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[Correction of congenital nipple inversion with bilateral rhombus deepithelialized subcutaneous pedicle skin flaps and continuous traction].

OBJECTIVE: A new method for correction of nipple inversion was introduced to improve the surgical result. METHODS: In this procedure, two opposite rhombus incisions on both sides of the inverted nipple were designed within the range of areola. The rhombus skin was deepithelialized and two subcutaneous pedicle skin flaps were created. Then the shortened lactiferous ducts and fibrous bands beneath the nipple were released. The subcutaneous pedicle skin flaps on both sides of the inverted nipple were advanced through the tunnel beneath the nipple as the supporting tissue. After the operation, continuous traction of the nipple lasted two weeks at least. RESULTS: Since 1999, 16 patients with congenital bilateral nipple inversion have been treated. No complications were found in all the cases. Postoperative follow-up for 2-12 months showed that the appearance of the nipple was satisfactory. CONCLUSIONS: This method is simple, safe and effective for correction of congenital nipple inversion. The incision scar is indistinct, the natural look and good function of the nipple were reserved.

Adolescent↗

Traction as a cause of gallbladder avulsion.

Following isolated blunt trauma to the abdomen, a 25-year-old man developed peritonitis. Laparotomy revealed a band between the transverse colon and gallbladder, with partial avulsion of the latter. Avulsion of the gallbladder is a rare injury and, to the best of our knowledge traction has not been described as a mechanism of injury.

Abdominal Injuries↗

Brachial plexus traction injuries.

Brachial plexus traction injuries most frequently occur following acute flexion or extension of the neck. The symptomatology following this injury may be defined clearly into the anatomic patterns of upper trunk, lower trunk, posterior cord, medial cord, and lateral cord radiations. This injury is the most common cause of the neurogenic form of thoracic outlet syndrome and is frequently seen in conjunction with cervical spine disease as well as peripheral entrapment syndromes of the ulnar, radial, and medial nerves.

Brachial Plexus↗

[A comparative experimental study on the bonding resistance to horizontal traction under progressive loading between a self-polymerizing composite (Right-On) and a photopolymerizing composite (Transbond)].

The paper examines the bond resistance between the orthodontic clamp and tooth enamel using two different compounds: an autopolymerizing type (Right-On), already widely used in orthodontal practice, and a photopolymerizing type (Transbond) which has been recently introduced into the market. The bond was tested by applying horizontal traction with a progressively increasing weight. The results obtained were compared for statistical significance (Student's t test).

Bicuspid↗

[Traction resistance of cast metal posts with and without retention, cemented with zinc phosphate cement in smooth and rough canals].

The purpose of this research was to test the traction resistance of cast posts and cores with and without roughness cemented with zinc phosphate cement in cuspids roots, with smooth and roughness canals walls. From the results of the tests and statistical analysis there was significant difference between roughness posts cemented in root canals with roughness walls and smooth posts cemented in smooth root canals. It was also analyzed, the retention of cast crows cemented on roughness posts and canals and it was concluded that posts are responsible for crows retention, when the cores were done at the correct way.

Cementation↗

[Treatment of fracture of the talar joint using the malleolar transtibial traction loop].

The authors submit their own experience with the treatment of malleolar fractures by means of a transtibial traction malleolar loop of their own modification which makes it possible by means of a minimal amount of osteosynthetic material to fix all three fragments of the malleolar fracture, incl. the tibiofibular syndesmosis. The authors applied this method in 20 patients with good results.

Ankle Injuries↗

Traction fibres in chromosome movement: the pros and cons.

The current discussion on the mechanism of chromosome movement in anaphase is dominated by a new hypothesis assuming active movement of the chromosome along stationary kinetochore microtubules. The aim of this article is to call attention to several older as well as to more recent observations on spindle structural dynamics and microtubule rearrangements which, in the author's opinion, cannot be explained by the new model. In fact, the observations seem to be more consistent with the classical concept of a traction fibre. For this reason, these observations should not be disregarded.

Animals↗

[Late results of surgical management of medial femoral neck fractures by spongiosa traction screws].

In 36 cases of medial fracture of the femoral neck percutaneous compression osteosynthesis by a specific traction-screw was carried out. During a 3-year follow up five femoral head necroses and three cases of non-union occurred. 28 patients showed good or excellent results. Comparison with results of AO-spongiosa screws and sliding-screw plate reveals no significant differences. Due to small additional operative trauma this percutaneous fixation technique is an appropriate alternative of osteosynthesis of medial fractures of the femoral neck, especially in polytraumatised patients and old patients with high operative risk.

Adolescent↗

Clinical diagnosis, testing, and electromyographic study in brachial plexus traction injuries.

A system for evaluation of patients with brachial plexus injury is based on careful observation, including the patient's history and a physical examination, a radiographic assessment, and electrodiagnosis. The clinical history and physical examination remain the cornerstone of this evaluation and their documentation is vital. Traction injuries, wherein there is a possibility of root avulsion, were examined myelographically and electromyographically at one month. Although they must be considered, the limitations of these methods of evaluation do not vitiate their usefulness. Modification of the evaluation procedures should be made according to the requirements imposed by specific causal agents and circumstances.

Arm Injuries↗

The traction apophysitises.

The traction apophysitises are one of the frequently encountered overuse injuries to children. Although known for many years and classed as osteochondroses, the traumatic origin of these disorders--from repetitive microtrauma--is now receiving wider acceptance. Discussion of the assessment, treatment, and prevention of these disorders is included.

Adolescent↗

Quantitative analysis of the oculocardiac reflex by traction on human extraocular muscle.

The oculocardiac reflex was quantitatively studied in 15 patients with strabismus. The reflex was observed in all patients when the medial rectus and inferior oblique muscles were stretched; the medial rectus muscle had a lower threshold than the inferior oblique. Bradycardia was evoked in 7 of the 15 patients when the lateral rectus was tractioned with tensions of 50 g and 600 g. The oculocardiac reflex was a graded phenomenon as a function of tension applied to the extraocular muscles. As tension was increased, bradycardia occurred rapidly and became deep. Systemic administration of atropine prevented completely the bradycardia from occurring. The results suggest that the response of the extraocular muscles to stretch are critically mediated through a polysynaptic path to the heart, resulting in suppression of the heart rate.

Arrhythmias, Cardiac↗

Pharmacologic management and controlled cord traction in the third stage of labour.

Active management of the third stage of 62 944 labours over a period of 15 years (1970-84) constituted an intramuscularly administered combination of ergometrine (0.2 mg) and oxytocin (5 units), and controlled cord traction as mechanical assistance in delivery of the placenta. By these means manual removal of the placenta was performed in 0.67% of all deliveries, uterine inversion was found in 5 cases (1 in 12 588 deliveries) and blood transfusion necessary in 1.67% of all deliveries during puerperium. Oxytocin injection of 40-100 units into the umbilical vein of the retained placenta was performed in 40 cases. In 12 (30%) of these cases the placenta was separated by this new method. Previous use of intrauterine devices was a new etiological factor in the abnormally adherent placenta.

Adult↗

[Neurogenic bladder caused by spinal cord traction].

A neurogenic bladder was the presenting syndrome in three cases of spinal cord traction. Of the typical symptomatic triad: neuro-orthopedic, cutaneous and urologic, the latter was of primary importance. Symptoms in the first case were incomplete bladder retention with distention of upper urinary tract, right-sided vesicorenal reflux and renal insufficiency. Six months after excision of a sacral lipoma and freeing of the filum terminale, micturition had become normal without residue, and renal function normalized. Right-sided reflux was corrected by submucosal advancement surgery with good results. The clinical history was more suggestive in the second case. Although inaugural symptoms were mictional, there was foot paralysis and a retrosacral lipoma above an abnormal hairy tuft in the upper part of the gluteal cleft. Operation revealed the presence of a dermoid cyst and a lipoma. Their excision combined with section of the filum terminale allowing ascension of the medullary cone. Marked clinical and urodynamic improvement was obtained with normal micturition and disappearance of incontinence. An anti-reflux operation suppressed residual reflux with good urographic results. Marked improvement in mictional disorders was obtained also in the 3rd case after excision of a sacral extradural lipoma and section of the filum terminale, allowing objective ascension of the medullary cone by 4 cm. A very detailed analysis was conducted of similar cases reported in the literature, about 2% of neurogenic bladders in children being affected. The importance of early diagnosis is emphasized as well as the essential need to establish a precise diagnosis of the lipoma of cauda equina and of medullary fixation. Early neurosurgery is justified by the high frequency of improvement in cases treated in this way.

Adolescent↗

A clinicopathologic case of cyclectomy for malignant melanoma of the ciliary body, complicated by total traction retinal detachment.

A case report is presented of a 43-year-old woman who underwent cyclectomy for malignant melanoma of the ciliary body of the left eye. One year after operation, the eye was enucleated because of inoperable total traction retinal detachment. The pathologic examination revealed no signs of local recurrence. At five-year follow-up, no systemic spread was found.

Adult↗

[Extraction of the electrodes by continuous traction--an effective procedure in treating pacemaker wearers with secondary inflammatory complications].

Using a continuous traction method we succeeded in extracting 24 bacterially contaminated and fixed in the heart electrodensounds around 4 years after pacemaker implantation without complications worth mentioning in 7.5 days (1-27). The tissue attached to 20 sound points contained 9 times portions of the myocardium, 9 times remainders of the endocardium, 12 times particles of the connective tissue and 17 times suppurative inflammatory tissue. After extraction of the sound and aimed chemotherapy in all 24 patients the inflammatory pathological conditions rapidly and free from recidivations receded.

Adult↗

[Our experience in the use of "traction" endoprosthesis as a palliative treatment of cardial carcinoma].

The Authors review the methods of palliative treatment of cardial carcinoma, and particularly report some results obtained through the application of oesophageal endoprostheses (by Celestin and by Haring), following the traction method, in 38 patients. The global mortality amounted to 8 cases (21%). In 12 patients (31%), complications such as stoppage or dislocation of the prosthesis were observed. In two cases the perforation of oesophageal wall occurred, with spontaneous resolution in one of the two patients and serious mediastinitis and exitus in the other. The Authors' present trend is toward the use of push type endoprosthesis, because of the lower mortality reported in literature.

Adenocarcinoma↗

[Traction screw osteosynthesis in the treatment of fracture of the angle of mandible (author's transl)].

The application of traction strapping with a single cortical screw in the form of lag screw osteosynthesis has been suggested for the treatment of angular factures of the mandible. This is also possible in those cases where there are other mandibular fractures, whether the molar teeth are present or not. The original occlusion is thereby easily reconstructed. The rehabilitation of the patient is generally possible 8 days postoperatively when the intra-oral stitches are removed.

Bone Screws↗