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At least 865 records · Page 48Linked to original sources
PubMed1982

[Clinical evaluation of effectiveness of cefmetazole in bone and joint infections in the orthopedic field].

1. Cefmetazole (CMZ) was administered to a total number of 12 patients, 10 having acute or chronic osteomyelitis and 2 pyarthrosis in the orthopedic field. The efficacy rate was 91.7%. 2. Patients received an intravenous instillation of 1 to 2 g CMZ daily for an average period of 29.8 days. 3. Causative organisms were identified in 8 of the cases examined. In 7 cases S. aureus was isolated. CMZ showed an extremely strong antibacterial activity against S. aureus in a disk test in support of its excellent clinical results. 4. No abnormality was found with respect to subjective and objective symptoms and in laboratory tests. 5. The above results and migration of CMZ into the bone tissue at a high concentration suggest that CMZ is an effective and safe drug for bone and joint infection in the orthopedic field.

Adolescent↗
PubMed1982

Third-generation beta-lactam antibiotics for treatment of orthopedic infections.

Third-generation beta-lactam antibiotics are effective against a wider range of microorganisms than are older antibiotics. Cefotaxime, moxalactam, cefoperazone, ceftizoxime, ceftazidime, cefsulodin, and ceftriaxone were used to treat 102 patients hospitalized with orthopedic infections. Sensitivity of the pathogens to the antibiotic used was established in all cases. Patients allergic to penicillin were given either moxalactam or ceftazidime. Pathogens were eradicated in all but six instances, five of which were Pseudomonas aeruginosa. Four of these developed resistance during therapy. Only three patients had clinical responses that were less than satisfactory. No serious adverse reaction occurred, and no allergic reactions developed. This new class of antibiotics is thus safe and effective as the sole therapeutic agent for many orthopedic infections, including those that require long periods of treatment.

Adolescent↗
PubMed1982

[Clinical use of amikacin sulfate in the treatment of bacterial infections and prevention of postoperative infections in the orthopedic field].

Investigation was made on the effectiveness and safety of amikacin (AMK) in the treatment of bacterial infections and prevention of postoperative infections in the orthopedic field. The details of 14 infectious patients treated with AMK were as follows; osteomyelitis in 5, purulent arthritis in 3, decubitius in 3, cystitis in 2 and purulent peritonitis in 1. For prevention of postoperative infections, AMK was administered to 9 patients. In 14 infectious patients, clinical response was excellent in 2, good in 11 and poor in 1, while in 9 postoperative patients clinical response was excellent or good in all of them. As side effects, a slight rise of the GOT and GPT levels was observed in 1 but normalized by discontinuation of the medication. In the aspects of effectiveness and safety, AMK may be considered to be a useful available antibiotic in the orthopedic field.

Adolescent↗
PubMed1995

Orthopedic casualties in an activated National Guard Mechanized Infantry Brigade during Operation Desert Shield.

From November 1990 to April 1991, the 48th Infantry Brigade (Mechanized), an Army National Guard unit, was activated under Operation Desert Shield and deployed to the National Training Center, Fort Irwin, California, for training in desert warfare. All casualties requiring care beyond the battalion aid stations were evacuated to the medical company organic to the 48th Brigade. Each of 727 orthopedic patient visits were grouped into one of eight etiologies: trauma, degenerative, overuse, infectious, neoplastic, congenital/pediatric, miscellaneous, and psychiatric. Each case was also classified according to anatomic region, severity, and disposition as well as need for a minor procedure, operation, or referral. Orthopedic casualties in a reserve mechanized infantry brigade undergoing intensive field training primarily arose from four common etiologic/regional presentations: wrist/hand trauma, knee/leg trauma, spine/pelvis degenerative, and ankle/foot overuse. Many of these injuries are predictable consequences of a particular soldier's military occupational specialty and unit mission.

Cumulative Trauma Disorders↗
PubMed1994

The effect of patient size and dose of recombinant human erythropoietin therapy on red blood cell volume expansion in autologous blood donors for elective orthopedic operation.

BACKGROUND: Recombinant human erythropoietin (EPO) therapy has been known to enhance erythropoiesis and facilitate autologous blood donation before elective orthopedic operations. However, the optimal EPO dose in this setting remains undefined. To help determine this, we have examined the effect of patient weight and EPO dose on red blood cell (RBC) volume expansion. STUDY DESIGN: Forty-six nonanemic autologous blood donors enrolled at our institution in two previously reported multicenter clinical trials were analyzed. Patients received either placebo or EPO (150, 300, or 600 units [U] per kg) given intravenously at each of six AB blood type donation visits. RESULTS: Total preoperative RBC volume expansion over a 22 day period was 465 +/- 135 mL (mean +/- SD) in patients receiving a placebo and 588 +/- 201 mL, 735 +/- 144 mL, and 881 +/- 292 mL in patients receiving graded concentrations of EPO. When RBC volume increase was corrected for patient weight and EPO dose, patients receiving placebo or EPO (150, 300, and 600 U per kg) expanded RBC volume by 5.9 mL per kg in patients receiving placebo and 7.9, 9.1, and 10.9 mL per kg in patients receiving EPO, respectively (p < 0.02 for each EPO group compared with placebo group). A direct relationship between EPO dose and RBC volume increase (response) over 22 days was determined by the linear regression equation: RBC volume (mL per kg) = 6.34 + 0.0013X, r = 0.98, where X equals total units EPO administered (per kg body weight). CONCLUSIONS: We conclude that EPO dose can be based on anticipated blood losses and transfusion needs in autologous blood donors before orthopedic operation.

Aged↗
PubMed1994

The application of modern imaging methods in orthopedic surgery.

In this paper the application of ultrasonography, computed tomography, magnetic resonance imaging and bone scintigraphy in the diagnosis of orthopedic diseases is discussed. Because of the advances in the diagnosis made possible by these investigations, diagnosis is often made earlier with the consequence that therapeutic modalities can be used in a better way. As a result, late complications of orthopedic diseases can be influenced in a positive way.

Bone Diseases↗
PubMed1994

The use of skull bone in maxillofacial reconstruction and its potential use in orthopedic surgery.

The calvarium provides a source of bone grafts that are widely applied in maxillofacial surgery, with minimal donor-site morbidity and less resorption than endochondral grafts. A technique of harvesting monocortical bone is described and possible indications in orthopedic surgery are proposed. Thus, we suggest that skull bone can be used in orthopedic surgery in some instances, resulting in less donor-site morbidity than when autogenous bone from other sources is used.

Facial Bones↗
PubMed1977

The changes produced by presurgical orthopedic treatment of bilateral cleft lip and palate.

A serial cephalometric analysis (with the aid of metallic implants) and an analysis of the models of 10 children with complete bilateral clefts, who received presurgical orthopedic treatment, was done. It revealed that such therapy can successfully reduce the protrusive deformity of the premaxilla, when forward growth of this structure is restrained so as to allow the remainder of the face to "catch up." Our other observations include the accentuation of the columella during treatment, but an absence of growth at the cleft margins. Orthopedic treatment which fails to achieve the desired aims in 12 weeks of active therapy should be discontinued then in favor of such surgical setback as may be necessary to allow a satisfactory lip repair.

Cephalometry↗
PubMed1993

[Orthopedic aspects of Rett syndrome].

Rett syndrome is a degenerative neurological disorder with onset between 6 and 18 months of age. Severity of motor impairment is variable; some patients lose the ability to walk whereas others walk nearly normally. Orthopedic problems, which mainly involve the lower limbs and spine, can increase functional impairment and cause discomfort. Abnormal joint alignment in the lower limbs due to muscle contractures requires physiotherapy and orthopedic appliances. Surgery may be necessary, in particular to prevent dislocation of the hip or to correct talipes equinus. Scoliosis is common and unresponsive to conservative therapy and should be treated surgically if severe.

Child, Preschool↗
PubMed1993

Standardization and management of orthopedic implants.

Because the price of orthopedic implants has soared to astronomical heights, and insurance companies are paying less for surgical procedures, institutions must find ways of decreasing their costs and reducing their overhead. In the operating room the orthopedic nurse manager can be instrumental in reducing the amount of implant inventory by collecting and reporting data concerning shelf life of implants and coordinating new product trials and evaluation periods to decrease the number of implant systems to one or two.

Humans↗
PubMed1996

Orthopedic manifestations of acute pediatric leukemia.

The variety and distribution of skeletal lesions in children with acute lymphoblastic leukemia is rarely seen in other diseases. Skeletal radiographic changes that can occur in a child with acute leukemia include diffuse osteopenia, metaphyseal bands, periosteal new bone formation, geographic osteolysis, osteosclerosis, mixed osteolysis and sclerosis, and permeative destruction. It is important for orthopedic surgeons to recognize the skeletal manifestations of acute leukemia of childhood because the physician who initially evaluates the child will often be an orthopedic surgeon, and a delay in diagnosis has an adverse affect on survival.

Acute Disease↗
PubMed1996

Epoetin alfa increases the volume of autologous blood donated by patients scheduled to undergo orthopedic surgery.

In patients scheduled to undergo major orthopedic surgery, predonation of autologous blood (AB) has emerged as a means of avoiding subsequent exposure to allogeneic blood. However, patients with a baseline hematocrit (Hct) less than 40% may not be able to donate sufficient AB to fully meet their requirements. In female patients with a baseline Hct < or = 39%, epoetin alfa (300 to 600 IU/kg twice weekly for 3 weeks) significantly increased the amount of AB donated prior to elective orthopedic surgery and significantly reduced allogeneic blood requirements in comparison with placebo. Iron availability was a critical factor in determining the response to epoetin alfa. In these patients, parenteral supplementation with iron saccharate significantly increased the amount of AB donated and the volume of red blood cells (RBCs) collected in comparison with oral iron alone. Parenteral iron supplementation, therefore, ensures that sufficient iron is available to meet the demands of epoetin alfa-accelerated erythropoiesis in patients enrolled in an AB donation program.

Administration, Oral↗
PubMed1996

[Transfusion strategy in programmed hemorrhagic orthopedic surgery].

OBJECTIVES: Prospectively assess autologous blood transfusion for programmed orthopedic procedures. METHODS: From January 1 to December 31 1993, 307 patients underwent programmed orthopedic procedures: total hip replacement (n = 191), total knee replacement (n = 83) and osteotomy (n = 33). General (94%) or spinal anesthesia (6%) was used. The anesthesist explained transfusion techniques and patients gave informed consent for inclusion in an autologous transfusion protocol including differed autologous transfusion, intentional normovolemic hemodilution and intraoperative transfusion of shed blood. RESULTS: A total of 269 autologous transfusion were performed among the 307 patients (87.6%). This was sufficient in 242 cases (78.8%) and in 65 (21.2%) homologous transfusion was required. Among the 269 patients given autologous transfusion, differed transfusion was used in 145 (53.9%), intentional normovolemic hemodilution in 124 (46%) and intraoperative transfusion of shed blood in 222 (82.5%). Among the patients given a differed autologous transfusion, 9 (6.2%) required a homologous transfusion and among the 40 patients in which all 3 techniques were used, only 2 (5%) received homologous blood, both due to secondary complications. CONCLUSION: These findings show that when differed autologous transfusion is included in the transfusion strategy, less than 10% of the patients require homologous blood. In addition, when the 3 autologous transfusion techniques are used, the rate of homologous blood transfusion approaches zero.

Adolescent↗
PubMed1977

[The incidence of hepatitis following orthopedic operations with massive blood-loss in adolescents (author's transl)].

Blood replacement in 527 thoracic spinal grafts (n=295) was greater (F=17.99; 1.116; 0.01) when grafting had to be done in two stages. Between 1953 and 1972 3 cases of postoperative jaundice were seen, negative to Australia-Antigen. Transfusion hepatitis appears to be rarer in this operative material of adolescent orthopedic patients then in other disciplines published. The reasons may be: homogenous material, intact youthful immunity reactions, thorough prevention of infection in orthopedic departments. More could be said only in polycentric prospective study. Preventive measures for hepatitis prophylaxis are discussed.

Adolescent↗
PubMed1996

[Quality of life after orthopedic surgery of the lower limbs. A new approach].

Measuring quality of life is a new approach of interest to all health professionals involved in orthopedic surgery. This paper is an introduction to the multidimensional concept of health related quality of life. Various types of measurement instruments are described: first the psychometric questionnaires, distinguishing generic measures useful in various conditions and disease-specific measures for a given disease or condition, and the recently developed individual instrument; second, econometric measures based on the decision theory. The potential objectives for use and the required measurement properties of these instruments are described. The need and corresponding methods for a cross-cultural adaptation into French when using questionnaire originally developed in English are reported. A literature review focuses on studies reporting such measures used to evaluate orthopedic surgery, particularly in the way patients perceive the results of hip and knee arthroplasty. Further perspectives for clinical and epidemiological research are numerous. Several avenues for research and for use in clinical practice are proposed.

Decision Support Techniques↗
PubMed1997

Antibiotic prophylaxis for orthopedic prostheses and GI procedures: report of a survey.

OBJECTIVE: To determine the practice recommendations of Program Directors of infectious disease training programs with regard to infection prophylaxis for patients with prosthetic orthopedic devices who undergo gastrointestinal procedures. METHODS: We surveyed Program Directors of infectious disease training programs to determine what they recommend when asked about antibiotic prophylaxis for patients with orthopedic prostheses who undergo gastrointestinal procedures. RESULTS: More than 50% of the respondents agreed that prophylaxis is not indicated at any time for these procedures, although there was an almost even split when confronted with colonoscopy and polypectomy within 6 months of prosthesis insertion. CONCLUSIONS: Most Program Directors agree with the recommendations of the American Society for Gastrointestinal Endoscopy and do not recommend prophylactic antibiotics for these patients. If antibiotics are chosen, they should be the same ones that are recommended for infectious endocarditis by The American Heart Association.

Anti-Bacterial Agents↗
PubMed1997

[Extracorporeal shockwave therapy in orthopedics. Positive results in tennis elbow and tendinosis calcarea of the shoulder].

Since the beginning of the 1990s scientific investigations on the use of extracorporeal shock wave therapy (ESWT) in the field of orthopedics have been carried out at the Orthopedic Department of the University of Mainz. Prospective studies demonstrated beneficial effects in chronic lateral humeral epicondylitis (tennis elbow), and in calcifying tendinitis of the shoulder in more than 50% of the cases. Additional indications for which positive results of prospective studies have been published during the past 2 years are plantar calcaneodynea and pseudoarthrosis. On the basis of the results achieved, it may be concluded that, for specific indications, extracorporeal shock wave therapy may now be taken out of the clinical testing stage and introduced into routine practice.

Calcinosis↗
PubMed1997

Bioresorbable fracture fixation in orthopedics: a comprehensive review. Part I. Basic science and preclinical studies.

Metal alloys are currently the most popular materials for manufacture of fracture-fixation devices. Two major disadvantages of these materials are their extreme stiffness, which causes stress shielding of the underlying bone, and the necessity, in a significant number of cases, of removing metallic implants after fracture healing is complete. These shortcomings of metal alloys have led to the study of bioresorbable materials for use in fracture fixation. Currently, polylactic acid, polyglycolic acid, and polydioxanone implants are available to the orthopedic surgeon for the fixation of small cancellous bone fractures. Part I of this article provides an overview of the basic science of bioresorbable materials and presents a comprehensive review of preclinical studies reported in the orthopedic literature. Clinical studies will be reviewed in Part II.

Alloys↗