Laparoscopic prosthesis fixation rectopexy for complete rectal prolapse.
Explore the source record for details and available documents.
Humans↗
SEARCH · Search PubMed
Results for “Prosthesis Fitting”
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.
Rehabilitation outcome 5 years after 100 lower-limb amputations.
Received wisdom commends a policy of maximizing the ratio of below-knee to above-knee amputations in patients with end-stage arterial disease. After adoption of this policy, the long-term outcome of 100 consecutive lower-limb amputations in 96 patients was monitored by annual review for 5 years. The ratio of primary below-knee to above-knee amputations was 2:1, with 9 per cent of below-knee amputations undergoing revision to a higher level. At 2 years after amputation only 26 per cent of patients were successfully walking out of doors, while 40 per cent had died. By 5 years 67 per cent were dead and only 9 per cent continued to walk out of doors with an artificial limb, although a further 8 per cent continued to use the limb within the confines of their own homes. In a previous audit of 193 amputations performed during the 3.5 years to December 1984, stump healing was a problem in 45 per cent of primary below-knee amputations, compared with 25 per cent in the present study. Although the below- to above-knee ratio in 1984 was only 1:2, the overall rehabilitation rate, as determined by the proportion of patients able to walk at 2 years, was 34 per cent. It is concluded that increasing the proportion of below-knee amputations from one-third to two-thirds of lower-limb amputations for occlusive arterial disease does not improve effective rehabilitation rates. Received wisdom on the desirability of a high below- to above-knee ratio may be wrong.
Age Factors↗
Bilateral tibial hemimelia I.
Congenital absence of tibia is a rare anomaly. We report a case of bilateral tibial hemimelia born to phenotypically normal parents. The two amputated legs with tibial dysplasia obtained from a 3-year-old boy were studied by radiography and anatomical dissection. The radiological evaluation revealed a normal hip joint. The lower end of femur was normal without any bifurcation, shortening or bowing. Fibula was present on both legs and there was no sign of bowing or doubling. Both right and left tibiae were absent. In addition, on the right side, five tarsal bones, two metatarsals and the corresponding digital rays were absent. On the left side, three tarsal bones were absent. Dissection of the amputated segments showed the presence of extensor digitorum longus, peroneus tertius, peroneus longus and brevis, gastrocnemius, and soleus. Following bilateral knee disarticulation the patient was fitted with prosthesis and is doing well.
Amputation, Surgical↗
Cervical spondylodiscitis: a rare complication after phonatory prosthesis insertion.
BACKGROUND: Tracheoesophageal puncture has excellent voice rehabilitation after total laryngectomy. However, despite its easy insertion and use, severe complications have been reported. METHODS: We report a case of cervical spondylodiscitis, occurring in a 67-year-old woman submitted to phonatory prosthesis insertion. After 1 month, she complained of severe cervicalgia associated with fever. Spondylodiscitis involving C6, C7, and the intervening vertebral disk with medullary compression was detected by means of imaging studies. RESULTS: A right cervicotomy with drainage of necrotic tissue was performed, and a de-epithelialized fasciocutaneous deltopectoral flap was interposed between the neopharynx-esophagus and the prevertebral fascia to protect the neurovascular axis. MR performed 1 month later showed a complete resolution of the infectious process. CONCLUSIONS: Severe neck pain after tracheoesophageal puncture should alert the physician about the possibility of a cervical spondylodiscitis. MR is the most useful imaging technique for preoperative and postoperative evaluation. When neurologic symptoms are detected, surgical exploration of the neck is mandatory.
Aged↗
Reduction in variability of acetabular cup abduction using computer assisted surgery: a prospective and randomized study.
Optimal orientation of the acetabular component of a total hip prosthesis is an important factor in determining the early and long-term result of a total hip arthroplasty (THA). Conventional positioning of the cup component is usually done using a free-hand method, or with the help of a mechanical acetabular alignment guide. However, these methods have proven to be inaccurate, and a great variation in orientation of the cup is found postoperatively. In this study, we wished to determine if the variability of the abduction angle of acetabular cups could be reduced with the use of computer navigation. The abduction angles of the acetabular components of three groups of 50 THAs were assessed. In the first group, a free-hand method was used to position the cup component. This group was operated in the period before we started using computer navigation for hip surgery. In the second group, CT-based computer navigation was used to plan and help position the cup. The third group consisted of 50 THA cases in which a free-hand method was used to position the cup, although these procedures were performed in the period after we had begun using the Computer Assisted Surgery (CAS) system. The variability in cup abduction angle was assessed in all three groups and compared. There was a significant reduction in variability in the CAS group compared to the first group. There was also a reduction in variability in the CAS group compared to the third group, although this was not statistically significant. It is concluded that the use of computer navigation helped the surgeon to place the cup component with less variability of the abduction angle, and, more importantly, we found that no cups were placed in the more extreme positions (outliers).
Acetabulum↗
Early amplification options.
Children with permanent hearing loss have been remediated with hearing amplification devices for decades. The influx of young infants identified with hearing loss through successful newborn hearing screening programs has established a need for amplification resources for infants within the first six months of life. For the approximately two of every 1000 infants born who are identified with bilateral hearing loss [Mehl and Thomson, 1998, Pediatrics 101, p. e4], the use of amplification is commonly the first step in treating the sequella of their loss. The use of hearing aids, combined with early intervention, has been shown to significantly improve the speech and language skills of young children with hearing loss [Yoshinaga-Itano, 2000, Seminars in Hearing 21, p. 309]. Speech and language delays have contributed to compromised academic performance of school aged children with hearing loss [Johnson et al., 1997, Educational Audiology Handbook, Singular Publishing, San Diego]. Most hard-of-hearing and deaf children use hearing aids and other assistive listening devices every day throughout their lifetime and the life expectancy of a hearing aid is only five to eight years. The current challenge for pediatric audiologists is selecting and evaluating the available amplification to provide the best options for children and their families. Amplification technology has seen an explosion in growth the past few years and the options continue to expand rapidly. This article examines currently available amplification technology and reviews the selection criteria that may be used for infants and young children. Issues such as style, type, amplification features, signal processing strategies, and verification and validation tools are also discussed.
Cochlear Implants↗
The enigma of underdrainage in shunting with hydrostatic valves and possible solutions.
OBJECTIVE: Hydrostatic devices have considerable advantages compared to "conventional" differential-pressure-valves concerning overdrainage, but are thought to imply a tendency to underdrain or to clog. The aim of this study was to evaluate the ability of the hydrostatic gravitational Dual-Switch-Valve (DSV) to minimize overdrainage-related complications without increasing the danger of underdrainage. RESULTS: In a series of 202 adult patients with different etiologies treated with a ventriculo-peritoneal shunt including the hydrostatic Dual-Switch-valve (DSV), 21 cases were suspected of suffering from underdrainage. Using a new algorithm we were able to differentiate obstruction in 6 patients from functional underdrainage in 15 cases, thus we saw an indication to reimplant a DSV with a lower opening pressure in the latter. CONCLUSION: The reasons for functional underdrainage were multifold in our series, especially the intraperitoneal pressure is still a "black box". Despite the ability of the DSV to avoid clogging and to minimize overdrainage by its high-pressure-chamber, it remains difficult to determine the optimal opening pressure of the low-pressure-chamber of the DSV for ideal clinical improvement. Therefore a new hydrostatic gravitational "programmable" valve (proGAV), entitled on avoiding the disadvantages of other adjustable devices, has been developed and implanted in 16 patients with promising results.
Adolescent↗
Interaction between the contact lens and the ocular surface in the etiology of superior epithelial arcuate lesions.
Explore the source record for details and available documents.
Adult↗
Results of humeral stump angulation osteotomy.
Between 1972 and 1989 angulation osteotomy was performed on 61 patients with long humeral stumps at the Orthopaedic Hospital of Heidelberg University. Marquardt's surgical technique was used to improve function in patients who had undergone above-elbow amputation and in children with a risk of terminal osseous overgrowth. Thirty-one patients with 43 angulation osteotomies were followed up. Of the 10 adults followed up, the osteotomy had not straightened, whereas with the 33 angulation osteotomies in children, one had straightened out within 6 months, seven within 12 months and a further 12 up to 24 months after surgery. The only recognizable reason for this difference was the patient's age depending on whether humeral growth was not yet completed. Marquardt's angulation osteotomy, however, is still the only surgical technique that improves humeral stump function, providing a rotation-stable humeral prosthesis and a free-moving shoulder joint.
Adolescent↗
Tympanoplasty in Korea (ossiculoplasty).
Three hundred and ninety three cases of ossicular reconstruction are presented. In the most favourable cases with both malleus handle and stapes present, this presents a closure of the air-bone gap to within 20 dB better than 80%. With connective tissue, underlay and fixation technique and staging are all important aspects of ossicular chain repair. Preservation of the function of the sound conduction mechanism in most favourable cases (malleus handle and stapes arch present) were improved by the employment of a sculptured, fitted incus prosthesis between the handle of the malleus and the head of the stapes.
Ear Ossicles↗
A special photo-epithesis. Case report.
We designed and fabricated a photo-epithesis constructed on a spectacle-frame for a patient who could no longer wear his prosthesis, because of severe socket contraction and in whom secondary reconstruction was not possible.
Contracture↗
[Early single-center experience with the 3F-enable aortic valve bioprosthesis].
BACKGROUND AND PURPOSE: Patients with aortic valve (AV) pathology and severe comorbidities should benefit from reduced myocardial ischemic and extracorporeal circulation (ECC) time. Sutureless implantation of AV prosthesis may reduce myocardial ischemic and ECC time significantly. The authors report on their preliminary results with the first implants of the 3F-Enable sutureless AV prosthesis. MATERIAL AND METHODS: The 3F-Enable prosthesis was implanted in five patients. Prostheses sizes were 27 mm (n = 3), 23 mm (n = 1), and 21 mm (n = 1), respectively. Intraoperatively, at patient's discharge as well as 3 and 6 months postoperatively, the AV prosthesis was evaluated by echocardiography. RESULTS: ECC time was 87 +/- 36 min (range 49-141 min), myocardial ischemic time 55 +/- 27 min (range 32-97 min), and AV implant time 184 +/- 195 s (range 10-420 s). The latest postoperative echo (5.2 +/- 1 months postoperatively) revealed a fully competent AV in three patients, in two patient paravalvular leakage was detected at the severity of an aortic regurgitation (AR) II degrees , and AR II degrees -III degrees , respectively. The mean pressure gradients were 5.8 +/- 1.3 mmHg (range 4.2-7.1 mmHg), valve orifice area was 3.2 +/- 0.4 cm2 (range 2.6-3.6 cm2). CONCLUSION: The first clinical results of the 3F-Enable sutureless AV prosthesis are feasible; however, a paravalvular leakage was detected in two patients (40%). Thus, device and procedural enhancements are required to assure positioning and anchoring of the prosthesis.
Aged↗
[Airlimb. Initial experiences with a new immediate early management prosthesis with individually adjustable air chambers].
Amputations of the lower extremity are still a common problem in diabetic feet and peripheral vasculopathies. The presented paper introduces a new device for an easier and faster mobilization of below-the-knee amputees. It is based on a new modular prostheses with individual inflatable air bladders. The compliance rate is higher with this device and it could be used from the day of surgery until the definitive prostheses is made. A biomechanical cadaver study with the prostheses will also be presented.
Adult↗
[Osseous echinococcosis].
Hydatid disease is caused by the parasitic tapeworm Echinococcus. The larval stage of this parasite can thrive in many parts of the body, most frequently in the liver. Primary bone location is very rare, accounting for less than 2% of all hydatid lesions. We report on a case of left-sided extended pelvic infestation. The destruction of the hip joint, os pubis, large parts of the ileum and the femoral head made pelvic resection and prosthetic replacement necessary. Recurrence of a hydatid cyst 5 years later in the left groin originating from the proximal femur was treated with second femoral resection and new total hip replacement. Because of instability, the primarily inserted polyacetal pelvic replacement had to be exchanged for a custom-made device fabricated with the aid of computer-aided design (CAD) techniques. This surgical procedure was combined with chemotherapy (mebendazole). The necessity of radical resection in osseus hydatid disease is discussed.
Antinematodal Agents↗
[Reconstruction of the upper stapes].
Explore the source record for details and available documents.
Animals↗
[Silicone as a foreign body in the middle ear: a rare complication after taking an impression of the auditory canal].
For the individual design of ear moulds, silicone is generally used for taking the impression of the external meatus and the cavum conchae. Complications are rare with only a few accounts in the literature. We report on three cases of accidental displacement of silicone into the middle ear cavity during impression taking. Clinical symptoms and detection of silicone as a rare middle ear foreign body are presented and discussed.
Aged↗
[Variable length titanium prostheses for type III tympanoplasty. Intraoperative length adjustment and fixation of the cartilage overlay].
INTRODUCTION: For type III tympanoplasty by partial ossicular replacement prosthesis (PORP) or total ossicular replacement prosthesis (TORP), the length of the prosthesis must match the individual intraoperative anatomical and physiological characteristics. MATERIALS AND METHODS: Databanks were used to determine the necessary sizer length of the sizer disc. The measurement template for the size of the cartilage to overlay the prosthesis headplate was derived from the headplates of the Tübinger titanium prostheses (TTP) and the Dresdener titanium prostheses. Finally all functions were integrated into a synthetic plate. RESULTS: The result was a simple and reasonably priced disposable multifunctional instrument (Tübinger sizer disc TSD) which allowed an exact measurement for every prosthesis in TORP and PORP. For the TTP-Variac, the TSD enabled the simple intraoperative production of prostheses with the length desired by the surgeon. For PORP the TSD enabled an adaptation of the diameter of the prosthesis foot for TTP, TTP-Vario and TTP-Variac and provided a template for the size determination of the cartilage overlay of the titanium prosthesis head. The sizers and the resulting prostheses were used for initial tympanoplastic operations. Audiometric investigations carried out 6 weeks postoperatively gave results corresponding to those previously obtained in a study with TTP and TTP-Vario using the old instrumentation. CONCLUSIONS: The new instrumentation leads to an improvement of the intraoperative practicability and a simplification. The audiological results remain the same.
Disposable Equipment↗
[New methods of type II tympanoplasty in erosion of the long incus process].
Reliable methods of reconstruction of the ossicular chain in the situation of an isolated errosion of the long process of the incus using a tympanoplasty type II have not been available until recently. Instead, the tympanoplasty type III has been generally performed with the interposition of an autologous incus. In this presentation, we are describing two methods for reconstruction of the ossicular chain between the in-situ residing incus and the stapes on the other side so that the direct connection eventually will result in a tympanoplasty type II. In the first case, we used ionomeric cement in a way that features two characteristics: the direct connection between the stapes and the long process of the incus could be achieved as well as an articulation that was created on the head of the stapes. Hence, a too stiff connection between the head of the stapes and the long process of the incus could be avoided. In addition, a new method for precise microapplication of cooled bone cement (IONOCAP LV) with a syringe will be presented. In the second method titanium-gold-angle prostheses have been crimped to the long process of the incus and positioned onto the head of the stapes in the way of an articulation. So far, comparison of the audiological results of those two methods of a tympanoplasty type II reveal in average better results than postoperative conductive hearing thresholds of the conventional tympanoplasty type III. If the achieved results can be reproduced on a larger number of patients, the expected audiological results are likely to resemble those of stapes surgery.
Auditory Threshold↗