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At least 1,117 records · Page 62Linked to original sources
PubMed2000

[Problems, obstacles and complications of femoral lengthening with the use of the Italian modification of the Ilizarov device].

The results of femoral lengthening using the Italian modification of the Ilizarov are presented. Mean age of the patients was 14 years (ranging from 7 to 29). The most frequent etiology of limb shortening was femoral hypoplasia (7 patients) and sequelae of septic arthritis of the hip and/or the knee (6 patients). Indications for surgical treatment were limb shortening from 3 to 12 cm (mean 6.5 cm), along with axial deviation ranging from 10 degrees to 40 degrees in 6 patients. Mean follow-up time was 15 months (ranging from 6 to 35 months). The Ilizarov apparatus was based on two distal rings, stabilized by "K" wires, and proximally by a ring connected with an Italian femoral arch, stabilized by a Schanz screw. Planned lengthening (ranging from 3.5 cm to 12 cm) was achieved in all treated patients. The healing index ranged from 0.8 to 2.1 month/cm (mean 1.4). Problems, obstacles and complications were analyzed according to the Paley classification. In all 16 patients without primary knee stabilization, limited knee flexion ranging from 5 degrees to 90 degrees (mean 40 degrees) was noted during the distraction phase, which didn't improve significantly during the consolidation phase. Knee flexion improved to a mean 90 degrees after a 6 month follow-up. Bone regenerate defects (cysts, narrowing) were noted in 4 patients. Secondary knee stabilization was performed in 2 cases. In the first case because of knee pain and a severe limitation of knee motion. In the second, during a revision procedure because of distal femur angulation. Premature consolidation was noted in one patient and was treated by osteotomy. In one case axial deviation during the consolidation phase required osteotomy. In another case a fracture of the femur was treated by a plaster cast. In one case 1.5 years after the lengthening procedure subluxation of the hip was noted. Permanent knee flexion limitation to less than 90 degrees was noted in 6 patients. Femoral lengthening with the use of the Italian modification of the Ilizarov device give a high incidence of knee range of motion limitation, which can be decreased by preserving more than 30 degrees knee flexion during the distraction phase.

Adolescent↗
PubMed1975

Modified conservative treatment of club foot.

In 120 cases of severe, neglected or recurrent club foot, a modified conservative method of treatment has yielded encouraging results. The method consists of blind calcaneal fasciotomy, repositioning of the foot in a corrected position and plaster cast application from the upper thigh to the toes. Nineteen recurrences in this series were treated by Dwyer's calcaneal osteotomy, or medial soft tissue release and/or tendon transposition.

Calcaneus↗
PubMedDate not supplied

Operative treatment of a unilateral bicondylar fracture of the femur.

A case of isolated tangential fracture of the dorsal part of both condyles of the femur (bicondylar Hoffa fracture) is described. After open reduction, four lag screws were introduced through the fractured condyles to fix the fragments. A plaster cast was applied for a period of four weeks. Full weight-bearing was authorized after six weeks. Full range of motion of the knee was observed as early as after three months, as well as after twenty-one months. The mechanism and therapeutic implications are discussed and the literature is reviewed.

Adolescent↗
PubMed2001

Early stage onychomadesis presenting as painful swellings of proximal nail folds.

Two Korean men complained of painful erythematous swellings of the proximal nail folds. When we removed the overlying nail plates, we observed new ones growing under the old ones. These painful swellings disappeared after the affected nails were extracted. We found typical onychomadesis in another finger during the follow-up, suggesting that the initial condition marked the onset of onychomadesis. Because both patients had plaster casts removed recently and histories of trauma, it was hypothesized that trauma might be responsible for this peculiar condition.

Adolescent↗
PubMed2001

Deformity after fracture of the lateral humeral condyle in children.

We studied 28 displaced (Jacob types II and III) fractures of the lateral humeral condyle in 28 children. There were only two Milch type I fractures. Twenty-one fractures were treated by open reduction and internal fixation with K-wires, Palmer nails, or sutures. Seven patients were treated with a plaster cast, five following closed reduction, and the primary displaced position being accepted in two. Anatomic reduction was obtained in 18 patients. All but one fracture were united at review 2 years to 16 years later. The distal humerus was wider on the injured side in all patients. Six patients had a visible varus deformity, and three patients had a visible valgus deformity. The radiologic tilt of the joint surface and the depth of the trochlear groove were measured in patients more than 10 years old at review. All patients with a final varus tilt of the joint surface on the injured side were less than 9 years of age at injury, and all but one of the patients with Milch type II fractures had a deepening of the trochlear groove. Two patients developed avascular necrosis of the trochlea. One of these had a concomitant fracture of the medial humeral epicondyle, and the other suffered a lateral condylar fracture preceded by a supracondylar fracture. We conclude that a reduced growth potential at the trochlear groove is a regular complication of the Milch type II fracture, and that the Jacobs classification is the most useful in the assessment of the method of treatment.

Adolescent↗
PubMed2001

Simple approach to the management of aseptic non-union of the shaft of long bones.

AIM: Internal fixation with a plate in the management of non-union for shaft of long bones has been condemned but the review of the literature does not provide such unequivocal evidence. Also there are certain situations where it is either technically not feasible or contraindicated to do closed intramedullary nailing. This study was done to see the outcome of plate-fixation for the treatment of non-union of the shaft of long bones. METHOD: The non-union was treated by freshening the fracture ends, opening the medullary canal, re-aligning and stabilizing the fracture with a plate and packing autogenous cancellous bone grafts around the non-union site. There were 25 patients with an average age of 35 years. The non-union involved 7 femurs, 8 humerii and 10 tibiae. The initial treatment was operative in 11 patients, by plaster cast in 5, by traction in 1 and by traditional practitioner in 8. There was no pathological fractures or infected cases. The average delay prior to operation was 14 months and the average follow up was 30 months. RESULTS: All non-unions healed on an average in 18 weeks. There was neither incidence of infection nor any complications at the bone graft donor site. Three cases of transient nerve paralysis recovered spontaneously. One femoral plate broke at 12 weeks, which required replating. In another patient the distal screws of the femoral plate pulled out, this was managed successfully with a cast brace. CONCLUSION: Plate fixation is useful and effective in the management of non-union, more so in situations where it is technically not feasible to do closed intramedullary nailing. The incidence of infection, success of union and time to union are comparable with other methods.

Adolescent↗
PubMed2000

[Results of treating septic non-unions of the tibia with vascularized bone grafts and the Zespol stabilizer].

The authors present their experiences with various applications of the Zespol stabilizer and different kinds of vascularized bone transfers used in the treatment of septic non-unions of the tibia. The clinical material consisted of 24 patients with infections of the lower extremities treated with different vascularized bone transplants. The Zespol method was used in 23 cases. Compression osteosynthesis was applied every time with the stabilizer placed over the skin. The necessity of mounting the stabilizer far from the bone did not influence the stability of the osteosynthesis. Depending on the length of the transplant single or multiple plare supports were used. Additional plaster cast was applied only during wound healing. No loosening of the stabilizer was observed. The importance of early weight bearing in order to achieve bone union and remodelling of the bone graft is strongly emphasized by the authors. The described treatment allows bone union within 8 months on average. The advantages of the Zespol stabilizer in treatment of complicated disturbances of bone union are presented.

Bacterial Infections↗
PubMed2001

Position of teeth on the edentulous atrophic maxilla.

For prosthetic treatment of strongly atrophic alveolar wall, some biometric methods have been developed. The measurements taken from plaster cast models of 230 edentulous, average 29.9 years, and 125 dentulous post-menopausal women were correlated. In the edentulous maxilla the sagittal position of canine teeth can be determined by the oral edge of incisive papilla. The transverse position of canine teeth was on the outer edge of the alveolar wall because of the extensive loss of buccal alveolar bone. On the incisor area the facial surfaces of the central incisors were determined by the oral edge of incisive papilla and the distance was about twice the length of the papilla. The sagittal position of the first premolars was one-third and the first molars two-thirds the length of the palate from the plane of the labial edge of incisive papilla. The transverse position of the premolars and molars was determined by the scar-line, which is a cord-like elevation or track on the alveolar mucosa after extractions of the teeth. According to the comparative method, the position of the scar-line differed from the lingual gingival margin line and was situated about half breadth of the tooth in a buccal direction from it. The transverse position of premolar and molar in the edentulous maxilla is about the middle of the scar-line in a facio-buccal direction. In the setting of the artificial teeth, the facial surfaces of these teeth should be on average 5.0-6.0 mm sideways from the scar-line, whilst the total bilateral breadth of the alveolar wall in the sulcus area was on average 1.0-2.0 mm larger.

Alveolar Bone Loss↗
PubMedDate not supplied

Flexion-type supracondylar elbow fractures in children.

SUMMARY: Flexion-type supracondylar elbow fractures are uncommon in children. Minimally displaced fractures were treated in plaster cast in 7 children, and 22 children with a displaced fracture were treated by closed reduction and percutaneous pinning. Results after an average follow-up of 6.3 years showed that the treatment of choice yielded excellent or good results in 86.2% of the patients. All patients were satisfied with the end result and had normal use of their elbow.

Accidental Falls↗
PubMed2001

Stress fracture of the proximal tibia after total knee arthroplasty: a case report.

Stress fracture of the proximal tibia after total knee arthroplasty (TKA) is very rare. We found only 16 cases in a review of the literature. We report the case of a 76-year-old obese woman who sustained a stress fracture of the right proximal tibia without trauma 18 months after TKA. Pain developed in the proximal medial aspect of the tibia during walking. Physical examination showed tenderness of the proximal medial aspect of the tibia and varus deformity of 15 degrees during stress test of the knee. Roentgenography 4 weeks after symptom onset showed an obvious stress fracture line. Treatment with bed rest and above-the-knee plaster cast immobilization for 8 weeks was successful. The causes of this rare complication may include increased level of activity after TKA, generalized osteoporosis, and varus deformity of the knee.

Aged↗
PubMed2001

[Lengthening of the IV metatarsal in the treatment of the shortened toe of the foot].

The author presents the results of surgical treatment of congenital shortening of the IV metatarsal in 3 girls. In 2 cases the defect was bilateral. A total of 5 feet were operated on the age of the patients at time of operation ranged from 10 years and 1 months to 16 years and 11 months. A one-stage procedure with the use of a Pumed mini-distraction device was performed. The fissure between the bone fragments was augmented with a bone graft from the fibula. It was harvested in such a way as to maintain internal cortical integrity. K-wire fixation of the bony fragments was applied for 7 weeks. Immobilization by means of a plaster cast was applied for 6 to 8 weeks. Follow-up ranged from 7 months to 3 years. In all cases an improvement of the finger shape and it's lengthening was noted, although in 2 cases lengthening wasn't complete. In one case it resulted from an axial deformity of the IV metatarsal, a sequel of early (5 weeks) removal of the K-wire.

Adolescent↗
PubMed1999

[The experimental study on improved cuirass-respirator].

OBJECTIVE: To study the factors that possibly affect the ventilatory efficiency of cuirass-respirator. METHODS: Cuirass shells were constructed with plaster casts according to the shape of dog's chest wall. Above the cuirass shell, two straps were added in order to hold the cuirass shell when the pump generated pressure. Tidal volume and Pab and Pes were measured during different negative pressure. In addition, tidal volume was recorded before and after the cuirass was held. RESULTS: Ventilatory efficiency was markedly raised after the cuirass was held. As negative pressure rose, ventilation increased and Pdi decreased. CONCLUSIONS: The improved cuirass respirator can markedly improve ventilatory efficiency.

Air Pressure↗
PubMed2001

Intraarticular fractures of the distal radius in young adults--a review of the outcome of treatment.

A retrospective review of 30 intraarticular fractures of the distal radius in 27 patients was done. Only young adults aged between 18 and 40 were included. Road traffic accidents accounted for 25 of the cases (23 motorcyclists). Fourteen fractures were treated by closed reduction and a plaster cast. Sixteen fractures were treated by open reduction with internal fixation using a buttress plate or multiple Kirschner wires. At a mean follow-up of 17 months, 63% of the wrists had a satisfactory result and 37% unsatisfactory result. The main adverse factor was intraarticular congruity. The grip strength on the injured side averaged 56% of that of the uninjured side and the pinch strength averaged 73%. Most of the patients were able to return to their former occupation in an average of four months.

Adolescent↗
PubMed1975

The effect of sensory denervation on rabbits' knee joints. A light and electron microscopic study.

Unilateral sensory denervation of the hind limb in a group of rabbits caused progressive atrophy of cells in all structures of the knee joint, whether or not the joint was protected by a plaster cast. Immobilization without denervation caused proliferative changes, first in the synovium and then in the articular cartilage. The initial changes in the articular cartilage following sensory denervation occurred in the middle layers, suggesting that nutritional deficiency was involved. In contrast, the first changes in the cartilage of intact immobilized limbs occurred in the superficial layers and were most likely of mechanical origin.

Animals↗
PubMedDate not supplied

Method for the placement of palatal implants.

PURPOSE: Palatal implants have been used in the last 2 decades to eliminate headgear wear and to establish stationary anchorage. The aim of this investigation was to establish a method and easy protocol for palatal implant placement. MATERIALS AND METHODS: The study comprised 8 male and 15 female patients each having a 4.5 x 8-mm stepped screw titanium implant placed in the palatal region for orthodontic purposes. A surgical template containing metal drill housing was prepared. Angulation of the drill housing was controlled according to the radiologic tracing of the maxilla transferred to a plaster cast section in the paramedian plane. Implants were placed using a noninvasive technique (incision, flap, and suture elimination) and left transmucosally to facilitate the surgical procedure and reduce operations. The paramedian region was selected so as to avoid connective tissues of the palatine suture and because it was considered to be a suitable host site for implant placement. RESULTS: After 3 months of healing, all implants were osseointegrated and no implant was lost throughout the orthodontic treatment. DISCUSSION: Palatal implants can be used effectively for anchorage maintenance and space-gaining procedures. CONCLUSION: Usage of a 3-dimensional surgical template eliminated faulty implant placement, reduced chair time, and minimized trauma to the tissues while enhancing osseointegration.

Adult↗
PubMed1996

An original orthodontic appliance for experimental mesial movements in rats.

The design of an original appliance to achieve mesial movement of the first upper molar on one side in rat is presented. The appliance is constructed in 0.4 mm stainless steel wire forming a parallelepiped 3 mm in width in its anterior sector, 4 mm in width in its posterior sector and 12 mm in length in its lateral branches. In addition a central longitudinal bar is welded to the structure. The lateral branches of the appliance slide freely through the tubes welded to the palatal aspect of the molar bands, cemented in turn to both first molars. A wire 2 mm in length is welded in the anchorage area to the mesial side of the molar tube at 3 mm from the anterior end of the appliance, which acts as a butt. A pre-formed nickel-titanium open coil spring 0.23 mm thick, lumen 0.60 mm and 5.00 mm in length is placed distal to the molar tube. The spring is compressed by 1 mm of its original length, the final force being approximately 50 g. The movement achieved was measured on plaster casts obtained from pre and postoperative impressions, and afforded values of 0.250 mm +/- 0.790 mm on the active side and 0.012 +/- 0.011 mm on the passive side. The histologic studies showed an extensive erosive area on the pressure side of the alveolar wall. The appliance presented will be useful to achieve models of experimental movements of only one molar towards mesial with a force of known magnitude.

Animals↗
PubMed1975

[Outcome of conservative treatment of traumatic hip dislocation].

The authors report an analysis of the results obtained after conservative therapy for femoral dislocations. Reduction of luxations was accomplished after the Djanalidze and Kocher method with subsequent immobilization of the extremity by means of skeletal extension, plaster cast and bandaging one leg to the other. The results proved to be different depending on the technic of reduction employed, fixation of the extremity and its duration, and the start of the weight-bearing on the injured extremity. Some recommendations on prophylaxis of arthroses immediately after femoral dislocation are given.

Bandages↗
PubMed1975

The management of long bone fracture in the spinal cord injured patient.

Principles of management of long bone fractures in patients with spinal cord injuries vary with the type of fracture and duration of quadriplegia. Class I fractures (acute injuries) are managed by existing principles of long bone fracture management with a tendency to open reduction and internal fixation to dispense with the necessity of plaster casts on insensate skin. Class II fractures (pathologic--osteoporotic) heal well, require minimal specific treatment, and open reduction is usually contraindicated. Class III fractures (acute injuries in chronic paraplegia) are treated with methods least likely to disrupt the patient's life style in a wheelchair. Open reduction should be used whenever there are difficulties with circular casts and traction methods.

Arm Injuries↗