degrees. Mean follow-up was six years. Minor complications due to halo pin infection or migration were observed in two patients and loss of correction with rod fracture in four. DISCUSSION: Because of the risk of physical and respiratory incapacity, we believe that spinal surgery and arthrodesis for spinal deformity should be considered after a preparation period by halo-traction with exceptional precautions to correct major curves and prevent complications that could occur in patients with osteogenesis imperfecta. Correction and stabilization of the scoliotic spine in osteogenesis imperecta has yet to be definitively described since we have noticed that the site of deformation is transferred to the sacroiliac region once spinal fusion is achieved.

Adolescent↗

Effect of vitamin C on frequency of reflex sympathetic dystrophy in wrist fractures: a randomised trial.

BACKGROUND: The pathogenesis of reflex sympathetic dystrophy (RSD) is not clear, nor is there a definitive treatment for this syndrome. The morbidity, costs in health care, and loss of work time justify the search for a means to prevent post-traumatic dystrophy. Although the role of toxic oxygen radicals has not yet been clarified, we investigated vitamin C (ascorbic acid) as a prophylactic antioxidant drug. METHODS: 123 adults with 127 conservatively treated wrist fractures were randomly allocated in a double-blind trial to take a capsule of 500 mg vitamin C or placebo daily for 50 days. Each participant's sex, age, side of fracture, dominance, fracture type, dislocation, reduction, and complaints with the plaster cast were recorded, and they were clinically scored for RSD. The follow-up lasted 1 year. FINDINGS: Eight patients were withdrawn after randomisation. 52 patients with 54 fractures (male 22%, female 78%; mean age 57 years) received vitamin C and 63 patients with 65 fractures (male 20%, female 80%; mean age 60 years) received placebo. RSD occurred in four (7%) wrists in the vitamin C group and 14 (22%) in the placebo group 15% (95% CI for differences 2-26). Other significant prognostic variables for the occurrence of RSD were complaints while wearing the cast (relative risk 0.17 [0.07-0.41]) and fracture type (0.37 [0.16-0.89]). INTERPRETATION: This prospective, double-blind study shows that vitamin C was associated with a lower risk of RSD after wrist fractures. Our hypothesis is that this beneficial effect of prophylaxis would be useful in other forms of trauma.

Adult↗

The development and significance of septal and dental deformity from birth to eight years.

The septa of a series of 145 babies at birth was assessed into 3 types: type A--in the midline, type B--unilateral bending or kinking at the vomerine junction, type C--deformed to both sides. These were reassessed aged 5-6 years with the primary dentition present, and 90 cases reassessed aged about 8 years. In some there was a change to types B and C, but none changed to type A. Of 15 cases of external deformity of the nose at birth, 10 (66%) had irregularity of the columella. The children had dental examination and plaster casts made, an ear, nose and throat examination, and were photographed. The chances (which were statistically significant) of developing dental abnormalities and malocclusion, palatal asymmetry, upper respiratory tract infections and ear disease were found to be mostly in type B cases, less in type C cases and least in type A cases. Thus ear troubles were found in 45% type B, 25% type C and only 10% of type A cases. The palatal height was not related to any septal deformity.

Australia↗

Early overuse and disuse of the affected forelimb after moderately severe intraluminal suture occlusion of the middle cerebral artery in rats.

We have previously shown that early forced overuse of the affected forelimb worsens outcome following moderately severe transient focal cortical ischemic stroke in rats using a distal middle cerebral artery occlusion (MCAo) model. This effect may be site-dependent, because we have also found that early forced use of the affected limb after unilateral 6-OHDA induced degeneration of ascending nigrostriatal dopamine neurons markedly enhanced functional outcome and is neuroprotective. The present study examines the effects of early overuse and disuse following a moderately severe proximal MCAo model, by means of intraluminal suture occlusion. Ischemia was produced in male Long-Evans rats with 60 min of occlusion, or sham surgery was performed. Early overuse or disuse of the affected forelimb was forced by immobilizing either the ipsilateral or contralateral forelimb, respectively, in a plaster cast or the animal was left uncasted. Casts were removed on day 10 and sensorimotor testing was performed weekly during days 17-38. Animals were sacrificed on day 45 and brains were fixed for later cresyl violet staining. The MCAo+contralateral cast group performed worse than all other groups on tests of forelimb sensorimotor function. All MCAo groups regardless of cast condition had significant atrophy of the ischemic striatum, but there was no significant atrophy of the ischemic cortex in any group. Forced disuse, but not overuse, of the affected forelimb immediately following proximal ischemia using the intraluminal suture model has detrimental effects on functional outcome, without exaggerating anatomical damage. The effects of disuse and overuse during the first 10 days after stroke differ depending on cortical or subcortical involvement.

Animals↗

Fracture of the hook of the hamate: report of six cases and the suitability of computerized tomography.

During the last 3 years, six patients with a fracture of the hook of the hamate were seen. All fractures were recognized by the carpal tunnel radiogram, but three were much more clearly demonstrated by computerized tomography of the carpal bones. Immobilization in plaster cast was beneficial in one patient and the other five patients required removal of the fractured fragment. All six patients were able to return to their previous occupations and sport activities.

Adolescent↗

Pouteau-Colles fracture: double-closed "basket-like" pinning according to Kapandji. Apropos of a homogeneous series of 70 cases.

First described by Kapandji, the double closed "basket-like" pinning is a new and quite attractive treatment of the Colles' fracture. With or without XR TV, following closed reduction the epiphysis is fixed steady with two Kirschner wires, sliding along its lateral and its posterior aspects, entering the radius at the fracture site and transfixing the bone cortex above. Plaster cast is unnecessary, and wrist reeducation begins on the first day post-op. Technical "know-how" is specified, and seventy-two patients followed up. Present findings indicate that the complication rate is very low, excellent and good results are 83%. Rehabilitation is quicker, socio-economically gratifying. We believe that the method significantly improves the conservative treatment of Colles' fracture and decide to use it extensively from now on.

Bone Nails↗

Long-term results in the treatment of fracture-dislocations of Galeazzi in adults. Report on twenty-nine cases.

The authors report 29 cases of a true Galeazzi fracture, (i.e. displaced fracture of the radial shaft and disruption of the distal radioulnar joint). In 1/4 of the cases, dislocation was overlooked and the injury was mistaken for a so-called "isolated" fracture of the radius. By accurate open reduction and compression plating of the fracture, both the torn radioulnar ligaments and the articular disc could be repaired and healed. Additional percutaneous Kirschner pinning across the ulna and the radius in order to avoid redislocation, does not seem to be necessary. It is important, however, to hold the reduction of the radioulnar dislocation in a plaster cast for 4-6 weeks, since the 8 persistent displacements of the ulnar head always resulted in a lack of pronosupination of more than 25 degrees. In these cases, pain and disability may require later surgical management. Late resection of the ulnar head or a Sauve-Kapandji procedure which yield an obvious cosmetic and functional improvement, are preferred to any immediate surgical repair of the radioulnar ligaments. This operation was carried out 3 times, but failed twice. Nevertheless out of 25 patients reviewed after a mean follow up time of 6.5 years, the results were gratifying in 20 who could resume their previous occupation 4 to 12 months postoperatively.

Adult↗

[Functional treatment of isolated fractures of the ulnar diaphysis in adults. A prospective study apropos of 10 cases and review of the literature].

In this prospective study, ten consecutive isolated fractures of the ulna were treated by short-arm plaster cast (an average of 16.8 days) with immediate mobilization in our institution since January 1995. The minimum follow-up was eight months and the longest was two years. All fractures were closed. The median age of the patients was 36.7 years (17 to 61), the male to female ratio was 7 to 3. The patients were seen and radiographed every two weeks until bridging external callus was detected by same surgeon. Monteggia fractures-dislocation, open fractures, fractures with elbow or wrist dislocation and gunshot fractures were also excluded. The fracture involved the distal third in 5 cases, the distal quarter in 4 cases and the middle third in one case. Seven fractures were displaced between 2.5 and 6 mm, but no fracture needed reduction. All patients returned to work a mean of 4 months after the accident. Some angulation was found in most cases, but it rarely exceeded 10 degrees. In this study, the average healing time was 8 weeks and there were no non-unions. We did not encounter any synostosis between the radius and ulna in our patients. Motion at the wrist and elbow was always restored. All patients were satisfied by the functional method. The method that we have described can be safely recommended as treatment of choice for these fractures. Completely displaced, Monteggia fractures, comminuted or gunshot fractures of the ulna should be treated by other methods.

Adolescent↗

Rupture of the quadriceps tendon after total knee arthroplasty. A case report.

Reported herein is the case of a 45-year-old woman with knee involvement due to rheumatoid arthritis. She had a total knee arthroplasty with a rupture of the quadriceps tendon 1 month later. Surgical repair of the rupture was performed following the Scuderi technique plus reinforcement with Dacron (Lig Aid, Levallois, Cedex, France) tape cerclage. An above-knee walking-plaster cast was applied with the knee in full extension for 6 weeks. The functional result was good 1 year after surgery.

Arthritis, Rheumatoid↗

Prediction of dental arch development: an assessment of Pont's Index in three human populations.

Pont's Index was established by Pont in 1909 to predict maxillary dental arch width from the sum of the mesiodistal diameters of the four maxillary incisors. The usefulness of Pont's Index is controversial and, as there has been a recent resurgence of interest in its clinical use for establishing dental arch development objectives particularly by nonspecialists, reassessment of the Index in different human populations was considered worthwhile. This study aimed to evaluate Pont's Index in untreated, noncrowded samples of Australian Aborigines (n = 80), Indonesians (N = 60), and white subjects (N = 60). Measurements were obtained directly from plaster casts; they included mesiodistal crown diameters of the four maxillary incisors, as well as intercanine, interpremolar and intermolar maxillary arch widths as specified by Pont. A series of double determinations confirmed the reliability of the method. Considerable individual variability was noted in each population with regard to the difference between observed values and Pont's estimates, ranging from -5.9 mm to +6.2 mm (interpremolar width) and -6.1 mm to +12.7 mm (intermolar width). No person displayed the ideal arch dimensions predicted by the Index, but values were within +/- 1.0 mm for 17.5% of the Indonesian sample, 20.6% of the Aboriginal sample, and 30.8% of the white sample. Dental arch width was generally underestimated by the Index in Indonesians who tended to display relatively small tooth size and large arch width. A more even distribution of estimates was noted in Australian Aborigines and white subjects, with the Aborigines showing large tooth size and broad dental arches, and the white subjects displaying smaller tooth size and narrow arches. Correlation coefficients computed between observed and expected values were low in all three populations studied (range r = 0.01 to r = 0.56). Although the concept of a simple index with predictive ability is very appealing to some clinicians, the results of this study have highlighted the marked variation in values of Pont's Index for persons with apparently good occlusions, representing three different human populations. Tooth size variation was poorly correlated with arch width variation, with persons often being over or under Pont's estimation due to variation in tooth dimension, particularly in the size of the maxillary lateral incisor. It is concluded that Pont's Index is unlikely to be a useful clinical predictor of dental arch width and the index should not be used as a guide to dental arch development in contemporary populations.

Adolescent↗

Evaluation of continuous arch and segmented arch leveling techniques in adult patients--a clinical study.

The purpose of this study was to compare the efficacy of overbite correction achieved by a conventional continuous arch wire technique and the segmented arch technique as recommended by Burstone. The sample comprised 50 adult patients (age 18 to 40 years) with deep bites. Twenty-five patients were treated with a continuous arch wire technique (CAW); in the second half of the sample, the segmented arch technique (Burstone) was used for correction of the vertical malocclusion. Lateral cephalograms and plaster cast models taken before and immediately after treatment were evaluated. Statistical analysis was performed on the collected data. The results showed that both techniques produced a highly significant overbite reduction (CAW: -3.17 mm, p < 0.001; Burstone: -3.56 mm, p < 0.001). The CAW group showed an extrusion in the molar area with subsequent posterior rotation of the mandible (6occl-ML: +1.30 mm; 6occl-NSL: +1.63 mm; ML/NSL: +1.94 degrees, all p < 0.001). The Burstone group, however, showed overbite reduction by incisor intrusion without any substantial extrusion of posterior teeth (upper 1-NSL: -1.50 mm; lower 1-ML: -1.72 mm; both p < 0.001). As a consequence, no significant posterior rotation of the mandible took place (ML/NSL: +0.52 degrees, n.s.). It is concluded that in adult patients the segmented arch technique (Burstone) can be considered as being superior to a conventional continuous arch wire technique if arch leveling by incisor intrusion is indicated.

Adolescent↗

Normal faciolingual inclinations of tooth crowns compared with treatment groups of standard and pretorqued brackets.

Faciolingual inclinations of tooth crowns were measured on plaster casts of normal occlusions and posttreatment orthodontic models of treated cases. Normal anatomic occlusion, standard edgewise and Roth bracket groups of 10 subjects were examined for a change in torque values. On study models, crown inclinations of right and left central teeth to second molar in the upper and lower dental arches were measured to the functional occlusal plane and mean tooth inclinations were calculated. In normal occlusion group, upper central and lateral teeth inclined lingually, lower central teeth inclined slightly labially and lower lateral teeth inclined lingually but the standard deviations of mean values for upper and lower anterior teeth were high. Upper posterior teeth, from canine to molar, had a lingual inclination and lower posterior teeth had a progressively increasing lingual inclination from lateral to molar teeth. In treatment groups, upper central and lateral teeth had labial crown inclination and lower molar teeth had more lingual inclination as compared with the normal occlusion group. No significant variation was found between the mean torque values of standard and Roth treatment groups.

Adolescent↗